【摘要】：目的：系統(tǒng)評(píng)價(jià)慢性非特異性頸痛(NCNP)患者的疼痛與頸椎功能,并分析中醫(yī)推拿聯(lián)合功法訓(xùn)練治療NCNP的療效。方法：1、臨床橫斷面研究,NCNP患者50例,相匹配的健康對(duì)照20例。使用視覺(jué)模擬評(píng)分(VAS)和頸椎功能障礙指數(shù)(NDI)評(píng)價(jià)NCNP患者的疼痛強(qiáng)度和功能障礙程度。使用頸椎多功能工作站(MCU)測(cè)量全體受試者頸椎主動(dòng)關(guān)節(jié)活動(dòng)度(AROM)(前屈、后伸、左側(cè)屈、右側(cè)屈、左旋、右旋)和頸肌最大肌力(前屈、后伸、左側(cè)屈、右側(cè)屈)。2、隨機(jī)對(duì)照研究,納入NCNP患者102例,隨機(jī)分為治療組(n=51)和對(duì)照組(n=51)。治療組中醫(yī)進(jìn)行推拿聯(lián)合功法訓(xùn)練,對(duì)照組采用間歇性頸椎牽引,每周5次,治療2周。分別在干預(yù)前、干預(yù)后即刻測(cè)量VAS、NDI、AROM(前屈、后伸、左側(cè)屈、右側(cè)屈、左旋、右旋)和頸肌最大肌力(前屈、后伸、左側(cè)屈、右側(cè)屈)。干預(yù)1個(gè)月后隨訪VAS和NDI。結(jié)果：1、NCNP患者VAS值為48(42.42,49.46)mm,NDI評(píng)分為12(10,15.25)分:患者AROM和最大頸肌肌力均顯著低于健康對(duì)照(P0.05)。2、干預(yù)后,治療組和對(duì)照組的VAS值、NDI評(píng)分均有下降：治療組在干預(yù)后即刻的VAS值(P=0.009)和1個(gè)月隨訪時(shí)VAS值(P=0.001)和NDI評(píng)分(P=0.008)均顯著低于對(duì)照組。干預(yù)后兩組AROM和頸肌最大肌力均顯著增加,組間比較無(wú)差異。結(jié)論：1、NCNP患者中度頸痛,頸肌肌力降低,頸椎活動(dòng)受限,輕度頸椎功能障礙。2、中醫(yī)推拿聯(lián)合功法訓(xùn)練治療NCNP安全有效,可操作性強(qiáng),患者接受度高,兼顧頸痛和頸椎功能的改善,療效優(yōu)于間歇性頸椎牽引,并有利于療效維持。
[Abstract]:Objective: to systematically evaluate the pain and cervical function of patients with chronic nonspecific cervical pain (NCNP), and to analyze the effect of combination of traditional Chinese medicine and massage on NCNP. Methods: 1, clinical cross-sectional study, 50 cases of NCNP patients, and 20 matched healthy controls. The visual analog score (VAS) and the cervical spine dysfunction index (NDI) were used to evaluate the NCNP patients. The cervical spine active joint activity (AROM) (anterior flexion, extension, left flexion, right flexion, left rotation, Dextre) and the maximum muscle strength of the neck muscle (anterior flexion, extension, left flexion, right lateral flexion) were measured by the cervical multifunction workstation (MCU) and randomly divided into 102 cases of NCNP patients and randomly divided into treatment group (n =51) and the control group (n=51). The treatment group was trained by combination of massage, and the control group was treated with intermittent cervical traction, 5 times a week for 2 weeks. Before intervention, VAS, NDI, AROM (anterior flexion, left flexion, right flexion, left rotation, right rotation) and the maximum muscle force of the neck muscle (anterior flexion, extension, left flexion, right flexion) were measured. The intervention group was intervened for 1 months. The results of VAS and NDI. were followed up: 1, the VAS of NCNP patients was 48 (42.42,49.46) mm, and the NDI score was 12 (10,15.25). The patients' AROM and maximum neck muscle strength were significantly lower than those of the healthy control (P0.05).2, and the prognosis of the treatment group and the control group decreased. P=0.001) and NDI score (P=0.008) were significantly lower than those in the control group. The maximum muscle strength of the two groups of AROM and neck muscles increased significantly, and there was no difference between the groups. Conclusion: 1, the moderate neck pain, the decrease of cervical muscle strength, the limited activity of cervical vertebra, the mild cervical spine dysfunction,.2, the combination of traditional Chinese medicine and massage therapy for NCNP are effective and effective in the treatment of NCNP, and the maneuverability is strong. Patients with high degree of acceptance, both neck pain and cervical function improvement, the curative effect is better than intermittent cervical traction, and is conducive to the maintenance of efficacy.
【學(xué)位授予單位】：中國(guó)人民解放軍醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R244.1

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