理筋正骨手法治疗颈型颈椎病临床观察

目的 观察理筋正骨手法结合运动锻炼治疗颈型颈椎病的临床疗效。方法 将60名颈型颈椎病患者随机分为治疗组和对照组，每组30例；治疗组采用理筋正骨手法结合运动锻炼，对照组采用牵引疗法联合运动锻炼；分别于治疗前后采用手持式压痛仪检测患者颈部疼痛部位压痛阈值，关节角度尺测量颈椎关节活动度，采集颈部肌肉表面肌电积分肌电值（integral electromyogram，iEMG），计算颈椎前屈、后伸、侧屈的肌肉协同收缩率（co-contraction ratio，CCR），采用颈部功能障碍指数（neck disability index，NDI）评价功能改善程度，并进行疗效评价。结果 与治疗前比较，两组患者治疗后疼痛减轻，颈椎活动度增加，颈部肌肉CCR下降，NDI降低（P＜0.05）；治疗组疼痛、颈椎关节活动度、颈部肌肉CCR、NDI改善程度均优于对照组（P＜0.05）。治疗组临床疗效优于对照组（P＜0.05）。结论 理筋正骨手法结合运动锻炼可有效减轻颈型颈椎病患者的疼痛，改善关节活动度，提高颈部肌肉协调性，改善患者颈椎功能，其疗效优于牵引疗法结合运动锻炼。

Clinical Effect of Tendon-regulating and Bone-setting Manipulation in Treatment of Cervical-type Cervical Spondylosis

Objective To investigate the clinical effect of tendon-regulating and bone-setting manipulation combined with exercise in the treatment of cervical-type cervical spondylosis. Methods A total of 60 patients with cervical-type cervical spondylosis were randomly divided into treatment group and control group, with 30 patients in each group.The patients in the treatment group were given tendon-regulation and bone-setting manipulation combined with exercise, and those in the control group were given traction therapy combined with exercise.Before and after treatment, a hand-held tenderness instrument was used to measure the tenderness threshold at the site of neck pain; a joint angle ruler was used to measure the joint range of motion of the cervical vertebra; the integrated electromyogram (iEMG) of surface electromyography was collected for neck muscles to calculate the co-contraction ratio (CCR) of the muscles in forward flexion, back extension, and lateral flexion of the neck;neck dysfunction index (NDI) was used to evaluate the degree of functional improvement;clinical outcome was evaluated finally. Results After treatment, both groups had alleviation of pain, an increase in the range of motion of cervical vertebra, a reduction in the CCR of neck muscles, and a reduction in NDI (P<0.05), and compared with the control group, the treatment group had significantly greater improvements in pain, the range of motion of cervical vertebra, the CCR of neck muscles,and NDI(P<0.05). The treatment group had a significantly better clinical outcome than the control group (P<0.05). Conclusion For patients with cervical-type cervical spondylosis, tendon-regulating and bone-setting manipulation combined with exercise can effectively alleviate pain and improve joint activity,neck muscle coordination,and dysfunction,with a better clinical effect than traction therapy combined with exercise.