桂枝加葛根汤加味治疗神经根型颈椎病气滞血瘀证患者颈部、上肢功能的临床观察  

Clinical Efficacy of Modified Guizhi Jia Gegen Tang on Qi Stagnation and Blood Stasis Syndrome of Cervical Spondylotic Radiculopathy and Function of Neck and Upper Limb

作　　者：刘胜[1] 刘玲[2] 海兴华[1] 房纬[1] LIU Sheng;LIU Ling;HAI Xing-hua;FANG Wei(The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China;Tianjin Fourth Central Hospital,Tianjin 300140,China)

机构地区：[1]天津中医药大学第一附属医院,天津300193 [2]天津市第四中心医院,天津300140

出　　处：《中国实验方剂学杂志》2020年第1期92-97,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81603711)

摘　　要：目的:探讨桂枝加葛根汤加味治疗神经根型颈椎病(CSR)气滞血瘀证的临床疗效及对颈椎活动度、等长肌力及疼痛相关因子的影响。方法:将162例CSR气滞血瘀证患者随机分为观察组和对照组,各81例,观察组给予桂枝加葛根汤加味口服,150 m L/次,2次/d,对照组给予颈舒颗粒口服6 g/次,2次/d,两组患者均治疗8周;记录治疗前后正中神经F波传导速度,颈椎活动度,等长肌力,CSR 20分量表评分和视觉模拟评分(VAS)变化,治疗结束后统计总有效率和治愈率;酶联免疫夹心法检测治疗前后患者血清疼痛相关因子5-羟色胺(5-HT),神经生长因子(NGF),前列腺素E2(PGE2)含量。结果:观察组总有效率为98.77%,治愈率为40.74%,优于对照组的总有效率83.95%,治愈率7.41%(P<0.01);与本组治疗前比较,两组患者正中神经F波传导速度增快,颈椎活动度、等长肌力及CSR 20分量表评分增加,VAS评分减少,疼痛相关因子5-HT,NGF及PGE2含量下降(P<0.01);与对照组治疗后比较,观察组患者正中神经F波传导速度增快,颈椎活动度、等长肌力及CSR 20分量表评分增加,VAS评分减少,疼痛相关因子5-HT,NGF及PGE2含量下降(P<0.01)。结论:桂枝加葛根汤加味治疗CSR气滞血瘀证临床疗效确切,可明显改善患者颈部、手部功能、减轻患者疼痛。Objective:To investigate the clinical efficacy of modified Guizhi Jia Gegen Tang on cervical spondylotic radiculopathy(CSR)with Qi stagnation and blood stasis syndrome and its effect on cervical vertebral mobility,isometric muscle strength and pain-related factors.Method:Totally 162 CSR patients with Qi stagnation and blood stasis syndrome were randomly divided into observation group(81 cases)and control group(81 cases).The observation group was given modified Guizhi Jia Gegen Tang orally,150 m L/time,twice a day,while the control group was given Jingshu granule orally for 6 g/time,twice a day.Both groups were treated for 8 weeks.The changes of median nerve F wave conduction velocity,cervical vertebral mobility,isometric muscle strength,CSR20 subscale score and visual analogue score(VAS)were recorded before and after treatment.The total effective rate and the cure rate were counted after treatment.The levels of serum pain-related factors(5-HT),nerve growth factor(NGF)and prostaglandin E2(PGE2)were measured before and after treatment.Result:The total effective rate of the observation group was 98.77%,and the cure rate was 40.74%,which were better than 83.95%and7.41%of the control group(P<0.01).Compared with before treatment,the conduction velocity of median nerve F wave,cervical vertebral mobility,isometric muscle strength and CSR 20 score increased,whereas VAS score,pain related factors 5-HT,NGF and PGE2 content decreased in both groups(P<0.01).Compared with control group,median nerve F wave conduction velocity,cervical vertebral mobility,isometric muscle strength and CSR 20 subscale scores increased,while VAS score decreased,pain related factors 5-HT,NGF and PGE2 contents decreased in the observation group(P<0.01).Conclusion:Modified Guizhi Jia Gegen Tang is effective in treating CSR with Qi stagnation and blood stasis syndrome,and can significantly improve the neck and hand functions and relieve pain.

关 键 词：桂枝加葛根汤加味 神经根型颈椎病 疼痛因子 肌电图 颈椎活动度 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]