神经动力学技术联合麦肯基力学疗法对神经根型颈椎病的临床疗效观察

关键词：神经根型颈椎病  神经动力学技术  麦肯基力学疗法

Keywords:cervical spine radiculopathy  neurodynamic solutions  McKenzie diagnosis and therapy

摘要：

      摘要 目的：观察神经动力学技术联合麦肯基力学疗法对神经根型颈椎病的疗效，寻找更优的颈椎病临床治疗手法方案。 方法：将符合入组条件且基本资料相匹配的33例神经根型颈椎病患者按随机数表法分为麦肯基治疗组（16例）和联合治疗组（17例），两组患者均接受常规物理因子及麦肯基力学疗法治疗，联合治疗组在此基础上同时接受神经动力学手法治疗。于治疗前、治疗2周后分别对两组患者进行颈椎关节活动度（range of motion， ROM）测量，同时采用疼痛视觉模拟评分法（visual analogue scale， VAS）评估患者的疼痛程度、采用颈椎功能障碍指数量表（neck disability index， NDI）评估患者的功能状态和治疗效果。 结果：治疗前，两组患者颈椎ROM、VAS、NDI评分组间差异对比均无显著性意义（P＞0.05）；治疗2周后联合治疗组的颈椎ROM（屈曲、伸展、左侧屈、右侧屈，左旋转、右旋转）分别为（42.65±3.12）°、（40.88±4.05）°、（41.18±4.52）°、（42.06±4.70）°、（73.53±5.80）°、（74.71±7.39）°、VAS评分为（0.76±0.75）分、NDI评分为（3.82±3.47）分，较治疗前及对照组均有明显改善（P＜0.05）。 结论：神经动力学技术联合麦肯基力学疗法能更好地改善神经根型颈椎病患者疼痛及颈椎活动受限症状，加快患者颈椎功能恢复，是有效的临床治疗方案。

Abstract:

      Abstract Objective： To observe the clinical effect of neurodynamic techniques combined with McKenzie diagnosis and therapy on patients with cervical spine radiculopathy， and to explore a better clinical treatment method for patients with cervical spine radiculopathy. Method： Thirty-three patients with cervical spine radiculopathy who met the inclusion and matched the baseline characteristics were randomly divided into the two groups: the McKenzie treatment group （n=16） and the combined treatment group （n=17） according to the random number table. The patients in both groups received conventional physical treatment and Mechanical diagnosis and therapy， while the combined treatment group received neurodynamic techniques additionally. Before treatment and 2 weeks after treatment, the cervical range of motion（ROM） was measured, and the visual analogue scale（VAS） was used to evaluate the patients' pain level and the neck disability index（NDI） were used to assess the functional status and treatment outcome. Result： Before treatment， there were no significant differences in cervical ROM， VAS and NDI between two groups（P>0.05）. After two weeks of treatment， the outcome of the combination group showed significant improvements cervical ROM for flexion (42.65±3.12)°, extension (40.88±4.05)°, left lateral flexion (41.18±4.52)°, right lateral flexion (42.06±4.70)°, left rotation (73.53±5.80)°, and right rotation (74.71±7.39)°, the VAS score was 0.76±0.75， NDI score was 3.82±3.47， compared with both the baseline and the control group （P<0.05）. Conclusion： Neurodynamic techniques combined with McKenzie diagnosis and therapy provide more effective relief of pain and ROM limitations in patients with cervical spine radiculopathy, accelerating the recovery of cervical function. The combination therapy is a useful clinical treatment option.