Abstract
Objective To investigate the improving effect of balanced reduction manipulation on cervical physiological curvature and inflammatory response in patients with vertebroarterial cervical spondylosis,so as to provide a reference for clin-ical treatment planning.Methods Between June 2021 and November 2023,a total of 160 patients with vertebral artery-type cervical spondylosis were enrolled and divided into two groups based on treatment modalities:a medication with bone-setting manipulation group and a medication with balance repositioning group.The medication with bone-setting manipulation group included 80 patients(48 males and 32 females),aged from 18 to 64 years with a mean age of(44.87±5.47)years and disease duration ranging from 1 to 24 months with a mean of(10.45±3.11)months.These patients received conventional western medicine therapy along with bone-setting manipulation techniques.The medication with balance repositioning group consisted of 80 patients(47 males and 33 females),aged 18 to 64 years old with a mean age of(44.91±5.44)years old,the disease dura-tion ranged from 1 to 24 monthsn with a mean duration of(10.49±3.08)months.This group was treated with conventional western medicine combined with balance repositioning bone-setting manipulation.Comparative analyses were performed be-tween the two groups regarding primary symptoms including neck and shoulder pain scores,cervical tenderness,limited cervi-cal mobility,upper limb numbness and pain,vertigo severity scores,peak systolic velocity(VP),end-diastolic velocity(VD),cervical physiological curvature(cervical arc-chord distance),neck disability index(NDI),interleukin-4(IL-4),interleukin-8(IL-8),tumor necrosis factor-alpha(TNF-α),clinical efficacy outcomes,and adverse reactions.Results The scores for neck and shoulder pain,cervical tenderness,limited cervical mobility,and upper limb numbness pain decreased significantly in both groups after treatment(P＜0.05).Post-treatment scores for neck and shoulder pain,cervical tenderness,limited cervical mobili-ty,and upper limb numbness pain in the medication with balance repositioning group were(1.13±0.22),(1.78±0.25),(1.68±0.27),and(0.64±0.14),respectively.The medication with bone-setting manipulation group were(1.95±0.37),(2.36±0.32),(1.91±0.35),and(0.92±0.21),respectively.The difference was statistically significant(P＜0.05).Vertigo severity scores im-proved significantly in both groups after treatment(P＜0.05).Notably,the post-treatment score in the medication with Balance repositioning group(13.52±2.04)was significantly higher than that in the medication with bone-setting manipulation group(12.04±1.93),there was statistically significant difference(P＜0.05).Both VP and VD increased significantly in both groups(P＜0.05).Specifically,the VP and VD values for the vertebral and basilar arteries in the medication with balance repositioning group were(43.64±8.11),(22.50±4.21),(49.44±7.31),and(33.78±4.52)cm·s-1,respectively.These values were signifi-cantly higher than those in the medication with bone-setting manipulation group,which were(40.25±7.92),(19.44±3.78),(45.26±6.93),and(30.62±4.11)cm·s-1,respectively(P＜0.05).The cervical arc-chord distance increased and the NDI de-creased significantly in both groups after treatment(P＜0.05).The post-treatment cervical arc-chord distance in the medication with balance repositioning group(9.45±1.70)mm was significantly greater than that in the medication with bone-setting ma-nipulation group(8.26±1.57)mm,there was statistically significant difference(P＜0.05).The NDI score was significantly lower in the medication with balance repositioning group(12.52±2.80)than in the medication with bone-setting manipulation group(21.74±3.16),there was statistically significant difference(P＜0.05).Post-treatment levels of IL-4 and TNF-αdecreased,while IL-8 levels increased significantly in both groups(P＜0.05).Specifically,the medication with balance repositioning group ex-hibited significantly lower levels of IL-4(14.13±1.92)ng·L-1 and TNF-α(11.68±2.07)ng·mL-1 compared to the medication with bone-setting manipulation group(21.95±2.37)ng·L-1 and(13.91±2.35)ng·mL-1,respectively,(P＜0.05).The IL-8 level was significantly higher in the medication with balance repositioning group(2.36±0.33)ng·L-1 than in the medication with bone-setting manipulation group(1.78±0.28)ng·L-1,(P＜0.05).The total effective rate was significantly higher in the medica-tion with balance repositioning group 93.75％(75/80)than in the medication with bone-setting manipulation group 81.25％(65/80),(P＜0.05).In terms of safety,the incidence of adverse reactions was 6.25％(5/80)in the medication with balance repositioning group and 8.75％(7/80)in the medication with bone-setting manipulation group,showing no statistically signifi-cant difference between the two groups(P＞0.05).Conclusion Balanced reduction manipulation achieves favorable therapeutic effects in patients with vertebroarterial cervical spondylosis.It can effectively relieve clinical symptoms,alleviate vertigo,in-crease vertebrobasilar artery blood flow velocity,improve cervical physiological curvature and cervical function,and reduce in-flammatory responses,and is worthy of clinical application.关键词
平衡复位正骨手法/椎动脉型颈椎病/颈椎生理曲度/炎症反应Key words
Balanced reduction bone-setting manipulation/Vertebroarterial cervical spondylosis/Cervical physiolog-ical curvature/Inflammatory response分类
医药卫生
