牵引锻炼颈托联合桂枝加葛根汤治疗神经根型颈椎病  

Treatment of traction exercise neck brace combined with Guizhi plus Gegen Decoction for patients with cervical spondylotic radiculopathy

作　　者：刘昌顺[1,3] 肖亮星 曾浪勇 章歆 LIU Changshun;XIAO Liangxing;ZENG Langyong;ZHANG Xin(School of Traditional Chinese Medicine,Southern Medical University,Guangzhou,Guangdong 510515,China;不详)

机构地区：[1]南方医科大学中医药学院,广州510515 [2]南方医科大学基础医学院,广州510515 [3]佛山市乙太医疗用品有限公司,广东528200 [4]江门市五邑中医院,广东529000

出　　处：《中国骨科临床与基础研究杂志》2020年第5期267-272,共6页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：广州市科技计划项目(201704020129)。

摘　　要：目的探讨牵引锻炼颈托联合桂枝加葛根汤治疗神经根型颈椎病(cervical spondylotic radiculopathy,CSR)的临床疗效。方法选择2019年10月至12月江门市五邑中医院门诊就诊的38例CSR患者,随机分为牵引组(18例)和牵引加中药组(20例),牵引组运用牵引锻炼颈托在牵引状态下进行颈部肌群等长收缩锻炼(2次/d),牵引加中药组在颈托牵引基础上联合桂枝加葛根汤治疗(1剂/d),疗程为4周。记录两组患者3个月内临床症状发作频次,采用视觉模拟量表(VAS)评分评价患者疼痛缓解程度,通过CT影像三维重建测量椎间孔面积和高度。结果入组受试者全部完成临床观察。治疗后两组VAS评分均较治疗前改善,但牵引加中药组下降幅度优于牵引组;临床症状发作频次亦少于牵引组。治疗后两组受试者左、右侧椎间孔面积和高度均提高,增加幅度较大的部位为C_(4)-C_(5)和C_(5)-C_(6)颈椎;相较于牵引组,牵引加中药组受试者C_(4)-C_(7)椎间孔面积、高度的增加更为明显,两组比较,差异有统计学意义(P<0.05)。结论牵引锻炼颈托联合桂枝加葛根汤治疗能减轻椎间神经压迫,有效缓解CSR临床症状,短期效果良好。Objective To investigate clinical effects of traction exercise neck brace(TENB)combined with Guizhi plus Gegen Decoction for patients with cervical spondylotic radiculopathy(CSR).Methods A total of 38 patients with CSR who treated in out-patient department of Jiangmen Wuyi TCM Hospital from October to December 2019 were recruited and randomized into two groups,traction group(group A,n=18)and traction plus Chinese medicine group(group B,n=20).Patients in group A used TENB to perform neck muscle isometric exercise under traction(twice per day),while patients in group B were treated by combination therapy of TENB and Guizhi plus Gegen Decoction(one dose per day).All patients were treated for four weeks.Frequency of symptomatic attack within 3 months was recorded,visual analogue scale(VAS)score was used to evaluate the relief of pain,and the area and height of intervertebral foramen were measured by 3D reconstruction of CT images.Results All the enrolled patients completed clinical observations.After treatment,VAS scores of the two groups were improved,in which the scores of patients in group B were better than those of patients in group A.Frequency of symptomatic attack was also less than that in group A.After treatment,the area and height of the left and right intervertebral foramina were increased in both groups,and among all segments of cervical vertebrae,C_(4)-C_(5)and C_(5)-C_(6)showed greater increase.Compared with group A,the area and height of the C_(4)-C_(7)intervertebral foramina in group B increased more obviously,the differences between two groups were statistically significant(P<0.05).Conclusion For patients with CSR,TENB combined with Guizhi plus Gegen Decoction can obtain good short-term effect with the decompression of intervertebral nerve and effective relief of clinical symptoms.

关 键 词：颈椎病 牵引术 颈托 桂枝加葛根汤 中西医结合疗法 

分 类 号：R681.531[医药卫生—骨科学] R274[医药卫生—外科学]