中医综合疗法联合颈前路零切迹椎间融合手术治疗神经根型颈椎病的临床研究  

Clinical research of traditional Chinese medicine comprehensive therapy combined with minimally invasive anterior cervical Zero profile intervertebral fusion system for cervical spondylotic radiculopathy

作　　者：陈思思[1] 刘沛[1] 石晨[1,2] 杨英[1,2] CHEN Sisi;LIU Pei;SHI Chen;YANG Ying(Medical Examination Center,Wuhan No.1 Hospital,Wuhan,Hubei 430022;不详)

机构地区：[1]湖北省武汉市第一医院体检中心,湖北武汉430022 [2]湖北省武汉市第一医院骨外科,湖北武汉430022

出　　处：《河北中医》2021年第12期2017-2021,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：2017年、2018年全国名老中医药专家传承工作室建设项目(国中医药人教函〔2018〕134号)。

摘　　要：目的观察中医综合疗法联合微创颈前路零切迹椎间融合(Zero-P)手术治疗神经根型颈椎病的临床疗效。方法将119例神经根型颈椎病患者按照随机数字表法分为2组,对照组59例予微创Zero-P手术治疗,治疗组60例在对照组基础上加用中医综合疗法(中药口服+按摩+中药贴敷)治疗。2组均治疗3个月后统计疗效,比较2组治疗前、治疗3 d、治疗3个月疼痛视觉模拟评分(VAS)法、颈椎日本骨科协会评估治疗(JOA)评分变化情况,比较2组治疗前后患椎椎间隙高度、矢状面Cobb角变化情况。结果治疗组优良率96.7%(58/60),对照组优良率81.4%(48/59),治疗组优良率高于对照组(P<0.05)。与本组治疗前比较,2组治疗3 d、治疗3个月疼痛VAS均降低(P<0.05),颈椎JOA评分均升高(P<0.05),且治疗组治疗3 d、治疗3个月疼痛VAS、颈椎JOA评分改善均优于对照组治疗后同期水平。与本组治疗前比较,2组治疗3 d、治疗3个月患椎椎间隙高度均增加(P<0.05),矢状面Cobb角均减小(P<0.05),但2组治疗3 d、治疗3个月组间同期比较差异均无统计学意义(P>0.05)。结论中医综合疗法联合微创Zero-P手术治疗神经根型颈椎病疗效确切,可明显缓解患者疼痛症状,提高颈椎功能,有效促进患者术后康复,是一种相对安全、高效的中西结合方法。Objective To observe the clinical efficacy of traditional Chinese medicine(TCM)comprehensive therapy combined with minimally invasive anterior cervical Zero profile intervertebral fusion system(Zero-P)for cervical spondylotic radiculopathy(CSR).Methods Totally 119 patients with CSR were randomly assigned into treatment group(n=60)and control group(n=59),patients in treatment group received minimally invasive Zero-P combined with TCM comprehensive therapy(oral medicine+massage+herbal plaster),while patients in control group only received minimally invasive Zero-P.The treatment period was 3 months,aiming to compare visual analogue scale(VAS)for pain,Japanese Orthopaedic Association(JOA)score,intervertebral space height(ISH),sagittal Cobb angle on days 0,3 and month 3;the curative effect was counted.Results The superior rate was 96.7%(58/60)in treatment group,higher than that of 81.4%(48/59)in control group(P<0.05).On the day 3 and month 3,VAS for pain in groups was decreased(P<0.05),JOA score was increased(P<0.05),improvement of VAS and JOA score in treatment group were better compared with concurrent treatment group(P<0.05);ISH in groups was increased(P<0.05),sagittal Cobb angle was decreased(P<0.05),there were no significant differences between groups in the concurrent comparison(P>0.05).Conclusion For patients with CSR,therapy of integrated medicine(TCM comprehensive therapy combined with minimally invasive Zero-P)has a definite curative effect,which is significantly capable of relieving pain symptoms and improving cervical function,promoting postoperative rehabilitation,with safety and efficiency.

关 键 词：颈椎病 神经根病 中西医结合疗法 

分 类 号：R274.9[医药卫生—中西医结合] R681.531[医药卫生—中医骨伤科学]