基于腋神经分布针刺治疗神经根型颈椎病肩臂痛临床研究  

Clinical research of shoulder-arm pain of cervical spondylotic radiculopathy treated with acupuncture based on the axillary nerve distribution

作　　者：李艳[1,2] 吴耀持[3] 范兴良 孙懿君[3] 

机构地区：[1]上海中医药大学,上海201203 [2]上海市长宁区天山中医医院骨伤科 [3]上海交通大学附属第六人民医院针推伤科,上海200233

出　　处：《中国针灸》2016年第2期135-138,共4页Chinese Acupuncture & Moxibustion

基　　金：上海市长宁区科委课题项目:CNKW2013F03;海派中医流派陆氏针灸传承研究项目:ZYSNXD-DD-HPGC-JD-004

摘　　要：目的:比较沿腋神经走行取穴针刺与常规取穴针刺治疗神经根型颈椎病的疗效差异。方法:将80例神经根型颈椎病患者随机分为观察组及对照组,每组40例。观察组沿腋神经走行取穴肩井、肩贞、肩髎、肩髃、曲垣、天宗、肩胛部激痛点等,激痛点采用合谷刺法,接电针仪,连续波,频率1Hz;对照组根据《针灸治疗学》取穴大椎、天柱、后溪、颈夹脊,常规针刺,颈夹脊连接电针,连续波,频率1Hz。两组均留针30min,隔日1次,10次为一疗程,1个疗程后评定疗效。采用日本学者田中靖久提出的神经根型颈椎病20分法量表以及疼痛视觉模拟标尺法(VAS)对患者治疗前后的临床症状及疼痛程度进行评分,并评定两组疗效。结果:两组治疗后症状评分及VAS评分均较治疗前明显改善(P<0.05,P<0.01),且观察组优于对照组(均P<0.05);观察组总有效率为85.0%(34/40),优于对照组的71.8%(28/39,P<0.05)。结论:沿腋神经走行取穴法针刺治疗神经根型颈椎病疗效确切,优于常规的针刺颈夹脊等穴方法。Objective To compare the difference in the efficacy on cervical spondylotic radiculopathy（CSR）between acupuncture at the acupoints on the axillary nerve distribution and the regular selection of acupoints.Methods Eighty patients of cervical spondylotic radiculopathy were randomized into an observation group and a control group,40 cases in each one.In the observation group,Jianjing（GB 21）,Jianzhen（SI 9）,Jianliao（TE14）,Jianyu（LI 15）,Quyuan（SI 13）,Tianzong（SI 11）and the trigger points in the scalpular region were selected along the axillary nerve distribution.The Heguneedling was adopted at the trigger points and stimulated with electric apparatus,continuous wave,1Hz.In the control group,Dazhui（GV 14）,Tianzhu（BL 10）,Houxi（SI3）,cervical Jiaji（EX-B 2）were selected and stimulated with the regular acupuncture.Electric stimulation was added at cervical Jiaji（EX-B 2）,with continuous wave,1Hz.The needles were retained for 30 min in the two groups,once every two days and 10 treatments made one session.The efficacy was assessed in one session of treatment.The 20-point scale of CSR developed by Japanese scholar,Tanaka Yasuhisa,and the visual analogue scale（VAS）were adopted to score the clinical symptoms and pain degree before and after treatment in the patients and assess the efficacy of the two groups.Results The symptom scores and VAS scores after treatment were improved apparently as compared with those before treatment in the two groups（P〈0.05,P〈0.01）,and the results in the observation group were better than those in the control group（both P〈0.05）.The total effective rate in the observation group was 85.0%（34/40）,better than 71.8%（28/39）in the control group（P〈0.05）.ConclusionThe acupuncture at the acupoints on the axillary nerve distribution achieves the definite efficacy on CSR,better than the regular acupuncture at cervical Jiaji（EX-B 2）.

关 键 词：神经根型颈椎病 腋神经 压痛点 合谷刺 针刺 

分 类 号：R246.2[医药卫生—针灸推拿学]