中医综合治疗根性疼痛100例随访研究  

Visiting study of 100 radicular pain cases treating with combined TCM

作　　者：田和炳 蒋小明[1] 郭旗[1] 陆亮亮[1] 李兴勇[1] 吴蓉[1] 石军[1] 

机构地区：[1]四川省德阳市旌阳区中医院(人民医院)康复科,四川德阳618000

出　　处：《中国现代医生》2013年第6期75-78,共4页China Modern Doctor

摘　　要：目的观察两种中医综合治疗方案治疗根性疼痛的远期疗效,总结根性疼痛的转归规律。方法按分层随机双盲对照法将根型颈椎病及腰突症各50例纳入试验,治疗组予小针刀神经根管松解术加中医综合治疗方案,对照组予小针刀神经根管假松解术加相同中医综合治疗。以无效、疗效不佳而要求结束试验为观察终点,试验中进行症状体征积分及MPQ量表评定、不良事件调查并记录,于试验结束后第1、3、6个月,分别从症状体征积分及疗效评估两方面随访并记录。结果对于两类根性疼痛,完成试验后有症状体征者中,选择继续治疗者及终止治疗者,在各自的两组比较中,症状体征积分均无显著性差异(P>0.05);选择终止与继续治疗的病例间相比,对于根型颈椎病,其症状体征积分无显著性差异(P>0.05),而于腰突症却有显著性差异(P<0.05),两类根性疼痛病例合并统计后仍有显著性差异(P<0.05)。少数患者症状体征积分仍高,但还是因对疗效满意而停止治疗,转归良好。因无效退出试验的病例中有选择手术治疗者,也有选择激素、脱水剂及神经阻滞等治疗者,转归均较好。同时,对照组因无效退出的病例,采用治疗组的方案仍然有效。结论根性疼痛患者选择治疗与否取决于症状体征的轻重程度,但也与患者的家庭与社会环境、心理与行为特征、对疾病的认知能力与情绪的波动、医生的引导等多种因素密切相关。各种对根性疼痛有效的干预方法,各有特色优势,应根据病情轻重缓急、患者接受度合理选择,综合应用。根性疼痛的干预应适度,症状体征积分减轻至(2.87±1.72)分时可停止治疗,加强健康教育。Objective To observe the prognosis regular pattern ot the raclicular pain on the 13asls ot wsltlng me long- term curative effect of two different comprehensive therapy of TCM treating radicular pain. Methods All of 50 cases of radicular type cervical spondylosis and 50 cases of lumbar disc protrusion were separately randomly divided into two groups. On the basis of both groups treating with the combined therapies of TCM, the patients of the treatment group were treated with DNRCA and the control group with the pseudo acupotomy. The study was end when the patients felt no effect or aggravated. Patients were evaluated with the cumulative score of the symptoms and signs（SS）, MPQ and adverse event during the treatment and visiting period. All patients were visited and recorded with the SS and the evaluation of effet within half a year after treatment, especially the lst,3rd,6th months. Results Those cases who remained symptoms and signs after completing test, either chose to continue the treatment or not, had no differences in the SS between two groups of two radicular pain separately（P 〉 0.05）. Among those patients who chose to continue the treatment or not, there was no difference of SS in the radicular cervical spondylosis, but significant difference （P 〈 0.05） in the lumbar disc herniation. And there was also significant difference（P 〈 0.05） of all cases with radicular pain be- . tween the two groups. A few patients felt well to cease curing with a high SS score at the end of the experiment, and recovered well in half a year in fact. Among those cases who withdrew from the experiment for less efficacy, someone chose to take surgical operation, to apply glucocorticoid and dehydrating agent, or to accept nerve blocking therapy, etc, they were all feeling well. Meanwhile, those who withdrew from the control group and then accepted the prescrip- tion of the treatment group were all effective yet. Conclusion The patients with radicular pain chose to continue treat- ing or not depende

关 键 词：小针刀神经根管直接松解术 中医综合治疗 根性疼痛 神经根型颈椎病 腰椎间盘突出症 

分 类 号：R681.15[医药卫生—骨科学]