熊氏“旋颈整脊”手法治疗神经根型颈椎病的经验特色与机制探析

The Characteristics and Mechanistic Insights of Xiong’s “Rotational Cervical Manipulation” in the Treatment of Cervical Spondylotic Radiculopathy

摘要: 神经根型颈椎病(cervical spondylotic radiculopathy, CSR)是临床最常见颈椎病类型，以颈肩疼痛、上肢放射痛为主要表现，近年来呈现年轻化趋势。CSR属中医学“项痹”范畴，核心病机为“筋骨失衡”——“骨错缝，筋出槽”。本文系统总结四川省名中医熊国龙所创以“筋骨并重”为核心的“旋颈整脊”手法，阐述其“理筋–正骨–松神经–善后”四步分层治疗策略的操作规范与理论内涵，并结合现代医学机制，从机械压迫缓解、神经根炎症调控、神经滑动性改善三个维度探讨其可能作用机制。该手法整合了传统正骨、软组织松解与神经动力学技术，体现了中医“筋骨并重”理论与现代康复医学的融合，为CSR的临床治疗提供了兼具中医特色与循证依据的整脊方案。

Abstract: Cervical spondylotic radiculopathy (CSR), the most prevalent type of cervical spondylosis characterized by neck-shoulder pain and radiating upper limb pain, has shown a trend toward younger onset in recent years. In traditional Chinese medicine, CSR falls under the category of “cervical bi-impediment” (Xiang Bi), with its core pathogenesis attributed to “imbalance between sinew and bone”—specifically “vertebral subluxation and sinew displacement”. This article systematically summarizes the “Rotational Cervical Manipulation” technique developed by Xiong Guolong, a renowned traditional Chinese medicine practitioner in Sichuan Province, which is centered on the principle of “emphasizing the equal importance of sinew and bone”. It elaborates on the operational specifications and theoretical connotations of the four-step stratified treatment strategy—“sinew regulation, bone realignment, nerve mobilization, and aftercare”. Furthermore, in conjunction with modern medical mechanisms, it explores the potential therapeutic mechanisms from three perspectives: alleviation of mechanical compression, regulation of nerve root inflammation, and improvement of nerve gliding. This technique integrates traditional bone setting, soft tissue release, and neurodynamic techniques, embodying the integration of the traditional Chinese medicine theory of “sinew-bone equilibrium” with modern rehabilitation medicine, thereby providing a clinical solution for CSR that combines Chinese medicine characteristics with evidence-based principles.