中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2014年
4期
19-22
,共4页
范德辉%林锦坤%张振宁%苏美意%吴维%李锡行%罗孟西%魏美华
範德輝%林錦坤%張振寧%囌美意%吳維%李錫行%囉孟西%魏美華
범덕휘%림금곤%장진저%소미의%오유%리석행%라맹서%위미화
眩晕%寰枢关节%脱位%针刺疗法%腹针%手法,捏脊%治疗,临床研究性
眩暈%寰樞關節%脫位%針刺療法%腹針%手法,捏脊%治療,臨床研究性
현훈%환추관절%탈위%침자요법%복침%수법,날척%치료,림상연구성
Vertigo%Atlanto-Axial joint%Dislocations%Acupuncture therapy%Abdominal acupuncture%Manipulation,chiropractic%Thera-pies,investigational
目的：比较龙氏手法、腹针疗法与腹针疗法结合龙氏手法治疗寰枢关节半脱位致颈性眩晕的临床疗效。方法：将164例寰枢关节半脱位致颈性眩晕患者随机分为3组，腹针手法组55例，腹针组53例和手法组56例。腹针手法组采用腹针疗法联合龙氏手法治疗，腹针组采用腹针疗法治疗，手法组采用龙氏手法治疗。治疗2个疗程后及治疗结束后1个月，比较3组患者的临床疗效。结果：①治疗结束后的即时疗效。治疗2个疗程后，腹针手法组痊愈32例，显效15例，有效5例，无效3例；腹针组痊愈21例，显效10例，有效13例，无效9例；手法组痊愈25例，显效11例，有效12例，无效8例。3组患者的临床疗效比较，差异有统计学意义（H＝6.600，P ＝0.037）。进一步两两比较（调整检验水准：α'＝0.017），腹针手法组的临床疗效优于腹针组（ Z ＝-2.635，P＝0.008）；腹针手法组的临床疗效与手法组比较，差异无统计学意义（ Z＝-2.028，P＝0.043）；腹针组的临床疗效与手法组比较，差异无统计学意义（ Z＝-0.622，P＝0.534）。②治疗结束后1个月时的近期疗效。治疗结束后1个月，腹针手法组痊愈25例，显效11例，有效12例，无效7例；腹针组痊愈16例，显效12例，有效10例，无效15例；手法组痊愈12例，显效9例，有效17例，无效18例。3组患者的临床疗效比较，差异有统计学意义（ H＝9.724，P＝0.008）。进一步两两比较（调整检验水准：α'＝0.017），腹针手法组的临床疗效与腹针组比较，差异无统计学意义（ Z＝-1.930，P＝0.054）；腹针手法组的临床疗效优于手法组（Z＝-3.128，P＝0.001）；腹针组的临床疗效与手法组比较，差异无统计学意义（Z＝-1.193，P＝0.233）。结论：腹针疗法联合龙氏手法治疗寰枢关节半脱位致颈性眩晕，可以改善患者的临床症状与体征，提高患者生活质量；其治疗结束后的即时疗效优于腹针疗法，而治疗结束后1个月时的近期疗效优于龙氏手法。但其即时疗效与龙氏手法比较以及近期疗效与腹针疗法比较均无优势；其临床疗效是否在不同时期均可达到协同的作用尚有待进一步研究。
目的：比較龍氏手法、腹針療法與腹針療法結閤龍氏手法治療寰樞關節半脫位緻頸性眩暈的臨床療效。方法：將164例寰樞關節半脫位緻頸性眩暈患者隨機分為3組，腹針手法組55例，腹針組53例和手法組56例。腹針手法組採用腹針療法聯閤龍氏手法治療，腹針組採用腹針療法治療，手法組採用龍氏手法治療。治療2箇療程後及治療結束後1箇月，比較3組患者的臨床療效。結果：①治療結束後的即時療效。治療2箇療程後，腹針手法組痊愈32例，顯效15例，有效5例，無效3例；腹針組痊愈21例，顯效10例，有效13例，無效9例；手法組痊愈25例，顯效11例，有效12例，無效8例。3組患者的臨床療效比較，差異有統計學意義（H＝6.600，P ＝0.037）。進一步兩兩比較（調整檢驗水準：α'＝0.017），腹針手法組的臨床療效優于腹針組（ Z ＝-2.635，P＝0.008）；腹針手法組的臨床療效與手法組比較，差異無統計學意義（ Z＝-2.028，P＝0.043）；腹針組的臨床療效與手法組比較，差異無統計學意義（ Z＝-0.622，P＝0.534）。②治療結束後1箇月時的近期療效。治療結束後1箇月，腹針手法組痊愈25例，顯效11例，有效12例，無效7例；腹針組痊愈16例，顯效12例，有效10例，無效15例；手法組痊愈12例，顯效9例，有效17例，無效18例。3組患者的臨床療效比較，差異有統計學意義（ H＝9.724，P＝0.008）。進一步兩兩比較（調整檢驗水準：α'＝0.017），腹針手法組的臨床療效與腹針組比較，差異無統計學意義（ Z＝-1.930，P＝0.054）；腹針手法組的臨床療效優于手法組（Z＝-3.128，P＝0.001）；腹針組的臨床療效與手法組比較，差異無統計學意義（Z＝-1.193，P＝0.233）。結論：腹針療法聯閤龍氏手法治療寰樞關節半脫位緻頸性眩暈，可以改善患者的臨床癥狀與體徵，提高患者生活質量；其治療結束後的即時療效優于腹針療法，而治療結束後1箇月時的近期療效優于龍氏手法。但其即時療效與龍氏手法比較以及近期療效與腹針療法比較均無優勢；其臨床療效是否在不同時期均可達到協同的作用尚有待進一步研究。
목적：비교룡씨수법、복침요법여복침요법결합룡씨수법치료환추관절반탈위치경성현훈적림상료효。방법：장164례환추관절반탈위치경성현훈환자수궤분위3조，복침수법조55례，복침조53례화수법조56례。복침수법조채용복침요법연합룡씨수법치료，복침조채용복침요법치료，수법조채용룡씨수법치료。치료2개료정후급치료결속후1개월，비교3조환자적림상료효。결과：①치료결속후적즉시료효。치료2개료정후，복침수법조전유32례，현효15례，유효5례，무효3례；복침조전유21례，현효10례，유효13례，무효9례；수법조전유25례，현효11례，유효12례，무효8례。3조환자적림상료효비교，차이유통계학의의（H＝6.600，P ＝0.037）。진일보량량비교（조정검험수준：α'＝0.017），복침수법조적림상료효우우복침조（ Z ＝-2.635，P＝0.008）；복침수법조적림상료효여수법조비교，차이무통계학의의（ Z＝-2.028，P＝0.043）；복침조적림상료효여수법조비교，차이무통계학의의（ Z＝-0.622，P＝0.534）。②치료결속후1개월시적근기료효。치료결속후1개월，복침수법조전유25례，현효11례，유효12례，무효7례；복침조전유16례，현효12례，유효10례，무효15례；수법조전유12례，현효9례，유효17례，무효18례。3조환자적림상료효비교，차이유통계학의의（ H＝9.724，P＝0.008）。진일보량량비교（조정검험수준：α'＝0.017），복침수법조적림상료효여복침조비교，차이무통계학의의（ Z＝-1.930，P＝0.054）；복침수법조적림상료효우우수법조（Z＝-3.128，P＝0.001）；복침조적림상료효여수법조비교，차이무통계학의의（Z＝-1.193，P＝0.233）。결론：복침요법연합룡씨수법치료환추관절반탈위치경성현훈，가이개선환자적림상증상여체정，제고환자생활질량；기치료결속후적즉시료효우우복침요법，이치료결속후1개월시적근기료효우우룡씨수법。단기즉시료효여룡씨수법비교이급근기료효여복침요법비교균무우세；기림상료효시부재불동시기균가체도협동적작용상유대진일보연구。
Objective:To compare the clinical curative effect of Long’s manipulation,abdominal acupuncture and and their combina-tion in the treatment of cervical vertigo caused by atlanto-axial subluxation. Methods:One hundred and sixty-four patients with cervical vertigo caused by atlanto-axial subluxation were randomly divided into 3 groups,55 cases were treated with abdominal acupuncture com-bined with Long’s manipulation( combination therapy group),53 cases were treated with abdominal acupuncture( abdominal acupuncture group)and 56 cases were treated with Long’s manipulation( manipulation group). The clinical curative effects were compared between the 3 groups after two courses of treatment and one month after the end of the treatment respectively. Results:Thirty-two patients obtained an excellent result,15 good,5 fair and 3 poor in the combination therapy group;while 21 patients obtained an excellent result,10 good,13 fair and 9 poor in the abdominal acupuncture group;and 25 patients obtained an excellent result,11 good,12 fair and 8 poor in the manipulation group after two courses of treatment. There were statistical differences in the curative effects between the 3 groups(H=6. 600,P=0. 037). Further pairwise comparison(α'=0. 017)showed that the curative effect of combination therapy was better than that of abdominal acupunc-ture(Z= -2. 635,P=0. 008);there was no statistical difference in the curative effect between combination therapy and monotherapy of manipulation(Z= -2. 028,P=0. 043);there was no statistical difference in the curative effect between monotherapy of abdominal acu-puncture and monotherapy of manipulation(Z= -0. 622,P=0. 534). One month after the end of the treatment,25 patients obtained an ex-cellent result,11 good,12 fair and 7 poor in the combination therapy group;while 16 patients obtained an excellent result,12 good,10 fair and 15 poor in the abdominal acupuncture group;and 12 patients obtained an excellent result,9 good,17 fair and 18 poor in the manipula-tion group. There were statistical differences in the curative effects between the 3 groups(H=9. 724,P=0. 008). Further pairwise compari-son(α'=0. 017)showed that there was no statistical difference in the curative effect between combination therapy group and abdominal acu-puncture group(Z= -1. 930,P=0. 054),and the curative effect of combination therapy was better than that of manipulation(Z= -3. 128,P=0. 001),and there was no statistical difference in the curative effect between abdominal acupuncture and manipulation( Z= -1. 193,P=0. 233). Conclusion:In the treatment of cervical vertigo caused by atlanto-axial subluxation,the therapy of abdominal acupunc-ture combined with Long’s manipulation can improve the clinical symptoms and signs of patients and improve the patients’live quality;and its immediate curative effect is better than that of abdominal acupuncture after the end of the treatment,while its short-term curative effect is better than that of Long’s manipulation one month after the end of the treatment. But the combination therapy has no advantage in imme-diate curative effect compared with Long’s manipulation and in short-term curative effect compared with abdominal acupuncture. The syn-ergistic clinical curative effect of combination therapy in different periods need to be further studied.
