本体感觉神经肌肉促进技术与针刺治疗舰艇官兵落枕的疗效比较

目的 探讨本体感觉神经肌肉促进技术（PNF）和针刺治疗舰艇官兵落枕的临床疗效。方法 选取50例舰艇官兵落枕患者，依据治疗方法分为PNF组和针刺组（分别接受PNF和针刺治疗），每组25例。比较分析两组患者治疗前、治疗后即刻和治疗后3个月时的疼痛视觉模拟量表（VAS）评分、治疗后即刻的关节活动度评分和治疗后5个月内的落枕复发率。结果 两组各1例患者因其他原因退出研究，共48例完成试验。针刺组和PNF组患者治疗后即刻的VAS评分低于治疗前（1.9±0.5 vs 7.6±1.6；2.7±0.7 vs 8.0±1.4；P均<0.01），但PNF组患者治疗后即刻的VAS评分高于针刺组（2.7±0.7 vs 1.9±0.5，P<0.05）；治疗后3个月时两组VAS评分差异无统计学意义。针刺组患者在治疗后即刻各方向关节活动度均较治疗前改善（P<0.01），且优于PNF组（P<0.01）。PNF组治疗后5个月内落枕复发率（4.2%，1/24）低于针刺组（25.0%，6/24），但差异无统计学意义（P>0.05）。结论 PNF治疗落枕的即刻效果虽然不及针刺，但其操作简单、可能降低落枕复发率，可以作为治疗落枕的替代方案。
Objective To explore the clinical efficacy of proprioceptive neuromuscular facilitation (PNF) and acupuncture in the treatment of naval soldiers with stiff neck. Methods Fifty naval soldiers with neck stiffness were divided into PNF group and acupuncture group (received PNF or acupuncture treatment, respectively), each group with 25 cases. The Visual Analogue Scale (VAS) score of patients in the two groups was compared immediately and at 3 months after treatment, the degree of range of motion was compared immediately after treatment, and the recurrence rate was compared at 5 months after treatment. Results The VAS scores of patients in the two groups immediately after treatment were significantly lower than those before treatment (1.9±0.5 vs 7.6±1.6, 2.7±0.7 vs 8.0±1.4; both P<0.01). The VAS score in the PNF group was significantly higher than that in the acupuncture group immediately after treatment (2.7±0.7 vs 1.9±0.5, P<0.05), with no significant difference at 3 months after treatment. The range of motion in all directions of patients in the acupuncture group immediately after treatment were significantly improved versus those before treatment (P<0.01), and were significantly better than those in the PNF group (P<0.01). The recurrence rate in the PNF group (4.2%, 1/24) was lower than that in the acupuncture group (25.0%, 6/24), but the difference was not significant (P>0.05). Conclusion Acupuncture has a better immediate effect than PNF in treating patients with stiff neck, but PNF is simple to operate and may reduce the recurrence rate of stiff neck, indicating that PNF can be used as an alternative in the treatment of stiff neck