推拿手法治疗神经根型颈椎病的研究进展

Research Progress in Manual Treatment of Cervical Spondylotic Radiculopathy

摘要: 神经根型颈椎病(cervical spondylotic radiculopathy, CSR)以颈痛和上肢放射痛为主要症状的疾病，其发病主要与脊髓神经的机械性压迫、局部无菌性炎症反应、血液黏滞度变高而局部血流减少及免疫系统失衡相关。本文通过在中国知网、PubMed数据库检索与推拿手法治疗神经根型颈椎病相关的近10年的研究文章，从推拿手法纠正紊乱解剖结构、减轻炎症反应、改善血液循环、恢复免疫细胞平衡四个方面对其治疗机制进行探讨，总结出手法具有可改善人体骨性结构、减少炎症因子表达、有效抑制无菌性炎症反应、改善局部血供、缓解血管缺血状态等作用。发现目前国内各家手法缺少统一的实行标准，故后续研究可从加强手法治疗的规范化、采用更加现代化的研究技术和方法及更加严谨的实验设计及量化标准作为切入点，为更加深入的、全面的、系统地探究手法治疗CSR的机制提供更多有利证据。

Abstract: Cervical spondylotic radiculopathy (CSR) is a disease with neck pain and upper limb radiation pain as the main symptoms. Its pathogenesis is mainly related to the mechanical compression of spinal nerves, local sterile inflammatory reaction, high blood viscosity and local blood lineage reduction, and immune system imbalance. In this paper, the research articles related to the treatment of cervical spondylotic radiculopathy with massage manipulation in the past 10 years were searched in CNKI and PubMed databases. The treatment mechanism of massage manipulation was discussed from four aspects: correcting the disordered anatomical structure, reducing the inflammatory reaction, improving blood circulation, and restoring the balance of immune cells. It was concluded that massage can improve the human bone structure, reduce the expression of inflammatory factors, effectively inhibit sterile inflammatory reaction, improve the local blood supply, and relieve vascular ischemia. It is found that at present, there is no unified implementation standard for various manipulations in China, so the follow-up research can take strengthening the standardization of manipulative therapy, adopting more modern research techniques and methods, and more rigorous experimental design and quantitative standards as the starting point, so as to provide more favorable evidence for more in-depth, comprehensive and systematic exploration of the mechanism of manipulative therapy for CSR.