深刺针法联合手法推拿治疗神经根型颈椎病疗效及对实验室指标水平的影响  

Clinical effects of deep needling combined with manipulative massage in the treatment of patients with cervical spondylotic radiculopathy and its influence on laboratory indexes

作　　者：李明礼 张晓贝 谢磊[3] 丁晓燕[2] LI Mingli;ZHANG Xiaobei;XIE Lei;DING Xiaoyan(Department of Pain,The First Rehabilitation Hospital of Shanghai,Shanghai 200090,China;Department of Orthopedics,Jiading District Hospital of Traditional Chinese Medicine,Shanghai 201800,China;Department of Pain,Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200000,China)

机构地区：[1]上海市第一康复医院疼痛科,上海200090 [2]上海市嘉定区中医医院骨伤科,上海201800 [3]上海中医药大学附属上海市中医医院疼痛科,上海200000

出　　处：《安徽医药》2020年第5期881-884,共4页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金资助项目(81603485)。

摘　　要：目的探讨深刺针法联合手法推拿治疗神经根型颈椎病疗效及对实验室指标水平的影响。方法选取2016年5月至2018年5月上海市第一康复医院收治神经根型颈椎病病人共140例,采用随机数字表法分为对照组(70例)和观察组(70例),两组均西医治疗,同时对照组给予手法推拿,而观察组则在对照组基础上加用深刺针法治疗,比较两组临床疗效、治疗前后中医证候评分、视觉模拟疼痛(VAS)评分、颈椎病临床评价量表(CASCS)评分、全血黏度、血浆黏度、肿瘤坏死因子α(TNF α)、白细胞介素1β(IL 1β)及白细胞介素6(IL 6)水平。结果观察组临床治疗总有效率92.86%显著高于对照组77.14%(P<0.05);观察组治疗后中医证候评分及CASCS评分均显著优于对照组及治疗前(P<0.05),观察组治疗后VAS疼痛评分(1.77±0.36)分显著优于对照组(2.52±0.58)分及治疗前(6.69±1.53)分(P<0.05);观察组治疗后血液流变学指标和血清炎症细胞因子水平均显著优于对照组、治疗前(P<0.05)。结论深刺针法联合手法推拿治疗神经根型颈椎病可显著提高症状控制效果,提高颈部活动能力,降低血液黏稠度,并有助于拮抗炎性细胞因子表达。Objective To investigate the clinical effects of deep needling combined with manipulative massage in the treatment of patients with cervical spondylotic radiculopathy and the influence on laboratory indexes.Methods 140 patients with cervical spon dylotic radiculopathy were chosen in the period from May 2016 to May 2018 and randomly divided into the control group(70 pa tients)with western medicine and the observation group(70 patients)with deep needling combined with manipulative massage on the basis of control group.The clinical efficacy,TCM syndrome score,VAS pain score,CASCS score,the levels of whole blood vis cosity,plasma viscosity,TNF α,IL 1βand IL 6 before and after treatment of both groups were compared.Results The clinical to tal efficacy of the observation group were significantly higher than the control group(92.86%vs.77.14%,P<0.05).VAS pain score[(1.77±0.36)vs.(2.52±0.58)and(6.69±1.53)],the TCM syndrome score and CASCS score of observation group after treatment were significantly better than the control group and before treatment(P<0.05).The levels of whole blood viscosity,plasma viscosity,TNF α,IL 1βand IL 6 after treatment were significantly better than the control group and before treatment(P<0.05).Conclusion Deep needling combined with manipulative massage in the treatment of patients with cervical spondylotic radiculopathy can effi ciently improve the control effect of symptom and the ability of neck movement,reduce blood viscosity,be helpful to antagonize the expression of inflammatory cytokines.

关 键 词：颈椎病 针刺疗法 推拿 脊柱 血液黏度 肿瘤坏死因子α 白细胞介素1Β 白细胞介素6 

分 类 号：R246.9[医药卫生—针灸推拿学]