摘要
目的评价桂葛舒颈方联合针刺治疗神经根型颈椎病寒瘀阻络证临床疗效。方法将符合入选标准的2019年5月-2021年5月本院86例神经根型颈椎病患者,按随机数字表法分为2组,每组43例。对照组常规基础治疗+针刺治疗,观察组常规基础治疗+针刺+桂葛舒颈方治疗。2组均治疗4周,随访6个月。分别于治疗前后进行中医证候评分,采用颈椎病临床评价量表(CASCS)评估颈椎功能,采用VAS量表评估疼痛程度,采用颈椎功能障碍指数(NDI)评估颈椎功能状态,采用ELISA法检测超敏-C反应蛋白(hs-CRP)、IL-1β、TNF-α水平。观察治疗期间的不良反应,记录随访期间的复发率,评价临床疗效。结果观察组总有效率为95.35%(41/43)、对照组为81.40%(35/43),2组比较差异有统计学意义(χ^(2)=4.07,P=0.043)。观察组治疗后肩颈疼痛、上肢麻木、颈部僵硬、头部闷痛沉重评分及总分均低于对照组(t值分别为10.66、12.89、9.12、12.27、8.75,P值均<0.001),CASCS评分高于对照组(t=2.64,P=0.010),VAS及NDI评分低于对照组(t值分别为5.62、7.00,P<0.01)。观察组治疗后血清hs-CRP、IL-1β、TNF-α水平低于对照组(t值分别为6.65、7.52、5.08,P值均<0.001)。2组治疗期间不良反应发生率比较,差异无统计学意义(χ^(2)=0.73,P=0.393)。随访6个月,观察组复发率为2.44%(1/41)、对照组为17.14%(6/35),2组比较差异有统计学意义(χ^(2)=3.89,P=0.048)。结论桂葛舒颈方联合针刺疗法可有效抑制神经根型颈椎病患者的神经源性炎症反应,减轻疼痛,改善患者颈椎功能,降低复发率,提高疗效。
Objective To explore the clinical effect of Guige Shujing Decoction combined with acupuncture in the treatment of cervical spondylotic radiculopathy with coldness-blood stasis obstructing meridians.Methods A total of 86 patients with coldness-blood stasis obstructing meridians of cervical spondylotic radiculopathy,who met the inclusion criteria from May 2019 to May 2021,were divided into two groups,with 43 cases in each group,according to the random number table method.The control group was treated with routine basic treatment and acupuncture,and the observation group was treated with routine basic treatment,acupuncture and Guige Shujing Decoction.Both groups were treated for 4 weeks and followed up for 6 months.The scores of TCM syndromes were performed before and after treatment,Clinical Assessment Scale for Cervical Spondylosis(CASCS)was used to evaluate cervical spine function,Visual Analogue Score(VAS)was used to evaluate the degree of pain,Neck Disability Index(NDI)was used to evaluate cervical spine function,and ELISA was used to detect levels of hypersensitive C-reactive protein(hs-CRP),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α).The adverse reactions were observed during treatment and the recurrence rate was recorded during follow-up.Results The total effective rate of the observation group was 95.35%(41/43),and that of the control group was 81.40%(35/43),the difference between the two groups was statistically significant(χ^(2)=4.07,P=0.043).After treatment,the scores and total scores of shoulder and neck pain,upper limb numbness,neck stiffness,head tenderness and heaviness in the observation group were significantly lower than those in the control group(t values were 10.66,12.89,9.12,12.27 and 8.75,respectively,P<0.001).After treatment,the CASCS score in the observation group was significantly higher than that of the control group(t=2.64,P=0.010).After treatment,the VAS and NDI scores in the observation group were significantly lower than those in the control group(t values were 5.62 and 7.00,respectively,P<0.001).After treatment,the levels of serum hs-CRP,IL-1βand TNF-αin the observation group were significantly lower than those in the control group(t values were 6.65,7.52 and 5.08,respectively,P<0.001).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(χ^(2)=0.73,P=0.393).After 6 months of follow-up,the recurrence rate in the observation group was 2.44%(1/41)and that in the control group was 17.14%(6/35).There was a statistically significant difference in the recurrence rate between the two groups(χ^(2)=3.89,P=0.048).Conclusion The Guige Shujing Decoction combined with acupuncture therapy can inhibit the neurogenic inflammatory reaction of patients with coldness-blood stasis obstructing meridians of cervical spondylotic radiculopathy,reduce pain,improve cervical spine function,reduce recurrence rate and improve curative effect.
作者
曾智
陈家平
陈亚锋
Zeng Zhi;Chen Jiaping;Chen Yafeng(Rehabilitation Department,Lu'an Chinese Medicine Hospital,Lu'an 237000,China;Massage Department,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230000,China)
出处
《国际中医中药杂志》
2022年第9期996-1000,共5页
International Journal of Traditional Chinese Medicine
基金
2020年安徽高校自然科学研究项目(KJ2020A0407)。
关键词
颈椎病
神经根型颈椎病
寒瘀阻络证
针刺疗法
桂葛舒颈方
Cervical spondylosis
Cervical spondylotic radiculopathy
Coldness-blood stasis obstructing meridians
Acupuncture therapy
Guige Shujing Decoction
