| 引用本文:陈焯贤1，2，冯敏山2，3，朱立国2，尹逊路2，张威2，温聪聪2，4，赵文龙1，2.500例旋提手法治疗颈椎病的影像学特点与疗效研究[J].世界中医药,2023,(04):. |
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| 500例旋提手法治疗颈椎病的影像学特点与疗效研究 |
| Imaging Features and Curative Effect of Cervical Spondylosis Treated by Cervical Rotation-traction Manipulation：A Retrospective Analysis of 500 Cases |
| 投稿时间：2021-06-24 |
| DOI：10.3969/j.issn.1673-7202.2023.04.015 |
| 中文关键词: 旋提手法 颈椎病 影像学特点 疗效 疗程 安全性 数据分析 回顾性研究 |
| English Keywords:Cervical rotation-traction manipulation Cervical spondylosis Imaging features Curative effect Course of treatment Safety Data analysis Retrospective study |
| 基金项目:国家自然科学基金项目(82074455);北京市中国中医科学院“十三五”第二批重点领域科研项目（ZZ10-022）;国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-C-202003) |
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| 中文摘要: |
| 目的：回顾性总结旋提手法治疗颈椎病的影像学特点及疗效。方法：选取2016年4月至2021年4月就诊于中国中医科学院望京医院脊柱二科，诊断为颈椎病（除外脊髓型颈椎病）且经旋提手法治疗的500例患者作为研究对象，对其一般情况、影像学特点（X线平片、CT及MRI）及手法治疗的疗效、疗程、安全性进行回顾性分析。结果：500例患者中男171例，女329例；年龄17～82岁，平均年龄（52.17±12.84）岁；颈型、神经根型、椎动脉型、混合型颈椎病比例分别为5.60%、62.60%、10.40%、21.40%；X线诊断生理曲度异常及颈椎失稳比例分别为96.00%和47.00%；CT诊断颈椎间盘突出、颈椎管狭窄及后纵韧带骨化比例分别为86.12%、48.98%、22.86%；MRI诊断颈椎间盘突出、颈椎管狭窄比例分别为96.18%、54.60%；旋提手法治疗颈型、神经根型、椎动脉型、混合型颈椎病的有效率分别为96.43%、96.17%、98.08%、96.26%，治愈率分别为17.86%、15.65%、17.31%、14.95%；疗程7～23 d，平均疗程(13.553.06)d；500例患者接受旋提手法治疗均无不良反应发生。结论：颈椎曲度异常和颈椎间盘突出是颈椎病的主要影像学表现；旋提手法治疗颈椎病疗效确切，安全性高，其中颈型与椎动脉型颈椎病患者见效较快；该手法可应用于无脊髓型颈椎病症状体征但存在颈椎间盘突出、颈椎管狭窄及后纵韧带骨化患者，但应重视询问病史与体格检查，排除手法禁忌。 |
| English Summary: |
| To retrospectively summarize the imaging features and curative effect of patients with cervical spondylosis treated by cervical rotation-traction manipulation.Methods:A total of 500 patients who were diagnosed with cervical spondylosis(except cervical spondylotic myelopathy) and treated with cervical rotation-traction manipulation in the Second Department of Spinal Surgery of Wangjing Hospital of China Academy of Chinese Medical Sciences from April 2016 to April 2021 were collected.The general data，imaging features(X-rays，CT or MRI)，as well as the curative effect，course of treatment and safety of the patients were retrospectively analyzed.Results:Among the 500 patients，there were 171 males and 329 females aged 17～82 years，with an average of(52.17±12.84) years.Neck type cervical spondylosis，cervical spondylotic radiculopathy，vertebral artery type of cervical spondylosis，and mixed type of cervical spondylosis accounted for 5.60%，62.60%，10.40%，and 21.40%，respectively.The proportions of abnormal curvature and cervical spine instability by X-ray diagnosis were 96.00% and 47.00%，respectively; the proportions of cervical disc herniation，cervical spinal stenosis and posterior longitudinal ligament ossification by CT diagnosis were 86.12%，48.98%，and 22.86%，respectively; cervical disc herniation and cervical spinal stenosis by MRI diagnosis accounted for 96.18% and 54.60%，respectively.The effective rate of cervical rotation-traction manipulation on neck type cervical spondylosis，cervical spondylotic radiculopathy，vertebral artery type of cervical spondylosis，and mixed type of cervical spondylosis was 96.43%，96.17%，98.08%，and 96.26%，respectively，and the cure rate was 17.86%，15.65%，17.31%，and 14.95%，respectively.The course of treatment was 7～23 days，with an average of(13.553.06) days.No adverse reaction occurred in the 500 patients.Conclusion:Abnormal curvature and cervical disc herniation are the main imaging manifestations of cervical spondylosis.Cervical rotation-traction manipulation is effective and safe in treating cervical spondylosis; especially neck type and vertebral artery type of cervical spondylosis.This method can be applied to patients without symptoms and signs of cervical spondylotic myelopathy but with cervical disc herniation，cervical spinal stenosis，and posterior longitudinal ligament ossification，and attention should be paid to patients' medical history as well as physical examination to rule out contraindications. |
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