摘要
目的:观察推拿整复手法联合胸夹脊理筋手法治疗胸椎小关节紊乱所致心脏不适的疗效。方法:选取2020年1月—2022年5月台州市中医院收治的84例胸椎小关节紊乱所致心脏不适患者,按随机数字表法分为对照组及观察组各42例,过程中观察组剔除1例、对照组剔除7例,最终观察组41例、对照组35例。对照组采取推拿整复手法治疗,观察组采取推拿整复手法联合胸夹脊理筋手法治疗。2组疗程均为4周。比较2组临床疗效及不良反应发生率、复发情况,比较2组治疗前、治疗1周、治疗2周疼痛视觉模拟评分法(VAS)评分、症状积分、颈椎活动度、脊柱偏斜程度、白细胞介素-6 (IL-6)、白细胞介素-1β (IL-1β)、肿瘤坏死因子-α (TNF-α)、前列腺素E2 (PGE2)、β内啡肽(β-EP)、P物质(SP)、5-羟色胺(5-HT)、神经生长因子(NGF)、神经肽(NPY)水平、SF-36健康量表评分的变化。结果:治疗1周、治疗2周、治疗4周,2组VAS评分均较治疗前下降(P<0.05),观察组VAS评分均低于对照组(P<0.05)。2组不同时间点VAS评分在时间因素、组别因素方面比较,差异有统计学意义(P<0.05)。治疗1周、治疗2周、治疗4周,2组症状体征积分均较治疗前下降(P<0.05),观察组症状体征积分低于对照组(P<0.05)。2组不同时间点症状体征积分在时间因素、组别因素方面比较,差异有统计学意义(P<0.05)。治疗后,2组颈椎前屈角、后伸角均较治疗前增加(P<0.05),脊柱偏斜程度均较治疗前减小(P<0.05);观察组颈椎前屈角、后伸角均大于对照组(P<0.05),脊柱偏斜程度组间比较,差异无统计学意义(P>0.05)。治疗后,2组IL-6、IL-1β、TNF-α水平均较治疗前下降(P<0.05),观察组IL-6、IL-1β、TNF-α水平均低于对照组(P<0.05)。治疗后,2组PGE2、SP、5-HT、NGF、NPY水平均较治疗前下降(P<0.05),β-EP水平均较治疗前上升(P<0.05);观察组PGE2、SP、5-HT、NGF、NPY水平均低于对照组(P<0.05),β-EP水平高于对照组(P<0.05)。治疗后,2组SF-36生理功能、心理状态评分均较治疗前升高(P<0.05),观察组SF-36生理功能、心理状态评分均高于对照组(P<0.05)。观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗期间,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:推拿整复手法联合胸夹脊理筋手法治疗胸椎小关节紊乱所致心脏不适的疗效较好,可纠正胸椎位置偏斜,缓解心脏不适,提高生活质量。
Objective:To observe the curative effect of t ctive:To observe the curative effect of tuina reconstructive f tuina reconstructive techniques combined with therapeutic manipulation for tendon injury on chest jia ji for cardiac discomfort caused by thoracic facet joint disorder.Methods:A total of 84 patients with cardiac discomfort caused by thoracic facet joint disorder admitted to Taizhou Traditional Chinese Medicine Hospital from January 2020 to May 2022 were divided into the control group and the observation group according to the random number table method,with 42 cases in each group.During the process,one case was excluded from the observation group and seven cases were excluded from the control group,resulting in 41 cases in the observation group and 35 cases in the control group.The control group was treated with tuina reconstructive techniques,while the observation group was treated with tuina reconstructive techniques combined with therapeutic manipulation for tendon injury on chest jia ji.Both groups were treated for four weeks.Compared the clinical effects,incidence of adverse reactions,and recurrence between the two groups.Compared the changes in Visual Analogue Scale(VAS)scores of pain,symptom scores,cervical vertebra activity,degree of spinal deviation,interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),prostaglandin E2(PGE2),β-endorphin(β-EP),substance P(SP),5-hydroxytryptamine(5-HT),nerve growth factor(NGF),neuropeptide(NPY)levels,and SF-36 health scale scores before treatment,and after one and two weeks of treatment.Results:After two and four weeks of treatment,the VAS scores in both groups were decreased when compared with those before treatment(P<0.05),and the VAS score in the observation group were lower than those in the control group(P<0.05).The VAS scores in the two groups at different time points were compared in terms of time and group factors,and the difference was significant(P<0.05).After one,two and four weeks of treatment,the symptom and sign scores in both groups were decreased when compared with those before treatment(P<0.05),and the symptom and sign scores in the observation group were lower than those in the control group(P<0.05).The symptom and sign scores at different time points were compared in terms of time and group factors,the difference being significant(P<0.05).After treatment,the flexion and extension angles of the cervical spine in both groups were increased when compared with those before treatment(P<0.05),and the degree of spinal deviation was decreased when compared with those before treatment(P<0.05);the flexion and extension angles of the cervical spine in the observation group were both greater than those in the control group(P<0.05),and there was no significant difference in the degree of spinal deviation between the two groups(P>0.05).After treatment,the levels of IL-6,IL-1β,and TNF-αin both groups were decreased when compared with those before treatment(P<0.05),and the levels of IL-6,IL-1β,and TNF-αin the observation group were lower than those in the control group(P<0.05).After treatment,the levels of PGE2,SP,5-HT,NGF,and NPY in both groups were decreased when compared with those before treatment(P<0.05),and theβ-EP levels were increased when compared with those before treatment(P<0.05);the levels of PGE2,SP,5-HT,NGF,and NPY in the observation group were lower than those in the control group(P<0.05),while theβ-EP level was higher than that in the control group(P<0.05).After treatment,the scores of physiological function and psychological status in SF-36 in the two groups were increased when compared with those before treatment(P<0.05);the scores of physiological function and psychological status in SF-36 in the observation group were higher than those in the control group(P<0.05).The clinical efficacy in the observation group was better than that in the control group,the difference being significant(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combination of tuina reconstructive techniques and therapeutic manipulation for tendon injury on chest jia ji has shown good therapeutic effects in treating cardiac discomfort caused by thoracic facet joint disorder.It can correct the deviation of thoracic spine position,alleviate cardiac discomfort,and improve the quality of life of patients.
作者
蒋行敏
朱希法
郑嵩
汤鑫发
滕飞
JIANG Xingmin;ZHU Xifa;ZHENG Song;TANG Xinfa;TENG Fei(Taizhou Traditional Chinese Medicine Hospital,Taizhou Zhejiang 318000,China)
出处
《新中医》
2025年第3期136-143,共8页
New Chinese Medicine
关键词
胸椎小关节紊乱
心脏不适
推拿
胸夹脊理筋
颈椎活动度
Thoracic facet joint disorder
Cardiac discomfort
Tuina
Therapeutic manipulation for tendon injury on chest jia ji
Cervical vertebra activity
作者简介
蒋行敏(1985-),男,住院医师,E-mail:jiangx0mi@163.com。
