悬吊推拿运动治疗颈型颈椎病的持续疗效

doi:10.3969/j.issn.1006-9771.2021.07.016

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (7): 834-839.doi: 10.3969/j.issn.1006-9771.2021.07.016

悬吊推拿运动治疗颈型颈椎病的持续疗效

李建飞¹,李倩²,李佳潞¹,王健¹,刘丽¹,李丽³()

1.山东中医药大学,山东济南市 250013
2.济南护理职业学院,山东济南市 250100
3.山东中医药大学第二附属医院康复医学科,山东济南市 250001

收稿日期:2021-03-30 修回日期:2021-05-06 出版日期:2021-07-25 发布日期:2021-07-28
通讯作者: 李丽 E-mail:lily.jinan@163.com
作者简介:李建飞(1996-),女,汉族,山东烟台市人,硕士研究生,主要研究方向：颈肩腰腿痛的防治、脑卒中患者的中西医结合康复。|李丽(1962-),女,汉族,山东济南市人,硕士,教授、主任医师,主要研究方向：颈肩腰腿痛的防治、中西医结合康复、脑卒中后运动障碍。
基金资助:
1.山东省重点研发计划项目(2017GSF19114);2.山东省中医药科技发展计划项目(2019-0249)

Long-term Effect of Sling-massage Exercise on Cervical Spondylopathy

LI Jian-fei¹,LI Qian²,LI Jia-lu¹,WANG Jian¹,LIU Li¹,LI Li³()

1. Shandong University of Traditional Chinese Medicine, Ji'nan, Shandong 250013, China
2. Ji'nan Vocational College of Nursing, Ji'nan, Shandong 250100, China
3. Department of Rehabilitation Medicine, the Second Affiliated Hospital of Shandong University of Chinese Medicine, Ji'nan, Shandong 250001, China

Received:2021-03-30 Revised:2021-05-06 Published:2021-07-25 Online:2021-07-28
Contact: LI Li E-mail:lily.jinan@163.com
Supported by:
Shandong Key R & D Program(2017GSF19114);Shandong Traditional Chinese Medicine Science and Technology Development Program(2019-0249)

摘要/Abstract

摘要：

目的观察悬吊推拿运动技术治疗颈型颈椎病的疗效。

方法 2020年6月至2021年2月,山东中医药大学第二附属医院颈型颈椎病患者68例随机分为对照组(n= 34)和观察组(n= 34),对照组接受常规推拿治疗,观察组经弱链测试寻找弱链接肌群,采用针对性推拿手法和悬吊运动。共治疗4周。治疗前后,采用McGill疼痛量表(MPQ)、颈椎功能障碍指数(NDI)进行评定;治疗前、治疗后、治疗后2周、治疗后4周,采用肌电生物反馈仪检测患侧斜方肌上束中值频率(MF)。

结果对照组脱落4例,观察组脱落3例。治疗后,两组MPQ和NDI评分均显著下降(|Z| > 4.879, P < 0.001),MF上升;两组间MPQ和NDI评分均无显著性差异(|Z| < 1.100, P >0.05),对照组MF低于观察组(t = 2.184, P <0.05)。治疗结束后,对照组MF迅速下降,观察组有所下降,对照组MF持续显著低于观察组(t > 3.770, P <0.001)。

结论悬吊推拿运动技术对颈型颈椎病的即刻疗效与常规推拿相似,但疗效持续时间较长。

关键词: 颈型颈椎病, 悬吊运动, 推拿, 长期疗效

Abstract:

Objective To explore the effect of sling-massage exercise on neck type cervical spondylopathy (NTCS).

Methods From June, 2020 to February, 2021, 68 patients with NTCS from the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control group (n= 34) and observation group (n= 34). The control group accepted routine massage, while the observation group accepted sling exercise and massage based on weak link test, for four weeks. They were assessed with McGill Pain Qusetionnaire (MPQ) and Neck Disability Index (NDI) before and after treatment, and measured median frequency (MF) of the upper trapezius muscle on the affected side with electromyography biofeedback before treatment, after treatment, two weeks after treatment and 4 weeks after treatment.

Results Four cases in the control group and three cases in the observation group dropped down. The scores of MPQ and NDI decreased in both groups after treatment (|Z| > 4.879, P < 0.001), while MF increased (P < 0.001). There was no significant difference in scores of MPQ and NDI between the two groups after treatment (|Z| < 1.100, P >0.05), while MF was less in the control group than in the observation group (t = 2.184, P <0.05). MF decreased more in the control group than in the observation group, and was continually less in the control group than in the observation group after treatment (t > 3.770, P <0.001).

Conclusion Sling-massage exercise is as effective as massage on NTCS immediately, and for more time.

Key words: neck type cervical spondylopathy, sling exercise, massage, long-term effect

中图分类号:

R681.5

李建飞,李倩,李佳潞,王健,刘丽,李丽. 悬吊推拿运动治疗颈型颈椎病的持续疗效[J]. 《中国康复理论与实践》, 2021, 27(7): 834-839.

LI Jian-fei,LI Qian,LI Jia-lu,WANG Jian,LIU Li,LI Li. Long-term Effect of Sling-massage Exercise on Cervical Spondylopathy[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(7): 834-839.

图/表 4

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参考文献 35

[1]	ZOU L, ZHONG C, XU X, et al. Effect of Baduanjin exercise on cervical spondylosis: a protocol for the systematic review of randomized controlled trials[J]. Medicine (Baltimore), 2021, 100(12):e24813. doi: 10.1097/MD.0000000000024813
[2]	YUN S, KIM Y L, LEE S M. The effect of neurac training in patients with chronic neck pain[J]. J Phys Ther Sci, 2015, 27(5):1303-1307. doi: 10.1589/jpts.27.1303
[3]	POPESCU A, LEE H. Neck pain and lower back pain[J]. Med Clin North Am, 2020, 104(2):279-292. doi: 10.1016/j.mcna.2019.11.003
[4]	王欣, 田秀娟, 王金玲, 等. 悬吊运动训练治疗慢性非特异性腰痛的效果[J]. 中国康复理论与实践, 2019, 25(4):385-389.
	WANG X, TIAN X J, WANG J L, et al. Effect of suspension exercise training in the treatment of chronic nonspecific low back pain[J]. Chin J Rehabil Theory Pract, 2019, 25(4):385-389.
[5]	DENG Z, WANG K, WANG H, et al. A finite element study of traditional Chinese cervical manipulation[J]. Eur Spine J, 2017, 26(9):2308-2317. doi: 10.1007/s00586-017-5193-5
[6]	杨子明, 李放, 陈华江. 颈椎病的分型、诊断及非手术治疗专家共识(2018)[J]. 中华外科杂志, 2018, 56(6):401-402.
	YANG Z M, LI F, CHEN H J. Expert consensus on classification, diagnosis and non-surgical treatment of cervical spondylosis (2018)[J]. Chin J Surg, 2018, 56(6):401-402.
[7]	房敏, 刘明军. 推拿学[M]. 北京: 人民卫生出版社, 2012.
	FANG M, LIU M J. Tuina [M]. Beijing: People's Medical Publishing House, 2012.
[8]	卢惠苹, 王乃针, 宋林, 等. 悬吊运动疗法对颈椎病患者颈部肌肉功能的影响[J]. 中华物理医学与康复杂志, 2020, 42(2):171-174.
	LU H P, WANG N Z, SONG L, et al. Effect of suspension exercise therapy on cervical muscle function in patients with cervical spondylosis[J]. Chin J Phys Med Rehebil, 2020, 42(2):171-174.
[9]	李丽, 王芹, 冯梓芸, 等. 悬吊循经弹拨技术治疗腰椎间盘突出症机制研究[J]. 康复学报, 2019, 29(3):13-16, 21.
	LI L, WANG Q, FENG Z Y, et al. Study on the therapeutic mechanism of lumbar disc herniation treated by sling and massage exercise technique[J]. J Fujian Univ Trad Chin Med, 2019, 29(3):13-16, 21.
[10]	HAWKER G A, MIAN S, KENDZERSKA T, et al. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)[J]. Arthritis Care Res (Hoboken), 2011, 63(Suppl 11):S240-S252. doi: 10.1002/acr.v63.11s
[11]	VAISHNAV A S, GANG C H, IYER S, et al. Correlation between NDI, PROMIS and SF-12 in cervical spine surgery[J]. Spine J, 2020, 20(3):409-416. doi: 10.1016/j.spinee.2019.10.017
[12]	CID M M, JANUARIO L B, ZANCA G G, et al. Normalization of the trapezius sEMG signal: a reliability study on women with and without neck-shoulder pain[J]. Braz J Phys Ther, 2018, 22(2):110-119. doi: 10.1016/j.bjpt.2017.09.007
[13]	JAFARI M, BAHRPEYMA F, TOGHA M. Effect of ischemic compression for cervicogenic headache and elastic behavior of active trigger point in the sternocleidomastoid muscle using ultrasound imaging[J]. J Bodyw Mov Ther, 2017, 21(4):933-939. doi: 10.1016/j.jbmt.2017.01.001
[14]	杨钦, 周红海, 胡梦婷, 等. 浅析颈椎病相关动静力学平衡[J]. 颈腰痛杂志, 2021, 42(1):131-133, 139.
	YANG Q, ZHOU H H, HU M T, et al. Analysis of dynamic and static balance related to cervical spondylosis[J]. J Cervic Lumb, 2021, 42(1):131-133, 139.
[15]	QUINZI F, SCALIA M, GIOMBINI A, et al. The effect of an orthotic device for balancing neck muscles during daily office tasks[J]. Hum Factors, 2019, 61(5):722-735. doi: 10.1177/0018720818814957
[16]	MADELEINE P, XIE Y, SZETO G P Y, et al. Effects of chronic neck-shoulder pain on normalized mutual information analysis of surface electromyography during functional tasks[J]. Clin Neurophysiol, 2016, 127(9):3110-3117. doi: 10.1016/j.clinph.2016.06.015
[17]	LASCURAIN-AGUIRREBEÑA I, NEWHAM D J, IRAZUSTA J, et al. Reliability of a method to measure neck surface electromyography, kinematics, and pain occurrence in participants with neck pain[J]. J Manipulative Physiol Ther, 2018, 41(5):413-424. doi: 10.1016/j.jmpt.2017.10.013
[18]	VIJENDREN A, DEVEREUX G, KENWAY B, et al. Effects of prolonged microscopic work on neck and back strain amongst male ENT clinicians and the benefits of a prototype postural support chair[J]. Int J Occup Saf Ergon, 2019, 25(3):402-411. doi: 10.1080/10803548.2017.1386411
[19]	MELLO R G, CARRIÇO I R, DA MATTA T T, et al. Lumbar multifidus and erector spinae electromyograms during back bridge exercise in time and frequency domains[J]. J Back Musculoskelet Rehabil, 2016, 29(1):123-133. doi: 10.3233/BMR-150607
[20]	HANVOLD T N, WÆRSTED M, MENGSHOEL A M, et al. The effect of work-related sustained trapezius muscle activity on the development of neck and shoulder pain among young adults[J]. Scand J Work Environ Health, 2013, 39(4):390-400. doi: 10.5271/sjweh.3357
[21]	OSTENSVIK T, VEIERSTED K B, NILSEN P. Association between numbers of long periods with sustained low-level trapezius muscle activity and neck pain[J]. Ergonomics, 2009, 52(12):1556-1567. doi: 10.1080/00140130903199889
[22]	SARILHO DE MENDONÇA F, DE TARSO CAMILLO DE CARVALHO P, BIASOTTO-GONZALEZ D A, et al. Muscle fiber conduction velocity and EMG amplitude of the upper trapezius muscle in healthy subjects after low-level laser irradiation: a randomized, double-blind, placebo-controlled, crossover study[J]. Lasers Med Sci, 2018, 33(4):737-744. doi: 10.1007/s10103-017-2404-6
[23]	张义, 张莉, 郭长青, 等. 针刀干预对大鼠触发点肌组织P物质和缓激肽的影响[J]. 中华中医药杂志, 2020, 35(1):97-100.
	ZHANG Y, ZHANG L, GUO C Q, et al. Effects of needle knife intervention on substance P and bradykinin in trigger point muscle tissue of rats[J]. Chin J TCM Pharm, 2020, 35(1):97-100.
[24]	WANG L, WANG D, TIAN Y. Treatment by electro-acupuncture and massage in 172 cases of cervical spondylopathy[J]. J Tradit Chin Med, 2003, 23(2):129-130.
[25]	丁懿, 郭琛琛, 王宁, 等. 肌内效贴结合悬吊推拿运动技术对腰椎间盘突出症的临床疗效观察[J]. 天津中医药, 2019, 36(6):561-564.
	DING Y, GUO C C, WANG N, et al. Observation of the clinical effect of intramuscular sticking combined with suspension massage technique on lumbar disc herniation[J]. Tianjin Trad Chin Med, 2019, 36(6):561-564.
[26]	俞周来, 孙琪, 谢国民, 等. 重复神经刺激在肌萎缩侧索硬化和重症肌无力患者的应用比较研究[J]. 中国全科医学, 2020, 23(S1):135-137.
	YU Z L, SUN Q, XIE G M, et al. Comparative study on the application of repetitive nerve stimulation in patients with amyotrophic lateral sclerosis and myasthenia gravis[J]. Chin Gener Prac, 2020, 23(S1):135-137.
[27]	CLONEY M, SMITH A C, COFFEY T, et al. Fatty infiltration of the cervical multifidus musculature and their clinical correlates in spondylotic myelopathy[J]. J Clin Neurosci, 2018, 57:208-213. doi: 10.1016/j.jocn.2018.03.028
[28]	INSHAW J R J, CUTLER A J, BURREN O S, et al. Publisher correction: approaches and advances in the genetic causes of autoimmune disease and their implications[J]. Nat Immunol, 2019, 20(3):375. doi: 10.1038/s41590-019-0327-z
[29]	于子惠. PNF技术结合悬吊训练对脑卒中偏瘫患者下肢运动功能障碍的康复效果研究[D]. 大连:辽宁师范大学, 2019.
	YU Z H. Rehabilitation effect of PNF technology combined with suspension training on lower limb motor dysfunction in stroke patients with hemiplegia[D]. Dalian: Liaoning Normal University, 2019.
[30]	雷正方, 张瑛秋. 整合性神经肌肉训练对听障乒乓球运动员下肢功能性不对称与平衡能力的影响[J]. 体育科学, 2018, 38(11):28-38, 97.
	LEI Z F, ZHANG Y Q. The effect of integrated neuromuscular training on the lower limb functional asymmetry and balance ability of hearing impaired table tennis players[J]. Chin Sports Sci, 2018, 38(11):28-38, 97.
[31]	ORANCHUK D J, KORAL J, DA MOTA G R, et al. Effect of blood flow occlusion on neuromuscular fatigue following sustained maximal isometric contraction[J]. Appl Physiol Nutr Metab, 2020, 45(7):698-706. doi: 10.1139/apnm-2019-0579
[32]	VAN DEN DOLDER P A, FERREIRA P H, REFSHAUGE K M. Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis[J]. Br J Sports Med, 2014, 48(16):1216-1226. doi: 10.1136/bjsports-2011-090553
[33]	ZHANG W DONG J G. Effectiveness of Radix astragali and Salvia miltiorrhiza injection in treatment of skeletal muscle injury of aerobics athletes[J]. Pak J Pharm Sci, 2018, 31(4(Special)): 1767-1771.
[34]	李小华, 王玉汶, 许志恒, 等. 中频穴位电刺激联合推拿治疗甲状腺术后颈肩不适的临床观察[J]. 广州中医药大学学报, 2021, 38(1):90-96.
	LI X H, WANG Y W, XU Z H, et al. Clinical observation on treatment of neck and shoulder discomfort after thyroidectomy by intermediate frequency acupoint electric stimulation and massage[J]. J Guangzhou Univ Trad Chin Med, 2021, 38(1):90-96.
[35]	CHEN L, CHEN J, PENG Q, et al. Effect of sling exercise training on balance in patients with stroke: a meta-analysis[J]. PLoS One, 2016, 11(10):e0163351. doi: 10.1371/journal.pone.0163351

组别	n	性别(男/女, n)	年龄(岁)	病程(月)	体质量指数(kg/m²)	患侧(左/右, n)
健康组	10	5/5	43.60±10.09	-	22.53±1.57	-
对照组	30	14/16	43.23±10.70	32.67±14.21	22.73±1.89	12/18
观察组	31	14/17	44.45±10.44	33.29±13.16	23.32±1.85	13/18
χ²/t值		0.778	-0.450	-0.178	-1.229	1.984
P值		0.378	0.654	0.859	0.631	0.159

组别	n	治疗前	治疗后	Z值	P值
对照组	30	20.94±2.73	6.29±2.25^a	-5.026	< 0.001
观察组	31	20.29±3.40	6.71±2.41^c	-4.879	< 0.001
Z值		-0.370	-1.100
P值		0.711	0.271

组别	n	治疗前	治疗后	Z值	P值
对照组	30	11.71±2.12	3.26±1.21	-4.898	< 0.001
观察组	31	11.68±2.14	3.42±1.39	-4.896	< 0.001
Z值		-0.175	-0.666
P值		0.861	0.506

组别	n	治疗前	治疗后即刻	治疗后2周	治疗后4周
对照组	30	59.27±9.58	75.26±7.03^a	70.75±7.87^a,b	61.68±9.84^b
观察组	31	58.45±7.97	79.40±7.76^a	78.47±8.12^a	74.67±9.01^a,b,c
t值		-0.362	2.184	3.770	5.373
P值		0.719	0.033	< 0.001	< 0.001

悬吊推拿运动治疗颈型颈椎病的持续疗效

Long-term Effect of Sling-massage Exercise on Cervical Spondylopathy

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