来源：风湿病与关节炎,2019,8（12）:17-21.

“解痉”“调曲”理论在颈椎病治疗中的临床研究

（临床研究）

任博文，杜旭召，史栋梁，李泊泊，杨　豪

　　【摘　要】目的：以“解痉”“调曲”理论为指导，观察治疗颈椎病的疗效，并探讨该理论的作用机制。方法：将150例颈椎病患者按照随机分组原则分为解痉组、调曲组、联合组，每组50例。解痉组给予桂枝加葛根汤加减、解痉调曲手法及练功疗法治疗，调曲组给予床头枕颌带牵引、解痉调曲手法及练功疗法治疗，联合组给予桂枝加葛根汤加减、床头枕颌带牵引、解痉调曲手法及练功疗法治疗。3组均治疗2周，并随访6个月。观察3组临床疗效，以及治疗前、治疗后、随访6个月时3组视觉模拟评分法（VAS）评分、颈椎病治疗成绩评分。结果：治疗后，联合组、解痉组、调曲组总有效率分别为96.00%、80.00%、82.00%，联合组与解痉组、调曲组比较，差异有统计学意义（P < 0.05）；3组VAS评分及颈椎病治疗成绩评分较治疗前均有明显改善（P < 0.05），且联合组较解痉组、调曲组改善更显著，差异有统计学意义（P < 0.05）。随访6个月时，联合组、解痉组、调曲组总有效率分别为92.00%、76.00%、78.00%，与治疗后比较，差异无统计学意义（P > 0.05），联合组总有效率优于解痉组和调曲组，差异有统计学意义（P < 0.05）；3组VAS评分及颈椎病治疗成绩评分与治疗后比较，差异无统计学意义（P > 0.05），联合组VAS评分及颈椎病治疗成绩评分优于解痉组、调曲组，差异有统计学意义（P < 0.05）。结论：“解痉”“调曲”理论在颈椎病的治疗中可明显改善患者症状和体征，且远期疗效稳定，安全性较高。

　　【关键词】　颈椎病；解痉；调曲；临床疗效

Clinical Study on the Theories of Spasmolysis and Curvature Adjusting in the Treatment of Cervical Spondylosis

REN Bo-wen,DU Xu-zhao,SHI Dong-liang,LI Bo-bo,YANG Hao

　　【ABSTRACT】Objective:Guided by the theories of spasmolysis and curvature adjusting,this paper is to observe the therapeutic effect of cervical spondylosis and to explore the mechanism of the theories.Methods:One hundred and fifty patients with cervical spondylosis were randomly divided into three groups:the spasmolysis group,the curvature adjusting group and the combined group,50 cases in each.The spasmolysis group was treated with modified Guizhi Jia Gegen Tang（桂枝加葛根汤）,spasmolysis and curvature adjusting manipulation and exercise therapy.The curvature adjusting group was treated with bedside pillow jaw belt traction,spasmolysis and curvature adjusting manipulation and exercise therapy.The combined group was treated with modified Guizhi Jia Gegen Tang,bedside pillow jaw belt traction,spasmolysis and curvature adjusting manipulation and exercise therapy.All the three groups were treated for 2 weeks and followed up for 6 months,observing their clinical effect respectively before and after treatment and 6 months after follow-up,as well as the visual analogue score（VAS）and cervical spondylosis treatment score.Results:After treatment,the total effective rates of the combined group,the spasmolysis group and the curvature adjusting group were respectively 96.00%,80.00% and 82.00%.The difference was statistically significant（P < 0.05）between the combined group,the spasmolysis group,and the curvature adjusting group;the VAS score and the treatment score of cervical spondylopathy in the three groups were significantly improved（P < 0.05）compared with those before treatment,and the combined group tended to improve compared with the spasmolysis group and the curvature adjusting group,the difference being of no statistical significance（P > 0.05）.After the 6 months follow-up,the total effective rates of the combined group,the spasmolysis group and the curvature adjusting group were 92.00%,76.00% and 78.00%,respectively,which had no statistical significance compared with those after treatment（P > 0.05）,and the combined group was better than that of the spasmolysis group and the curvature adjusting group（P < 0.05）.The VAS score and cervical spondylosis treatment score of the three groups had no statistical significance compared with those after treatment（P > 0.05）,and the combined group was better than that of the spasmolysis group and the curvature adjusting group（P < 0.05）.Conclusion:Using the theories of spasmolysis and curvature adjusting can obviously improve the symptoms and signs of patients with cervical spondylosis in the treatment of cervical spondylosis,with a stable and long-term effect and more safety.

　　【Keywords】 cervical spondylosis;spasmolysis;curvature adjusting;clinical effect