悬吊运动疗法结合推拿改善神经根型颈椎病上肢神经传导的效果

doi:10.3969/j.issn.1006-9771.2022.01.014

摘要/Abstract

摘要：

目的观察悬吊运动疗法(SET)结合推拿对神经根型颈椎病的疗效。方法 2015年8月至2016年12月,本院72例神经根型颈椎病患者随机分为对照组(n = 36)和试验组(n = 36),分别采用颈椎牵引和SET结合推拿进行治疗,共4周。治疗前后检测正中神经和尺神经F波传导速度、上肢体感诱发电位(SEP)峰潜伏期、上肢电流感觉阈值(CPT),观察治疗显效率。结果治疗后,试验组显效率83.33%,高于对照组的58.33% (Z = 2.093, P < 0.05)。治疗后两组正中神经和尺神经F波传导速度显著加快(t > 12.059, P < 0.001),试验组明显快于对照组(t > 3.266, P < 0.01);两组的臂丛电位(N9)和颈髓电位(N13)的SEP峰潜伏期显著缩短(t > 7.061, P < 0.001),试验组显著少于对照组(t > 8.033, P < 0.001);两组CPT分级均显著降低(t > 8.895, P < 0.001),且试验组低于对照组(t = 8.913, P < 0.001)。结论 SET结合推拿治疗可促进神经根型颈椎病患者神经传导功能修复。

关键词: 神经根型颈椎病, 悬吊运动疗法, 推拿, 神经传导, 上肢, 体感诱发电位, 电流感觉阈值

Abstract:

Objective To observe the effect sling exercise therapy (SET) and Tuina on radicular cervical spondylosis. Methods From August, 2015 to December, 2016, 72 patients with radicular cervical spondylosis were randomly divided into control group (n = 36) and trial group (n = 36), who accepted traction and SET+Tuina, respectively, for four weeks. They were measured F-wave conduction velocity with electromyogram from median nerve and ulnar nerve, somatosensory evoked potential (SEP), and current perception threshold (CPT) before and after treatment. The clinical ratio of improvement was calculated. Results The ratio of improvement was 83.33% in the trial group more than 58.33% in the control group (Z = 2.093, P < 0.05). F-wave conduction velocity increased in both groups after treatment (t > 12.059, P < 0.001), and increased more in the trial group than in the control group (t > 3.266, P < 0.01); while the latency of SEP decreased in N9 and N13 in both groups (t > 7.061, P < 0.001), and decreased more in the trial group than in the control group (t > 8.033, P < 0.001); the grade of CPT decreased in both groups (t > 8.895, P < 0.001), and decreased more in the trial group than in the control group (t = 8.913, P < 0.001). Conclusion The combination of SET and Tuina can promote the repair of nerve conduction of cervical spondylotic radiculopathy.

Key words: radicular cervical spondylosis, sling exercise therapy, Tuina, nerve conduction, upper extremities, somatosensory evoked potential, current perception threshold

中图分类号:

R681.5

阴涛,郑遵成,高强. 悬吊运动疗法结合推拿改善神经根型颈椎病上肢神经传导的效果[J]. 《中国康复理论与实践》, 2022, 28(1): 95-99.

YIN Tao,ZHENG Zuncheng,GAO Qiang. Effect of sling exercise therapy combined with Tuina on nerve conduction of upper extremities after radicular cervical spondylosis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(1): 95-99.

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组别	n	性别 (男/女)/n	年龄/岁	病程/月
对照组	36	11/25	44.08±8.88	22.17±14.96
试验组	36	9/27	45.19±10.09	24.94±18.07
χ²/t值		0.276	0.496	0.709
P值		0.599	0.621	0.481

组别	n	治疗前	治疗后	t值	P值
对照组	36	42.13±3.80	53.83±4.41	12.059	< 0.001
试验组	36	41.73±4.51	58.76±6.07	13.512	< 0.001
t值		0.407	3.943
P值		0.685	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	36	38.50±4.41	53.34±4.69	13.831	< 0.001
试验组	36	38.73±4.87	57.27±5.49	15.158	< 0.001
t值		0.210	3.266
P值		0.834	0.002

组别	n	治疗前	治疗后	t值	P值
对照组	36	13.08±0.71	11.83±0.79	7.061	< 0.001
试验组	36	13.14±0.68	9.96±0.53	22.131	< 0.001
t值		0.366	11.794
P值		0.715	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	36	15.22±0.68	13.97±0.80	7.143	< 0.001
试验组	36	15.37±0.81	12.59±0.65	16.061	< 0.001
t值		0.851	8.033
P值		0.398	< 0.001