| Objective:Observe the clinical effectiveness of "meridian-tendon-bone banlance regulating" manipulation in treating CSA, and compared with the traditional Tuina-massage therapy as well as the biomechanical effect of the "meridian-tendon-bone banlance regulating" manipulation on CSA from the posterior muscle chain tension and the symmetry of postures to provide scientific basis for the clinical evaluation system of Chinese medical Tuina-massage and objective western medicine evidence for Chinese medicine theories—"gu zheng jin rou" and "jin gu bing zhong".Methods:By adopting RCT methods,60 CSA patients are divided into to observation group and control group,30 cases in each group. For observation group, use "meridian-tendon-bone banlance regulating" manipulation..For control group, apply traditional Chinese Tuina massag-e.The treatment time are one session including 10 times treatment for both of groups; Meanwhile, test the the posterior muscle chain tension and the symmetry of postures according to the Tbed method to study the instant effect of each treatment and the effect of one session treatment. Comparing the clinical efficacy and biomechanical effect of two groups before and after treatments to observe the improving situation by the symptoms, signs, function scores, difference of lateral atlanto-dental space,difference of atlanto-dental axes, vertebrobasilar hemodynamics and the posterior muscle chain tension and the symmetry of postures of CSA patients so that to evaluate the clinical efficacy and biomechanical effect synthetically.Results:1. Study the two groups difference in symptoms, signs and the function score before and after treatment indicates statistical significance(P<0.05). Both of the two groups can improve relevant symptoms, signs and function; comparing the two groups after treatment, the difference is statistically significant (P< 0.05); Point out that the "meridian-tendon-bone banlance regulating" manipulation group is superior to the traditional manual therapy group.2. Before and after treatment, comparing the Vm of RVA, LVA and BA, there are significant differences (P< 0.01) which indicates both of the two groups can improve the Vm of vertebrobasilar hemodynamics; before and after treatment, comparing the RI of RVA and LVA, there are statistical significance (P< 0.05) which shows both of the two groups can decrease vertebral artery RI; comparing the two groups after treatment, the difference is statistically significant (P< 0.05),which point out that the "meridian-tendon-bone banlance regulating" manipulation group is superior to the traditional manual therapy group.3. Compare two groups the difference of lateral atlanto-dental space and the difference of atlanto-dental axes before and after treatment, the difference in "meridian-tendon-bone banlance regulating" manipulation group has statistical significance (P< 0.05) which indicates the "meridian-tendon-bone banlance regulating" manipulation group can decrease the above index difference, however, the traditional manual therapy group has no statistical significance (P> 0.05) which shows the traditional manual therapy group cannot regulate the above index difference; comparing the two groups after treatment, the difference is statistically significant (P< 0.05),which point out that the "meridian tendon-bone banlance regulating" manipulation group is superior to the traditional manual therapy group in regulating atlanto-axial joint structure abnormity.4. After one session treatment, the total effective rate is 90.3% in "meridian-tendon-bone banlance regulating" manipulation group, the total effective rate is 70.3% in traditional Tuina-massage group, the difference has statistical significance (P<0.05), which points out the "meridian-tendon-bone banlance regulating" manipulation group is superior to the traditional manual therapy group; after 3 months follow-up, the total effective rate is 83.3% in "meridian-tendon-bone banlance regulating" manipulation group, the total effective rate is 60% in traditional Tuina-massage group, the difference has statistical significance (P< 0.05), which indicates the "meridian-tendon-bone banlance regulating" manipulation group is superior to the traditional manual therapy group in long-term follow-up result.5. After one treatment, comparison in angel and muscle tension of two groups shows no statistical significance (P>0.05),which indicates both of the two groups cannot regulate the above indicator; After treatment comparison among the two groups does not have statistical significance (P>0.05), which indicates the two groups have fairly effect in regulating Posterior muscle chain and angle of muscle tension. Before and after treatment, comparing anterior and posterior head and neck section as well as the difference of overall posture symmetry, the "meridian-tendon-bone banlance regulating" manipulation group has statistical significance ((P<0.05), which indicates the "meridian-tendon-bone banlance regulating" manipulation group works well in regulating overall posture symmetry. However, the traditional therapy group has no statistical significance ((P>0.05).After treatment comparison among the two groups does have statistical significance ((P<0.05).which indicates the "meridian-tendon-bone banlance regulating" manipulation group is superior to the traditional therapy group in improving the symmetry of head and neck section and the whole body.6. After one session, comparison in angel and muscle tension of two groups shows statistical significance ((P<0.05),which indicates both of the two groups can regulate the above indicator; After treatment comparison among the two groups does not have statistical significance (P> 0.05), which indicates the two groups have fairly effect in regulating posterior muscle chain and angle of muscle tension. Before and after treatment, comparing anterior and posterior head and neck section as well as the difference of overall posture symmetry, the "meridian-tendon-bone banlance regulating" manipulation group has statistical significance (P<0.05), which indicates the "meridian-tendon-bone banlance regulating'" manipulation group works well in regulating overall posture symmetry. However, the traditional therapy group has no statistical significance (P>0.05).After treatment comparison among the two groups does have statistical significance (P<0.05).which indicates the "meridian tendon-bone banlance regulating" manipulation group is superior to the traditional therapy group in improving the symmetry of head and neck section and the whole body.7. After one session, using canonical Correlation Analysis to study the index difference between the posterior muscle chain tension and the CSA patients symptoms-signs score, there is a positive correlation.Conclusions:1."meridian-tendon-bone banlance regulating" manipulation can effectively improve clinical symptoms, signs and function in patients with CSA, and the effect is stable during follow-up period.2."meridian-tendon-bone banlance regulating" manipulation can effectively improve CSA patients atlanto-axial joints staggered joints of vertebral displacement and vertebral-basilar artery blood supply, so this methos can regulate the cervical spine line of strength increase vertebral canal volume, increase head blood supply to improve the insufficient condition. This may be the effective mechanism of action.3."meridian-tendon-bone banlance regulating" manipulation can regulate the angle of muscle tension and postural symmetry, it provides objective western medicine evidence for Chinese medicine theories—"gu zheng jin rou"and "jin gu bing zhong". |
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