微创医学

目的探讨热敏灸联合本体感觉神经肌肉促进疗法（PNF）治疗上交叉综合征的临床疗效。方法选取90例上交叉综合征患者作为研究对象，采用随机数字表法将患者分为3组，每组30例，PNF组采用PNF，热敏灸组采用热敏灸治疗，联合组采用热敏灸联合PNF同步干预，3组均连续治疗4周。治疗前及治疗4周后，比较3组的疼痛视觉模拟评分法（VAS）评分、Fugl-Meyer评估表（FMA）评分、颈椎功能障碍指数（NDI）评分、颈椎关节活动度、WHO生活质量测定量表简表（WHOQOL-BREF）各维度（心理、生理、环境、社会关系）评分。治疗后比较3组临床疗效。结果治疗后，3组疼痛VAS评分、NDI评分低于治疗前，FMA评分高于治疗前，且与PNF组、热敏灸组相比，联合组疼痛VAS评分、NDI评分更低，FMA评分更高（P<0.05）；3组矢状位及自然直立位C2～T12长度高于治疗前，且联合组长度高于PNF组、热敏灸组（P<0.05）；3组WHOQOL-BREF各维度评分高于治疗前，且联合组高于PNF组、热敏灸组（P<0.05）。联合组疗效优于PNF组、热敏灸组（P<0.05）。结论热敏灸联合PNF能有效减轻上交叉综合征患者疼痛症状，促进其上肢功能与颈椎功能的恢复，提升临床疗效及生活质量。

Objective To investigate the clinical efficacy of heat-sensitive moxibustion combined with proprioceptive neuromuscular facilitation (PNF) in the treatment of upper crossed syndrome. Methods A total of 90 patients with upper crossed syndrome were selected and randomly divided into three groups using a random number table, with 30 patients in each group. The PNF group received PNF therapy, the heat-sensitive moxibustion group received heat-sensitive moxibustion treatment, and the combination group received synchronous intervention of heat-sensitive moxibustion combined with PNF. All three groups received continuous treatment for 4 weeks. Before and 4 weeks after treatment, the pain visual analogue scale (VAS) scores, Fugl-Meyer assessment scale (FMA) scores, neck disability index (NDI) scores, cervical range of motion, and scores of each dimension (physical, psychological, environmental, social relationships) of the WHO quality of life-BREF (WHOQOL-BREF) were compared among the three groups. The clinical efficacy was compared among the three groups after treatment. Results After treatment, the pain VAS scores and NDI scores in the three groups were lower than those before treatment, while the FMA scores were higher than those before treatment. Compared with the PNF group and the heat-sensitive moxibustion group, the combination group had lower pain VAS scores and NDI scores, and higher FMA scores (P<0.05). The lengths from C2 to T12 in the sagittal plane and natural upright position in the three groups were longer than those before treatment, and the length in the combination group was longer than that in the PNF group and the heat-sensitive moxibustion group (P<0.05). The scores of all dimensions of WHOQOL-BREF in the three groups were higher than those before treatment, and the scores in the combination group were higher than those in the PNF group and the heat-sensitive moxibustion group (P<0.05). The efficacy of the combination group was superior to that of the PNF group and the heat-sensitive moxibustion group (P<0.05). Conclusion Heat-sensitive moxibustion combined with PNF can alleviate pain symptoms in patients with upper crossed syndrome, promote the recovery of upper limb function and cervical function, and improve clinical efficacy and quality of life.