椎间盘源性颈肩痛的特征及中医药治疗  

Characteristics of cervical discogenic pain and its treatment with traditional Chinese medicine

作　　者：刘建航[1] 刘汝专[1] 潘汉升[1] 鲍杰[1] 

机构地区：[1]广西中医学院附属瑞康医院骨颈胸科,广西壮族自治区南宁市530011

出　　处：《中国临床康复》2006年第47期135-138,共4页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:椎间盘源性痛可能是慢性、持续性颈肩痛的常见原因之一,其提出对于进一步阐明颈椎病的发病机制和提供新的治疗思路具有重要意义。回顾性分析椎间盘源性颈肩痛的实验及临床研究结果,提高对颈椎病的认识。资料来源:应用计算机检索Medline数据库1985-01/2006-06的相关文章,检索词“cervicaldiscogenicpain,neckandarmpain”,限定文章语言种类为英文。同时计算机检索中国期刊全文数据库1994-01/2006-06的相关文章,检索词“椎间盘源性疼痛”,限定文章语言种类为中文。资料选择:对资料进行初审,主要选取包括动物模型试验在内的针对颈椎退行性变中椎间盘致病因素的基础研究和临床文献及关于中医药对颈型颈椎病治疗的文献,同时选取关于椎间盘源性腰痛的相关研究资料,进行全文查找。资料提炼:共收集到符合条件的39篇,其中关于颈椎间盘源性疼痛的动物实验基础研究的7篇,关于临床报道研究的21篇,关于中医药治疗对照组治疗的11篇。7篇动物实验包括106只动物,临床研究共包括224个椎间盘组织,治疗上包括223个患者经手术治疗,915个患者经非手术治疗。资料综合:①椎间盘源性颈肩痛的病因病理:目前看法一致的病理学基础为颈椎间盘的退变,这一改变过程不仅表现在颈椎间盘的形态学变化上,更表现在颈椎间盘内在的生物化学平衡的改变上;其发生机制与其解剖基础、髓核免疫特性、异物组织有关。②椎间盘源性颈肩痛诊断:椎间盘源性颈肩痛的临床表现为肩胛区痛,并向头、颈、肩及上臂放射,常伴有麻木,但无沿皮节分布的运动、感觉神经障碍,一般不涉及前臂和手,且无明确的神经节段性定位体征;有不良的生活习惯病史。X射线对椎间盘源性疼痛无诊断意义,有学者认为无痛性椎间盘造影对痛性椎间盘的确诊和定位是最有用手段。③治疗:髓核摘除植骨融OBJECTIVE： Cervical discogenic pain as one of the reasons for chronic and continuous neck and ann pain is important to clarify the pathogenesis of cervical syndrome and provide new therapy. In this paper, we retrospectively analyze the experiment and clinical results of cervical discogenic pain, so as to better understand ceirvical spondylosis. DATA SOURCES： A computer-based online search of Medline database was undertaken to identify relevant articles published in.English between January 1985 and June 2006 with the key words of ＂cervical discogenic pain, neck and ann pain＂. Meanwhile, we searched CNKI database for Chinese articles published from January 1994 to June 2006 by using the key words of ＂discogenic pain＂ in Chinese. STUDY SELECTION： The data were selected primarily to choose the experimental study and clinical literature on etiological factor in patients or animal models and literature on the treatment of discogenic neck disease with traditional Chinese medicine. Meanwhile, the relevant study on discogenic back pain was also included, and the full-texts were looked up. DATA EXTRACTION： Together 39 articles met the criteria were collected including 7 experimental study in animals with discogenic pain, 21 clinic study in patients and 11 on treatment with traditional Chinese medicine. The 7 animal trials involved in 106 animals; the clinical study involved in 224 discus intervertebralis tissues; 223 patients were treated with operation and 915 with non-operation. DATA SYNTHESIS：①Pathogenesis of discogenic neck and ann pain： The popular pathogenesis is the degeneration of discus intervertebralis, which is not only showed in the morphological changes of neck intervertebral disk, but also in the internal changes of biochemical balance of neck intervertebral disk; the mechanism is related to the anatomic foundation, nucleus pulposus immunity traits and extraneous material tissues.②Diagnosis of discogenic neck and ann pain： The clinical symptoms of this disease include scapular pain,

关 键 词：疼痛 颈痛/诊断 中药疗法 颈椎/病理学 椎间盘/化学 

分 类 号：R681.5[医药卫生—骨科学]