整合复曲调衡手法治疗神经根型颈椎病临床疗效评价的研究

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1、目录中文摘要··················································3英文摘要···················································4引言····················································6正文····················································71研究对象和方法········································71.1研究对象················

2、······························71.2研究方法·············································92.观察结果···············································162.1人口资料分析·······································162.2基线比较············································162.3有效性评价···········································17

3、3.小结···················································184.讨论···················································194.1中医学对神经根型颈椎病的认识·····················194.2中医学对神经根型颈椎病的治疗方法················214.3西医学对神经根型颈椎病的认识···························234.4西医学手术治疗神经根型颈椎病···························284.5神经根型颈椎病的疗

4、效判定。······························294.6整合复曲调衡手法治疗神经根型颈椎病的机理讨论···········34结论·················································40参考文献··················································41附录·················································45致谢··················································48攻读学位期

5、间发表的学术论文目录·······················48作者声明··················································49-1-个人简历·················································50-2-中文摘要目的：评价整合复曲调衡手法治疗神经根型颈椎病的疗效，提高手法治疗神经根型颈椎病的安全性。方法：本课题基于循证医学科研思路设计，对整合复曲调衡手法治疗神经根型颈椎病的疗效、不良反应以及安全性进行系统研究，观察治疗前后临床症状、颈曲、肌电图变化.结果：本研究中，男74例（51%），

6、女71例（49%），共145例。平均年龄39.9±11.2岁。血压，心率，脉搏，呼吸，在三次记录中并无明显差异，无统计学意义。本课题病例纳入标准为神经根型颈椎病，而神经根型颈椎病主要以放射痛，感觉障碍等症状为主，因此治疗前后基本生命体征变化不明显。椎动脉型及交感神经型颈椎病在治疗前后血压，呼吸等生命体征一般会有显著改变，这从侧面证明本课题病例选入严格遵守神经根型颈椎病的诊断标准，所选病例为单纯神经根型颈椎病。就诊时症状体征评分，NorthwickPark颈痛量化表评分在三次记录中逐次递减，差异有统计学意义（P<0.01），从数据可知患者的症状及疼痛在治疗后得到极大改善和缓解，手法治疗

7、的疗效可持续到治疗后三个月，疗效稳定，持久。颈曲Borden值治疗后三个月与治疗前比较，颈曲增加显著，由4.1±1.8（mm）增加到6.6±2.7（mm）差异有统计学意义（P<0.01）,颈椎的结构性改变促进了功能性改变。肌电图治疗前异常率为99.3%，治疗后下降到95.2%，治疗刚结束时在肌电图所反映的数值显示效果并不明显。但在治疗后三个月随访中异常率下降到了59.0%，提示在手法治疗解除神经压迫后，受损神经并不能马上恢复正常，需要修复一段时间。因此在治