CAJ | 학술논문

目的：观察应用三维动静态平衡康复模式治疗非脊髓型颈椎病的临床疗效。方法：将符合要求的98例非脊髓型颈椎病患者随机分为三维康复组和传统治疗组，每组49例。三维康复组采用三维颈椎康复垫结合三维颈肌抗阻静力锻炼治疗，传统治疗组采用枕颌带牵引、药物治疗和颈肩锻炼治疗，共治疗3周。比较2组患者的颈部疼痛视觉模拟评分（visual analogue scale， VAS）、颈部功能残障指数（neck disability index，NDI）、颈椎前缘序列线弧弦距及临床疗效。结果：治疗前2组患者的颈部疼痛VAS 评分、NDI 及颈椎前缘序列线弧弦距比较，组间差异均无统计学意义[（5．16±1．21）分，（5．21±1．17）分，t ＝0．168，P ＝0．829；（28．63±5．07），（28．56±5．11），t ＝0．131，P ＝0．896；（7．15±5．68）mm，（7．08±5．77）mm，t ＝0．156，P ＝0．863]；治疗3周后三维康复组的颈部疼痛 VAS 评分和 NDI 低于传统治疗组，颈椎前缘序列线弧弦距大于传统治疗组[（2．53±1．05）分，（3．79±1．71）分，t ＝1．680，P ＝0．012；（17．21±4．75），（24．15±5．82），t ＝1．132，P ＝0．023；（9．83±5．98）mm，（7．69±6．03）mm，t ＝－3．265，P ＝0．002]。治疗3周后三维康复组的颈部疼痛 VAS 评分和 NDI 均较治疗前降低，颈椎前缘序列线弧弦距较治疗前增加（t ＝2．946，P ＝0．004；t ＝2．685，P ＝0．013；t ＝－3．496，P ＝0．001）；传统治疗组的 VAS 评分、NDI 及颈椎前缘序列线弧弦距与治疗前相比，差异均无统计学意义（t ＝0．489，P ＝0．617；t ＝0．632，P ＝0．582；t ＝0．182，P ＝0．632）。治疗3周后，三维康复组治愈39例、有效8例、无效2例，传统治疗组治愈18例、有效20例、无效11例，三维康复组的临床疗效优于传统治疗组（R三维康复组＝38．51，R传统治疗组＝60．49，Z ＝－4．339，P ＝0．000）。结论：应用三维动静态平衡康复模式可有效减轻非脊髓型颈椎病患者的疼痛症状，促进颈椎生理曲度和功能恢复，值得临床推广应用。目的：觀察應用三維動靜態平衡康複模式治療非脊髓型頸椎病的臨床療效。方法：將符閤要求的98例非脊髓型頸椎病患者隨機分為三維康複組和傳統治療組，每組49例。三維康複組採用三維頸椎康複墊結閤三維頸肌抗阻靜力鍛煉治療，傳統治療組採用枕頜帶牽引、藥物治療和頸肩鍛煉治療，共治療3週。比較2組患者的頸部疼痛視覺模擬評分（visual analogue scale， VAS）、頸部功能殘障指數（neck disability index，NDI）、頸椎前緣序列線弧絃距及臨床療效。結果：治療前2組患者的頸部疼痛VAS 評分、NDI 及頸椎前緣序列線弧絃距比較，組間差異均無統計學意義[（5．16±1．21）分，（5．21±1．17）分，t ＝0．168，P ＝0．829；（28．63±5．07），（28．56±5．11），t ＝0．131，P ＝0．896；（7．15±5．68）mm，（7．08±5．77）mm，t ＝0．156，P ＝0．863]；治療3週後三維康複組的頸部疼痛 VAS 評分和 NDI 低于傳統治療組，頸椎前緣序列線弧絃距大于傳統治療組[（2．53±1．05）分，（3．79±1．71）分，t ＝1．680，P ＝0．012；（17．21±4．75），（24．15±5．82），t ＝1．132，P ＝0．023；（9．83±5．98）mm，（7．69±6．03）mm，t ＝－3．265，P ＝0．002]。治療3週後三維康複組的頸部疼痛 VAS 評分和 NDI 均較治療前降低，頸椎前緣序列線弧絃距較治療前增加（t ＝2．946，P ＝0．004；t ＝2．685，P ＝0．013；t ＝－3．496，P ＝0．001）；傳統治療組的 VAS 評分、NDI 及頸椎前緣序列線弧絃距與治療前相比，差異均無統計學意義（t ＝0．489，P ＝0．617；t ＝0．632，P ＝0．582；t ＝0．182，P ＝0．632）。治療3週後，三維康複組治愈39例、有效8例、無效2例，傳統治療組治愈18例、有效20例、無效11例，三維康複組的臨床療效優于傳統治療組（R三維康複組＝38．51，R傳統治療組＝60．49，Z ＝－4．339，P ＝0．000）。結論：應用三維動靜態平衡康複模式可有效減輕非脊髓型頸椎病患者的疼痛癥狀，促進頸椎生理麯度和功能恢複，值得臨床推廣應用。
목적：관찰응용삼유동정태평형강복모식치료비척수형경추병적림상료효。방법：장부합요구적98례비척수형경추병환자수궤분위삼유강복조화전통치료조，매조49례。삼유강복조채용삼유경추강복점결합삼유경기항조정력단련치료，전통치료조채용침합대견인、약물치료화경견단련치료，공치료3주。비교2조환자적경부동통시각모의평분（visual analogue scale， VAS）、경부공능잔장지수（neck disability index，NDI）、경추전연서렬선호현거급림상료효。결과：치료전2조환자적경부동통VAS 평분、NDI 급경추전연서렬선호현거비교，조간차이균무통계학의의[（5．16±1．21）분，（5．21±1．17）분，t ＝0．168，P ＝0．829；（28．63±5．07），（28．56±5．11），t ＝0．131，P ＝0．896；（7．15±5．68）mm，（7．08±5．77）mm，t ＝0．156，P ＝0．863]；치료3주후삼유강복조적경부동통 VAS 평분화 NDI 저우전통치료조，경추전연서렬선호현거대우전통치료조[（2．53±1．05）분，（3．79±1．71）분，t ＝1．680，P ＝0．012；（17．21±4．75），（24．15±5．82），t ＝1．132，P ＝0．023；（9．83±5．98）mm，（7．69±6．03）mm，t ＝－3．265，P ＝0．002]。치료3주후삼유강복조적경부동통 VAS 평분화 NDI 균교치료전강저，경추전연서렬선호현거교치료전증가（t ＝2．946，P ＝0．004；t ＝2．685，P ＝0．013；t ＝－3．496，P ＝0．001）；전통치료조적 VAS 평분、NDI 급경추전연서렬선호현거여치료전상비，차이균무통계학의의（t ＝0．489，P ＝0．617；t ＝0．632，P ＝0．582；t ＝0．182，P ＝0．632）。치료3주후，삼유강복조치유39례、유효8례、무효2례，전통치료조치유18례、유효20례、무효11례，삼유강복조적림상료효우우전통치료조（R삼유강복조＝38．51，R전통치료조＝60．49，Z ＝－4．339，P ＝0．000）。결론：응용삼유동정태평형강복모식가유효감경비척수형경추병환자적동통증상，촉진경추생리곡도화공능회복，치득림상추엄응용。
Objective:To observe the clinical curative effects of three-dimensional dynamic and static equilibrium rehabilitation modali-ty in the treatment of non-myelopathy type cervical spondylosis.Methods:Ninety-eight patients with non-myelopathy type cervical spondylo-sis enrolled in the study were randomly divided into three-dimensional rehabilitation group and traditional therapy group,49 cases in each group.The patients in three-dimensional rehabilitation group were treated with three-dimensional cervical vertebra rehabilitation cushion combined with three-dimensional neck muscle resistance isometric exercises,while the others in traditional therapy group were treated with jaw-occiput traction combined with drug therapy and neck-shoulder functional exercises.After 3-week treatment,the neck pain visual ana-logue scale(VAS)scores,neck disability index(NDI),horizontal distance between C2 and C7 plumb lines and clinical curative effects were compared between the 2 groups.Results:There was no statistical difference in neck pain VAS scores,NDI and horizontal distance between C2 and C7 plumb lines between the 2 groups before the treatment(5.16 +/-1.21 vs 5.21 +/-1.17 points,t =0.168,P =0.829;28.63 +/-5.07 vs 28.56 +/-5.11,t =0.131,P =0.896;7.15 +/-5.68 vs 7.08 +/-5.77 mm,t =0.156,P =0.863).The neck pain VAS scores and NDI were lower and the horizontal distance between C2 and C7 plumb lines was greater in the three-dimensional rehabilitation group compared to the traditional therapy group after 3-week treatment(2.53 +/-1.05 vs 3.79 +/-1.71 points,t =1.680, P =0.012;17.21 +/-4.75 vs 24.15 +/-5.82,t =1.132,P =0.023;9.83 +/-5.98 vs 7.69 +/-6.03 mm,t =-3.265,P =0.002).The neck pain VAS scores and NDI decreased while the horizontal distance between C2 and C7 plumb lines increased after 3-week treatment in three-dimensional rehabilitation group(t =2.946,P =0.004;t =2.685,P =0.013;t =-3.496,P =0.001).However,no statistical differ-ence was found between pretreatment and post-treatment in above parameters in traditional therapy group(t =0.489,P =0.617;t =0.632, P =0.582;t =0.182,P =0.632).After 3-week treatment,39 patients were cured,8 fair and 2 poor in the three -dimensional rehabilitation group;while 18 patients were cured,20 fair and 11 poor in traditional therapy group.The three-dimensional rehabilitation group surpassed the traditional therapy group in the clinical curative effect(Rthree-dimensional rehabilitation group =38.51,Rtraditional therapy group =60.49,Z =-4.339,P =0.000).Conclusion:The three-dimensional dynamic and static equilibrium rehabilitation modality can effectively relieve the neck pain and improve the cervical curve and promote the cervical function recovery in patients with non-myelopathy type cervical spondylosis,so it is wor-thy of popularizing in clinic.