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

摘要： 背景　我国颈椎病的患病率逐渐增加，逐渐成为中老年人的常见病，其中神经根型颈椎病患病率较高，治疗方式有药物治疗、颌带牵引、制动等，但是在治疗效果方面疗效不一，且治疗周期一般较长。目的　探讨美式整脊在社区治疗神经根型颈椎病的效果。方法　收集2017年1月—2018年4月于首都医科大学附属复兴医院月坛社区卫生服务中心康复科进行治疗的神经根型颈椎病的患者40例，按患者意愿分为两组，手法矫正组进行手法矫正治疗6次，牵引组进行电动牵引治疗6次，每次10 min，牵引重量为患者体质量的7%~10%。观察治疗前后患者X线中生理曲度、椎体角度位移、椎间孔面积变化的情况，并采用视觉模拟评分量表（VAS）评价治疗前后的治疗效果。结果　两组患者性别、年龄、病程、VAS评分比较，差异无统计学意义（P>0.05）。两组治疗前后颈椎生理曲度、颈椎角度位移比较，差异无统计学意义（P<0.05）。治疗前两组椎间孔面积、VAS评分比较，差异无统计学意义（P>0.05）；治疗后手法矫正组椎间孔面积、VAS评分高于牵引组，差异有统计学意义（P<0.05）。手法矫正组治疗后椎间孔面积、VAS评分高于治疗前，差异有统计学意义（P<0.05）。牵引组治疗后VAS评分高于治疗前，差异有统计学意义（P<0.05）。相关性分析结果显示，椎间孔改变与VAS评分变化呈线性正相关（r=0.564，P=0.023）。结论　手法矫正治疗在改善患者椎间孔面积，改善患者症状方面有效果；牵引治疗在改善患者症状方面有效果；手法矫正在改善椎间孔面积方面，改善患者症状方面优于牵引治疗；改善椎间孔面积与改善患者症状方面呈正相关。

关键词: 颈椎病, 颈痛, 神经根病, 美式整脊, 社区卫生服务, X线