神经根型颈椎病不同针具提插刺法安全性临床比较研究  

Clinical safety of lifting and thrusting manipulation with different needles in treatment of cervical spondylotic radiculopathy:A comparative study

作　　者：熊国星[1] 万飞[1] 赵盛惠 姚开荣 李淋 Xiong Guoxing;Wan Fei;Zhao Shenghui;Yao Kairong;Li Lin(Rehabilitation Teaching and Research Section,Chongqing Medical and Pharmaceutical College;Rehabilitation of TCM Department,Chenjiaqiao Hospital Affiliated to Chongqing Medical and Pharmaceutical College)

机构地区：[1]重庆医药高等专科学校康复医学教研室,重庆401331 [2]重庆医药高等专科学校附属陈家桥医院中医康复科,重庆401331

出　　处：《重庆医科大学学报》2019年第9期1220-1223,共4页Journal of Chongqing Medical University

基　　金：重庆市卫生计生委中医药科技资助项目（编号：ZY201702123）

摘　　要：目的:观察神经根型颈椎病不同针具提插刺法治疗后不良事件的发生率及类型,以客观评价不同针具特别是小针刀提插切割治疗的安全性。方法:采集120例神经根型颈椎病患者随机分成针刺、针刀2组,每组60例,相同直径的2种针具提插治疗1次后,评估其不良事件特别是刺后疼痛的发生率及严重程度。结果:神经根型颈椎病针刀组刺后遗留疼痛反应42例,针刺组仅4例(P=0.000);刺后全身有疲乏反应针刀组7例,针刺组仅1例(P=0.028);疼痛、疲劳3 d内均逐渐消失。针刀后常见不良事件局部为刺后疼痛酸胀、全身为身体疲乏,酸痛不适通常在针刀刺颈椎棘旁、横突或大结节等骨突位置,有时也可以见到头痛、烧心感等周边组织反应。结论:小针刀提插切割治疗神经根型颈椎病发生不良事件的比率较针刺提插治疗高的多,不过总体是安全的,需要规范化其治疗流程以尽量避免医患纠纷。Objective:To observe the incidence and types of adverse events after lifting and thrusting treatment with different needles for cervical spondylotic radiculopathy(CSR),and to evaluate the safety of lifting and thrusting manipulation with different needles,especially small needle knife,in the treatment of CSR.Methods:A total of 120 CSR patients were randomly divided into acupotomy group(n=60)and acupuncture group(n=60).The incidence and severity of adverse events,particularly pain,were assessed after a single lifting and thrusting manipulation with two needles of the same diameter.Results:Forty-two patients of the acupotomy group experienced pain after treatment,while only 4 of the acupuncture group experienced this symptom,with a significant difference in the number of cases between the two groups(P=0.000).Generalized fatigue was seen in 7 patients in the acupotomy group and 1 patient in the acupuncture group,with a significant difference in the number of cases between the two groups(P=0.028).Pain and fatigue all disappeared within 3 days.After acupotomy,the common local adverse reaction was pain and sore and swelling,usually next to the cervical spinous process or at the transverse process or tubercles,and the common systemic adverse reaction was fatigue;headache and heartburn were seen in some cases.Conclusion:In the lifting and thrusting treatment of CSR,acupotomy is more likely to cause adverse events than acupuncture,but it is generally safe.Treatment guidelines for acupotomy are needed to avoid medical disputes.

关 键 词：不良事件 治疗流程 医疗纠纷 

分 类 号：R245.3[医药卫生—针灸推拿学]