CAJ | 학술논문

目的：观察石氏手法治疗神经根型颈椎病的临床疗效。方法：将120例符合要求的神经根型颈椎病患者随机分为石氏组和常规组，每组60例。石氏组采用石氏手法治疗，常规组采用传统推拿、针灸、理疗或药物等非手术方法综合治疗，共治疗4周。分别于治疗前及治疗2周、4周后采用视觉模拟评分法（visual analogue score，VAS）评定患者颈肩部疼痛情况，治疗结束后采用按照《中医病证诊断疗效标准》中颈椎病的疗效标准自拟的标准评定疗效。结果：石氏组2例未完成治疗，常规组3例未完成治疗。治疗前后不同时间颈肩痛 VAS 评分的差异有统计学意义，即存在时间效应（F ＝16．011，P ＝0．000）。2组颈肩痛 VAS 评分比较总体上有统计学意义，即存在分组效应（F ＝3．498，P ＝0．001）；除治疗前外，治疗2周、4周后石氏组的评分均低于常规组[（5．733±1．013）分，（5．830±1．046）分，t ＝0．256，P ＝0．614；（2．905±1．214）分，（3．790±1．389）分，t ＝13．265，P ＝0．000；（1．219±1．107）分，（2．547±1．554）分，t ＝27．932，P ＝0．000]。时间因素与分组因素不存在交互效应（F ＝1．089，P ＝0．299）。治疗4周后，石氏组治愈26例、显效22例、有效9例、无效1例，常规组治愈19例、显效17例、有效18例、无效3例，石氏组的疗效优于常规组（R石氏组＝52．13，R常规组＝63．97；Z ＝－2．021，P ＝0．043）。结论：石氏手法可有效减轻神经根型颈椎病患者的颈肩痛，疗效确切。
목적：관찰석씨수법치료신경근형경추병적림상료효。방법：장120례부합요구적신경근형경추병환자수궤분위석씨조화상규조，매조60례。석씨조채용석씨수법치료，상규조채용전통추나、침구、리료혹약물등비수술방법종합치료，공치료4주。분별우치료전급치료2주、4주후채용시각모의평분법（visual analogue score，VAS）평정환자경견부동통정황，치료결속후채용안조《중의병증진단료효표준》중경추병적료효표준자의적표준평정료효。결과：석씨조2례미완성치료，상규조3례미완성치료。치료전후불동시간경견통 VAS 평분적차이유통계학의의，즉존재시간효응（F ＝16．011，P ＝0．000）。2조경견통 VAS 평분비교총체상유통계학의의，즉존재분조효응（F ＝3．498，P ＝0．001）；제치료전외，치료2주、4주후석씨조적평분균저우상규조[（5．733±1．013）분，（5．830±1．046）분，t ＝0．256，P ＝0．614；（2．905±1．214）분，（3．790±1．389）분，t ＝13．265，P ＝0．000；（1．219±1．107）분，（2．547±1．554）분，t ＝27．932，P ＝0．000]。시간인소여분조인소불존재교호효응（F ＝1．089，P ＝0．299）。치료4주후，석씨조치유26례、현효22례、유효9례、무효1례，상규조치유19례、현효17례、유효18례、무효3례，석씨조적료효우우상규조（R석씨조＝52．13，R상규조＝63．97；Z ＝－2．021，P ＝0．043）。결론：석씨수법가유효감경신경근형경추병환자적경견통，료효학절。
Objective:To observe the clinical curative effect of Shi’s manipulation in the treatment of cervical spondylotic radiculopa-thy(CSR).Methods:One hundred and twenty patients with CSR enrolled in the study were randomly divided into Shi’s group and conven-tional group,60 cases in each group.Patients in Shi’s group were treated with Shi’s manipulation for 4 consecutive weeks,while the others in the conventional group were treated with non-operative treatment such as traditional massage,acupuncture,physical therapy or drugs for 4 consecutive weeks.The neck and shoulder pain were evaluated by using visual analogue score(VAS)before treatment and after 2 and 4-week treatment respectively,and the curative effect were evaluated after the treatment according to the self-designed therapeutic effect evalu-ation standard of cervical spondylosis which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes.Results:The treatment were unfinished in 2 patients(Shi’s group)and 3 patients(conventional group)respec-tively.There was statistical difference in VAS scores of neck and shoulder pain between different time points,in other words,there was time effect(F =16.011,P =0.000).There was statistical difference in VAS scores of neck and shoulder pain between the 2 groups,in other words,there was group effect(F =3.498,P =0.001).The VAS scores were lower in Shi’s group compared to conventional group after 2 and 4-week treatment(5.733 +/-1.013 vs 5.830 +/-1.046 points,t =0.256,P =0.614;2.905 +/-1.214 vs 3.790 +/-1.389 points, t =13.265,P =0.000;1.219 +/-1.107 vs 2.547 +/-1.554 points,t =27.932,P =0.000).There was no interaction between time factor and grouping factor(F =1.089,P =0.299).Twenty-six patients were cured,22 got a good result,9 fair and 1 poor in the Shi’s group;while 19 patients were cured,17 got a good result,18 fair and 3 poor in the conventional group after 4-week treatment.The Shi’s group sur-passed the conventional group in the curative effect(RShi’s group =52.13,Rconventional group =63.97;Z =-2.021,P =0.043).Conclusion:Shi’s manipulation can effectively reduce the neck and shoulder pain in patients with CSR,and its clinical effect is definite.