Gao Hui, Ye Yong-Jun
department of Orthopaedics, 1st Affiliated Hospital of Gannan Medical College, Ganzhou 341000, Jiangxi, China.
Zhongguo Gu Shang. 2010 Apr;23(4):257-60.
To compare the effects of the three manipulative methods in treating vertebral artery type of cervical spondylosis.
From December 2006 to December 2008, 300 patients (male 138 and female 162, the age from 18 to 76 years with an average of 38.6 years) with vertebral artery type of cervical spondylosis were randomly divided into group A, B, C (100 cases each group). Patients in group A, B were respectively treated with rotation-traction and rotation-turn manual reduction (one time per week, 30 min per time, 4 times a course of treatment; patients in group C were treated with traction (one time per day, 30 min per time, 10 times a course of treatment). Therapic time was a course of treatment in all groups. At 6 months after treatment, the clinical effects, cervical curvature, change of blood flow were respectively observed according sympotoms, X-ray, transcranial doppler sonography (TCD).
All patients were followed up more than 6 months. The improving average of cervical curvature (C2-C7 Cobb angle): group A, B, C was respectively 1.82 +/- 0.88, 0.12 +/- 0.06, 0.56 +/- 0.22; group A was better than group B (P < 0.01) and group C (P < 0.05). There was no significantly difference between group B and C (P > 0.05);and there was significantly difference in three groups (P < 0.05). TCD detection: LVA, RVA, BA improving significantly in group A than group B (P < 0.01) and group C (P < 0.05); there was no significantly difference between group B and C (P > 0.05) and there was significantly difference among three groups (P < 0.05). Clinical effects: in group A, 36 cases obtained curing results, 36 excellent, 20 utility, 8 ineffective, the rate of excellent and good was 92%; in group B: 6 cases obtained curing results, 20 excellent, 10 utility, 64 ineffective, the rate of excellent and good was 36%;in group C,10 cases obtained curing results, 26 excellent, 8 utility, 56 ineffective, the rate of excellent and good was 44%; there was significantly difference in three groups (P < 0.05).
All three methods can significantly relieve headache and vertigo through improving cervical curvature and VA, BA blood flow, but its long-term effect should be observed.
比较三种推拿手法治疗椎动脉型颈椎病的疗效。
选取2006年12月至2008年12月椎动脉型颈椎病患者300例（男138例，女162例，年龄18～76岁，平均38.6岁），随机分为A、B、C组，每组100例。A、B组患者分别采用旋转牵引和旋转扳法手法复位治疗（每周1次，每次30分钟，4次为1个疗程）；C组患者采用牵引治疗（每天1次，每次30分钟，10次为1个疗程）。所有组治疗时间均为1个疗程。治疗后6个月，分别根据症状、X线、经颅多普勒超声（TCD）观察临床疗效、颈椎曲度、血流变化。
所有患者均随访6个月以上。颈椎曲度（C2-C7 Cobb角）改善平均值：A组、B组、C组分别为1.82±0.88、0.12±0.06、0.56±0.22；A组优于B组（P<0.01）和C组（P<0.05）。B组与C组比较差异无统计学意义（P>0.05）；三组间比较差异有统计学意义（P<0.05）。TCD检测：A组左侧椎动脉（LVA）、右侧椎动脉（RVA）、基底动脉（BA）改善程度明显优于B组（P<0.01）和C组（P<0.05）；B组与C组比较差异无统计学意义（P>0.05），三组间比较差异有统计学意义（P<0.05）。临床疗效：A组治愈36例，显效36例，有效20例，无效8例，优良率为92%；B组治愈6例，显效20例，有效10例，无效64例，优良率为36%；C组治愈10例，显效26例，有效8例，无效56例，优良率为44%；三组间比较差异有统计学意义（P<0.05）。
三种方法均可通过改善颈椎曲度及椎动脉、基底动脉血流，显著缓解头痛、眩晕症状，但长期疗效有待进一步观察。
