短刺夹脊穴配合芒针治疗神经根型颈椎病的随机临床对照试验  

Randomized Clinical Trial of Near-to-Bone Needling Jiaji Points Combined with Elongated Needling in Treating CSR

作　　者：王永亮[1] 吴建丽[1] 公维志[1] 史文强[1] 李岳峰 梁峰[1] 吴咚咚[1] WANG Yongliang;WU Jianli;GONG Weizhi;SHI Wenqiang;LI Yuefeng;LIANG Feng;WU Dongdong(Heilongjiang University of Chinese Medicine, Harbin 150040, China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《针灸临床杂志》2021年第8期43-48,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：黑龙江省自然科学基金,编号:YQ2020H029。

摘　　要：目的:观察短刺夹脊穴配合芒针治疗神经根型颈椎病的的临床疗效及对血清炎性因子的影响。方法:将60例患者随机分为对照组30例、试验组30例。对照组在基础治疗基础上,予以传统针刺干预;试验组在基础治疗的基础上,予以短刺夹脊穴配合芒针干预。两组均每日治疗1次,每周6 d,疗程为2周,3个月后进行随访。分别于治疗前后观察两组视觉模拟疼痛量表(VAS)、上肢功能评分量表及血清白介素-1β(IL-1β)、白介素-6(IL-6)和肿瘤坏死因子(TNF-α)的水平变化,对比临床疗效差异,并对3个月后复发率进行比较分析。结果:治疗后两组患者VAS评分均较治疗前明显降低,差异具有统计学意义(P<0.01),且试验组优于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者上肢功能评分较治疗前水平显著增高,差异具有统计学意义(P<0.01),且试验组优于对照组,差异具有统计学意义(P<0.05)。治疗后两组血清炎性因子IL-1β、IL-6和TNF-α的含量均较治疗前下降,差异具有统计学意义(P<0.05),且试验组低于对照组,差异具有统计学意义(P<0.05)。疗效评定方面,对照组总有效率为80.0%(24/30),试验组总有效率为96.7%(29/30),差异有统计学意义(P<0.05)。疾病复发方面,试验组症状复发率为10.3%(3/29),明显低于对照组的41.7%(10/24),差异具有统计学意义(P<0.01)。结论:短刺夹脊穴配合芒针治疗神经根型颈椎病可有效缓解颈椎疼痛程度,改善上肢功能状态,其临床疗效明显优于传统针刺治疗,其机制可能与降低血清IL-1β、IL-6和TNF-α等炎性因子水平有关。Objective:To observe the clinical effect of near-to-bone needling Jiaji points combined with elongated needling in the treatment of cervical spondylotic radiculopathy(CSR)and to investigate its influence to serum inflammatory factors.Methods:60 patients were randomly divided into the control group(n=30)and the study group(n=30).The control group was given traditional acupuncture intervention on the basis of basic treatment;on which basis,the study group was also treated with near-to-bone needling Jiaji points combined with elongated needling.Both groups were treated once a day,6 days a week for 2 weeks,and were followed up 3 months later.The scores of Visual Analogue Scale(VAS)and upper limb function scale,as well as the serum levels of interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor(TNF-α)were observed before and after the treatment in the two groups.The clinical efficacy and the recurrence rate after 3 months were compared between the two groups.Results:The VAS scores were significantly decreased after the treatment compared to those before the treatment in the two groups(P<0.01),and the decreases in the study group were more significant(P<0.05).The scores of upper limb function were significantly increased after the treatment compared to those before the treatment in the two groups(P<0.01),and the increases in the study group were more significant(P<0.05).The serum inflammatory factors of IL-1β,IL-6 and TNF-αwere significantly decreased after the treatment compared to those before the treatment in the two groups(P<0.05),and the decreases in the study group were more significant(P<0.05).The total effective rate of the study group was 96.7%(29/30),which was significantly higher than 80.0%(24/30)of the control group(P<0.05).The recurrence rate of the study group was 10.3%(3/29),which was significantly lower than 41.7%(10/24)of the control group(P<0.01).Conclusion:Near-to-bone needling Jiaji points combined with elongated needling can effectively relieve the degree of cervical pain and impr

关 键 词：短刺 夹脊穴 芒针 神经根型颈椎病 

分 类 号：R246.2[医药卫生—针灸推拿学]