【目的】 观察查式推拿手法联合肌肉能量技术（MET）对第二、三颈椎小关节紊乱症患者颈肩疼痛、颈椎功能障碍指数 （NDI）等的影响，为临床治疗第二、三颈椎小关节紊乱症提供精准、安全有效的治疗方法。【方法】 采用随机对照试验方法， 将2023年6月至2024年7月在广东省中西医结合医院康复科门诊就诊的60例符合纳入标准的第二、三颈椎小关节紊乱症患 者随机分为治疗组和对照组，每组各 30例。治疗组给予查式推拿手法联合MET治疗，对照组给予常规推拿治疗。每天治疗 1次，连续治疗5次为1个疗程。观察2组患者治疗前后疼痛视觉模拟法量表（VAS）评分及颈椎功能障碍指数（NDI）评分的变 化情况，并评价2组患者的临床疗效。【结果】（1）脱落情况方面，治疗过程中，2组患者均无脱落病例，均能完成全部疗程的 治疗。（2）疗效方面，治疗5 d后，治疗组的总有效率为96.7%（29/30），对照组为86.7%（26/30）；组间比较（秩和检验），治疗 组的疗效明显优于对照组（P < 0.05）。（3）疼痛程度改善方面，治疗后，2 组患者的颈部疼痛 VAS 评分均较治疗前明显降低 （P < 0.05），且治疗组对颈部疼痛VAS评分的降低作用明显优于对照组（P < 0.05）。（4）颈椎功能改善方面，治疗后，2组患者 的NDI评分均较治疗前明显改善（P < 0.05），且治疗组对NDI评分的改善作用明显优于对照组（P < 0.05）。【结论】 查式推拿手 法联合MET治疗可以有效缓解第二、三颈椎小关节紊乱症患者的疼痛症状，改善患者的颈椎关节功能，其疗效优于传统推 拿手法治疗。

Objective To observe the effect of Zha􀆳s manipulation combined with muscle energy technique（MET） on neck and shoulder pain and Neck Disability Index（NDI）of patients with second and third cervical facet joint disorders，and then to find out a precise，safe and effective therapies for the its treatment. Methods A randomized controlled trial was conducted for 60 patients with second and third cervical facet joint disorders who met the inclusion criteria. The patients who admitted to the outpatient clinic of the Rehabilitation Department of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine from June 2023 to July 2024 were randomly divided into a treatment group and a control group，with 30 patients in each group. The treatment group was given the treatment of Zha􀆳s manipulation combined with MET，and the control group was given conventional tuina therapy. The treatment was performed once a day and the course of treatment covered five consecutive treatments. The changes of Visual Analogue Scale（VAS）scores of pain and NDI scores in the two groups before and after treatment were observed. After treatment，the clinical efficacy of the two groups was evaluated. Results（1）During the treatment， there were no fell-off cases in the two groups， and all patients completed the whole course of treatment.（2）After five days of treatment，the total effective rate of the treatment group was 96.7%（29/30），and that of the control group was 86.7%（26/30）；the intergroup comparison（tested by rank sum test）showed that the therapeutic efficacy of the treatment group was significantly superior to that of the control group（P < 0.05）.（3）After treatment，the VAS scores of neck pain in the two groups were significantly decreased compared with those before treatment（P < 0.05），and the decrease of the VAS scores of neck pain in the treatment group was significantly superior to that in the control group（P < 0.05）.（4）After treatment，the NDI scores for evaluating the cervical vertebra function in the two groups were significantly improved compared with those before treatment（P < 0.05）， and the improvement of NDI scores in the treatment group on was significantly superior to that in the control group （P < 0.05）. Conclusion Zha􀆳s manipulation combined with MET therapy can effectively alleviate pain and improve the cervical vertebra function of patients with second and third cervical facet joint disorders，and its therapeutic efficacy is superior to that of conventional tuina therapy.

R274.9

广东省中医药局科研项目（编号：20241040）