桃红四物汤结合低温等离子射频消融术治疗交感型颈椎病的疗效观察  

Curative Effect of Taohong Siwu Decoction Combined with Low Temperature Radiofrequency Ablation on Sympathetic Cervical Spondylosis

作　　者：丁晓燕[1] 戚倩云 刘薛峰 谢磊[3] 刘伙生 Ding Xiaoyan;Qi Qianyun;Liu Xuefeng;Xie Lei;Liu Huosheng(Department of Pain Management,TCM Hospital of Jiading District,Shanghai,201800;Department of Pain Management,Shanghai Pudong New Area Gongli Hospital,Shanghai;Department of Pain Management,Municipal TCM Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200071,P.R.China)

机构地区：[1]上海市嘉定区中医医院疼痛科,201800 [2]上海市浦东新区公利医院疼痛科,200135 [3]上海中医药大学附属市中医医院疼痛科,200071

出　　处：《老年医学与保健》2019年第2期234-238,共5页Geriatrics & Health Care

摘　　要：目的观察桃红四物汤结合低温等离子射频消融术治疗交感型颈椎病的临床疗效,为临床治疗提供新思路,为推广该应用提供理论依据。方法全部120例病例来源于上海中医药大学附属市中医医院疼痛科及上海市嘉定区中医医院疼痛科。设立中西医结合组(桃红四物汤结合低温等离子射频消融术)及西医对照组(单纯低温等离子射频消融术),中医对照组(单纯桃红四物汤),每组各40例。观察指标(1):一般指标:常规体格检查指标(a routine medical examination,以下简称A):(2)主要疗效指标:采用经颅多普勒监测血流指标(transcranial Doppler,简称TCD),观察治疗前后systolic peak velocity(VS):(椎动脉、基底动脉的收缩期峰值血流速度)、diastolic peak velocity(VD):(椎动脉、基底动脉的舒张末期血流速度)、pulsatility index(PI)(阻力指数)变化,客观评价治疗前后对椎动脉、基底动脉的血流速度进而对脑部供血的影响。(3)综合评价指标:采用王新伟等的"20分评分法"及于泽生的"主观满意度"(分为优、良、中、差4个等级)评价交感神经症状。结果治疗前3组年龄、性别、病程比较差异无统计学意义(P>0.05)。治疗后2周,1月,3月后中西医结合组、西医对照组、中医对照组总有效率分别为95.00%、89.00%、72.50%,3组比较均具有统计学意义(P<0.05),且中西医结合组均优于西医对照组和中医对照组(P<0.05);治疗2周后,3组血流指标与治疗前比较均有统计学意义(P<0.05),且中西医结合组均优于两个对照组(P<0.05)。结论桃红四物汤结合低温等离子射频消融术治疗交感型颈椎病在交感症状程度改善、临床综合疗效方面及椎动脉血流改善情况方面优于单纯低温等离子射频消融术和单纯服用桃红四物汤治疗组,差异均有统计学差异(P<0.05)。中药结合低温等离子射频消融术的治疗,作为一种新的治疗方法在治疗交感型颈椎病方面值得探索Objective To observe the curative effect of Taohong Siwu Decoction combined with low temperature radiofrequency ablation on sympathetic cervical spondylosis.Methods 120 cases were divided into 3 groups:integrated group(Taohong Siwu Decoction combined with low temperature radiofrequency ablation),traditional Chinese medicine(TCM)control group and western medicine(WM)control group,40 cases in each;observation was made to the results of routine medical examination,the indexes of tanscranial Doppler(TCD),the changes of systolic peak velocity(VS),diastolic peak velocity(VD)and pulsatility index(PI)after treatment;the changes of sympathetic symptoms were evaluated by Wang Xinwei's"20-point scoring method"and Yu Zesheng's"subjective satisfaction"(4 grades:excellent,good,medium and poor).Results There existed no statistical differences in age,gender and disease courses of the cases among the 3 groups(P>0.05);the total effective rate in integrated group at the time point of 2 weeks,1 month and 3 months after treatment was 95.00%,superior to that in TCM control group(89.00%)and that in WM control group(72.50%),the differences among the 3 groups was of statistical significance(P<0.05);the blood flow indexes of the cases in the 3 groups 2 weeks after treatment were statistically different from those before treatment(P<0.05)and the changes in integrated group were bigger than those in the 2 control groups(P<0.05).Conclusions The combined application of Taohong Siwu Decoction and low temperature radiofrequency ablation is more effective than single application of Taohong Siwu Decoction or low temperature radiofrequency ablation on sympathetic symptom improvement,general clinical curative effect and the improvement of vertebral artery blood flow;as a new therapeutic method for sympathetic cervical spondylosis,it is worthy of further research and wider application.

关 键 词：桃红四物汤 低温等离子射频消融术 交感神经型颈椎病 临床疗效 

分 类 号：R681.55[医药卫生—骨科学]