“肌骨同治”学术思想指导神经根型颈椎病治疗的临床观察  

Clinical Observation on the Treatment of Cervical Spondylotic Radiculopathy Guided by the Academic Thought of Musculoskeletal Co-treatment

作　　者：陈伟健[1] 陈泽华 许学猛[1,2] 杜建平[2] CHEN Wei-Jian;CHEN Ze-Hua;XU Xue-Meng;DU Jian-Ping(The Fifth Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China)

机构地区：[1]广州中医药大学第五临床医学院,广东广州510405 [2]广东省第二中医院,广东广州510095

出　　处：《广州中医药大学学报》2021年第11期2353-2359,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科技计划项目(编号:2021B1111610007);广东省软科学研究计划项目(编号:2018B020207009);广东省自然科学基金项目(编号:2021A1515011545)。

摘　　要：【目的】观察"肌骨同治"学术思想指导治疗肝肾不足型神经根型颈椎病的临床疗效。【方法】将68例肝肾不足型神经根型颈椎病患者随机分为观察组和对照组,每组各34例。观察组给予"肌骨同治"学术思想指导下行"三位动正"整脊手法、小针刀疗法、功能锻炼和口服补肾强筋胶囊治疗,对照组给予小针刀疗法联合口服塞来昔布胶囊治疗,疗程为6周。分别于治疗前和治疗6周后用MyotonPRO手持便携肌肉性能测量仪测量2组患者的胸锁乳突肌及上斜方肌的肌肉张力和硬度,并观察2组患者治疗前后疼痛视觉模拟量表(VAS)评分、Northwick Park颈痛量表(NPQ)评分的变化情况。【结果】(1)治疗6周后,2组患者的VAS评分和NPQ评分均较治疗前明显降低(P<0.01),且观察组对VAS评分和NPQ评分的降低作用均明显优于对照组,差异均有统计学意义(P<0.01)。(2)治疗6周后,观察组的胸锁乳突肌及上斜方肌的张力和硬度均较治疗前降低(P<0.05或P<0.01),而对照组的胸锁乳突肌及上斜方肌的张力和硬度治疗前后比较,差异均无统计学意义(P>0.05);组间比较,观察组对胸锁乳突肌及上斜方肌的张力和硬度的降低作用均明显优于对照组,差异均有统计学意义(P<0.01)。【结论】"肌骨同治"学术思想指导治疗肝肾不足型神经根型颈椎病临床疗效确切;"肌骨同治"学术思想对全面认识和诊治神经根型颈椎病具有较高理论指导及临床应用价值。Objective To observe the clinical effect of comprehensive therapy guided by the academic thought of musculoskeletal co-treatment in treating cervical spondylotic radiculopathy with liver and kidney insufficiency syndrome. Methods Sixty-eight patients of cervical spondylotic radiculopathy with liver and kidney insufficiency syndrome were randomly divided into observation group and control group, 34 cases in each group. The observation group was treated with the three-pronged movement chiropractic manipulations,acupotomy,functional exercises and oral use of Bushen Qiangjin Capsules under the guidance of academic thought of musculoskeletal cotreatment,while the control group was treated with acupotomy combined with oral use of Celecoxib Capsules. The course of treatment for the two groups lasted 6 weeks. The muscle tension and hardness of sternocleidomastoid muscle and superior trapezius muscle were measured by MyotonPRO portable instrument for measuring muscle performance before treatment and after 6 weeks of treatment. The visual analogue scale(VAS)pain scores and Northwick Park Questionnaire(NPQ)scores for neck pain were observed before and after treatment. Results(1)After 6 weeks of treatment,the VAS scores and NPQ scores of the two groups were significantly lower than those before treatment(P < 0.01),and the effect on decreasing the VAS scores and NPQ scores in the observation group was significantly superior to that in the control group,the difference being statistically significant(P < 0.01).(2)After 6 weeks of treatment, the tension and hardness of sternocleidomastoid muscle and superior trapezius muscle in the observation group were decreased compared with those before treatment(P < 0.05 or P < 0.01),while there was no statistical significance in the control group before and after treatment(P > 0.05). The intergroup comparison showed that the effect on decreasing tension and hardness of the sternocleidomastoid muscle and superior trapezius muscle in the observation group was significantly superior to that i

关 键 词：肌骨同治 神经根型颈椎病 肝肾不足型 整脊手法 小针刀疗法 补肾强筋胶囊 

分 类 号：R274.9[医药卫生—中西医结合] R681.55[医药卫生—中医骨伤科学]