关键词: 颈椎病, 颈痛, 神经根病, 美式整脊, 社区卫生服务, X线

Abstract: Background　The incidence of cervical spondylosis in China is gradually increasing，and it has become a common disease in middle-aged and elderly people.In particular，the incidence of cervical spondylotic radiculopathy （CSR） is higher.Although there are many treatments，such as pharmacologic treatment，jaw traction and braking and so on，the therapeutic effects are different，and the treatment cycles are long in general.Objective　To explore the effect of chiropractic therapy in community-based treatment of CSR.Methods　40 patients with CSR who were treated in Department of Rehabilitation，Yuetan Community Health Center，Fuxing Hospital，Capital Medical University from January 2017 to April 2018 were recruited and divided into massage group and traction group according to the patient's self-reported preferred therapy.The former group received manual correction treatment for 6 times，while the latter received 6 times of 10-minute electric traction treatment，with an amount of traction of 7% to 10% of the body weight.The physiological curvature，angular displacement of the vertebral body and the area of the intervertebral foramen were observed before and after treatment by X-ray examinations.Therapeutic effects were evaluated by the Visual Analogue Score（VAS）．Results　There were no significant differences in gender ratio，average age，and distribution of course of CSR between the two groups （P>0.05）．The cervical physiological curvature and angular displacement of the vertebral body showed no significant differences either before or after treatment between the groups （P<0.05）．Although the average intervertebral foramen area and average VAS score were similar in both groups at baseline （P>0.05），the former was much larger and the latter was much higher in the massage group compared with traction group after treatment （P<0.05）．After treatment，both the average intervertebral foramen area and VAS score increased significantly in the massage group，but only average VAS score increased significantly in the traction group （P<0.05）．The results of correlation analysis showed that the change of intervertebral foramen was positively correlated with the change of the VAS score （r=0.564，P=0.023）．Conclusion　Massage correction therapy can effectively improve the intervertebral foramen area and symptoms of CSR patients，but traction therapy can only alleviate the symptoms，indicating that the former is superior to the latter in improving the aforementioned two aspects.Moreover，there is a positive correlation between the improvement of intervertebral foramen area and the alleviation of symptoms in CSR patients.

Key words: Cervical spondylosis, Neck pain, Radiculopathy, Chiropractic, Community health services, X-ray