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目的:观察理筋正骨手法结合耐力性抗阻运动治疗女性慢性颈痛的临床疗效,并探讨其作用机制.方法:将符合纳入标准的57例女性慢性颈痛患者根据随机数字表法分为手法组(29例)和中频电组(28例).两组均进行相同的耐力性运动治疗,手法组加用理筋正骨手法治疗,中频电组加用中频电疗法.两组均治疗5周.治疗前后采用视觉模拟量表(VAS)、压痛仪、Northwick Park颈痛量表(NPQ)以及胸锁乳突肌和颈后伸肌的表面肌电均方根值(RMS)和中位频率值(MF)对患者颈部功能进行评定,并在治疗1月后对患者进行随访.结果:全部患者均完成治疗并获得随访.与本组治疗前相比,两组治疗后VAS评分下降,压痛值增大,RMS和MF值增大,NPQ颈痛量表评分下降(均P<0.05);手法组的各项改善情况均优于中频电组(均P<0.05);1月后随访时,手法组VAS和NPQ评分均低于本组治疗前和治疗后,中频电组VAS和NPQ评分仅低于本组治疗前;手法组两项评分均低于中频电组(均P<0.05).结论:理筋正骨手法结合耐力性抗阻运动可减轻女性慢性颈痛患者的颈部疼痛,降低颈椎功能障碍程度,其疗效优于调制中频电疗法结合耐力性运动,且疗效更持久.“,”Objective: To observe the clinical efficacy of tendon-regulating and bone-setting manipulation combined with endurance resistance exercises in treating female with chronic neck pain, and explore the mechanism. Methods: A total of 57 female patients with chronic neck pain who met the inclusion criteria were randomly divided into a manipulation group (29 cases) and a medium-frequency electrotherapy group (28 cases). Patients in both groups received the same endurance exercise therapy, while those in the manipulation group received additional tendon-regulating and bone-setting manipulation, and those in the medium-frequency electrotherapy group received additional medium-frequency electrotherapy. Both groups were treated for 5 weeks. Before and after treatment, the neck function of patients was evaluated by visual analog scale (VAS), Analgesy-Meter, Northwick Park questionnaire (NPQ), root mean square (RMS) and median frequency (MF) of surface electromyography of sternocleidomastoid muscle and posterior cervical extensor muscle, and the patients were followed up at a month after treatment. Results: All patients completed the treatment and were followed up. Compared with the same group before treatment, the VAS scores of both groups decreased, the tenderness values increased, the RMS and MF values increased, and the NPQ scores decreased after treatment (all P<0.05). The improvement of manipulation group was more notable than that of medium-frequency electrotherapy group (all P<0.05). At one-month follow-up, the VAS and NPQ scores of the manipulation group were lower than those before and after treatment, and the VAS and NPQ scores of the medium-frequency electrotherapy group were only lower than those before treatment; the two scores of the manipulation group were lower than those of the medium-frequency electrotherapy group (both P<0.05). Conclusion: Tendon-regulating and bone-setting manipulation combined with endurance resistance exercises can relieve neck pain and cervical dysfunction in female patients with chronic neck pain. The efficacy of this method is more durable and better than that of medium-frequency electrotherapy combined with endurance exercises.