目的：观察四步整复法配合理筋推拿手法与间歇式牵引治疗寰枢关节半脱位的临床疗效。方法：选择寰枢关节半脱位患者84例，按随机数字表法分为观察组与对照组各42例。治疗过程中，观察组脱落1例，对照组脱落4例。观察组进行四步整复法配合理筋推拿手法与间歇式牵引治疗，对照组仅进行理筋推拿手法配合间歇式牵引治疗，两组均以6次治疗为1个疗程。比较两组治疗前后数字分级评分法（NRS）评分、颈椎功能障碍指数（NDI）评分、寰齿侧间隙差值（VBLADS），评价临床疗效。结果：治疗1个疗程后，两组NRS评分、VBLADS及NDI评分较治疗前均降低（P<0.001），且观察组NRS评分、VBLADS及NDI评分均低于对照组（P<0.05）；观察组治疗总有效率高于对照组（P<0.05）。结论：四步整复法配合理筋推拿手法与间歇式牵引治疗寰枢关节半脱位疗效确切，可减轻患者疼痛症状，调整寰齿侧间隙，恢复颈椎功能活动。

Objective:To observe the clinical curative efficacy of four-step manipulative reduction combined with tendon-regulating manipulation and intermittent traction in the treatment of atlanto-axial subluxation.Methods:A total of 84 patients with atlanto-axial subluxation were divided into observation group and control group according to the random number table method,with 42 patients in each group. The observation group was treated with four-step manipulative reduction combined with tendon-regulating manipulation and intermittent traction,while the control group was treated with tendon-regulating manipulation and intermittent traction. Both the two groups were treated for one course of treatment(6 times). The numeric rating scale( NRS) score, neck disability index(NDI) score,and value between lateral atlanto-dental spaces(VBLADS) were compared between the two groups before and after the treatment,and the clinical curative efficacy was evaluated. Results:After one course of treatment,the NRS score,VBLADS,and NDI score of the two groups were lower than those before treatment(P<0.05),and these indicators of the observation group were better than those of the control group(P<0.05). The total effective rate of the observation group was higher than that of the control group(P<0.05). Conclusions:Four-step manipulative reduction combined with tendon-regulating manipulation and intermittent traction is effective in the treatment of atlanto-axial subluxation. It can relieve the pain symptom,adjust the VBLADS,and restore cervical function and activities.