【摘要】 目的 :探讨寰枢关节骨错缝对颈椎病发病的作用,为临床中医手法诊治颈椎病提供思路。方法 :研究设颈椎病和无颈椎病两组,其中颈椎病组(来源于2006年3月至2008年12月曙光医院骨伤科门诊)患者333例,男119例,女214例,平均年龄(48.11±12.21)岁;无颈椎病组受试者73例(来源于上海中医药大学在校大学生、曙光医院研究生和进修生及部分社区人员),男18例,女55例,平均年龄(45.99±11.47)岁。对两组受试者的颈椎开口位X线片进行寰枢关节位置关系观测,比较两组中寰枢关节骨错缝的发生率的差异性,并对两组寰枢关节骨错缝的临床特点进行分析比较。结果:与无颈椎病组相比,颈椎病组患者寰枢关节骨错缝的发生率高达81.38%(271/333),二者之间差异具有统计学意义(P=0.000<0.01);且颈椎病组寰枢关节骨错缝的分型较复杂和多样化,其中单纯平移错缝占50.55%(137/271),单纯旋转错缝占7.01%(19/271),平移合并旋转错缝占42.44%(115/271)。结论 :寰枢关节骨错缝是各型颈椎病常见X线征象,且寰枢关节骨错缝形式较复杂和多样化,临床应重视寰枢关节骨错缝分型的研究,并按照不同临床分型,对寰枢关节进行定性、定点、定向手法矫正,将对颈椎病的临床防治具有重要指导意义。更多还原

【Abstract】 Objective:To explore the effect of articulatio atlantoepistrophica sublaxation on the pathogenesis of cervical spondylosis,and provide a thread for diagnosis and treatment of cervical spondylosis with manipulation. Methods:There were two groups in the study,which were non cervical spondylosis group and cervical spondylosis group. There were 333 patients in cervical spondylosis group,included 119 males and 214 females with the mean age of(48.11±12.21) years old. The patients were recruited from clinic service of orthopaedics in Shuguang Hospital between March 2006 and December 2008. There were73 subjects in non cervical spondylosis group,included 18 males and 55 females with the mean of(45.99±11.47) years old.The subjects were recruited from undergraduate students,postgraduate,advanced study persons,and community personnel. The position relation of the atlanto axial joint was observed by cervical X rays with opening position,and the incidence rate of articulatio atlantoepistrophica sublaxation was compared between two groups,and their clinical characteristics were analyzed. Results:The incidence of articulatio atlantoepistrophica sublaxation in cervical spondylosis group was 81.38%(271 / 333)and was more than non cervical spondylosis group(P<0.01). Furthermore,the pattern of the articulatio atlantoepistrophica sublaxation in cervical spondylosis group was complicated and diversified,which was 50.55%(137 / 271)with single moving sublaxation,7.01%(19 / 271) with revolving sublaxation,42.44%(115 / 271) with single moving and revolving sublaxation. Conclusion:The articulatio atlantoepistrophica sublaxation may be a X ray diagnostic indication to the cervical spondylosis,which should be grouping studied in clinic. It will provide guidance for the diagnosis and treatment of cervical spondylosis.更多还原