针刺“五输穴”联用黄芪桂枝五物汤加减治疗神经根型颈椎病疗效研究  

Therapeutic effect and mechanism of acupuncture on“Wushu points”combined with Huangqi Guizhi Wuwu decoction in the treatment of cervical radiculopathy

作　　者：周燕飞[1] 孔文良[1] 杨晓媛 何飞[1] ZHOU Yanfei;KONG Wenliang;YANG Xiaoyuan;HE Fei(Department of Acupuncture and Massage,Jiangyin Hospital of Traditional Chinese Medicine,Jiangyin 214400,China)

机构地区：[1]江阴市中医院针灸推拿科,江苏江阴214400

出　　处：《陕西中医》2022年第10期1463-1466,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：江苏省无锡市中医药管理局科技项目(ZYKJ202127)。

摘　　要：目的:观察针刺“五输穴”联用黄芪桂枝五物汤加减治疗神经根型颈椎病(CSR)的临床疗效。方法:将100例CSR患者按照随机数字表法均分为对照组和观察组。对照组采用活血止痛软胶囊联合针刺“五输穴”治疗,观察组采用黄芪桂枝五物汤加减联合针刺“五输穴”治疗。比较两组颈椎功能、血流动力学、Mc Gill疼痛问卷评分、血清因子、疗效及安全性。结果:治疗前,两组患者颈椎功能比较差异无统计学意义(P>0.05);治疗后,两组患者颈椎活动度、颈椎曲度均上升,且观察组CSR患者颈椎功能优于对照组(P<0.05)。治疗前,两组患者血清因子、椎-基底动脉血流动力学比较差异无统计学意义(P>0.05);治疗后,两组患者白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、IgG、IgM及椎-基底动脉阻力指数(RI)均下降,而椎-基底动脉收缩期峰值流速(Vs)、峰值平均血流速度则上升(Vm),且观察组血清因子及椎-基底动脉RI低于对照组,而椎-基底动脉Vs、Vm高于对照组(P<0.05)。治疗前,两组患者Mc Gill疼痛问卷评分比较差异无统计学意义(P>0.05);治疗后,两组患者Mc Gill总分及其涵盖的疼痛分级评分(PRI)、目测类比(VAS)、现有疼痛强度(PPI)评分均下降,且观察组患者整体Mc Gill评分低于对照组(P<0.05)。观察组患者总有效率为92.00%,高于对照组的76.00%,差异有统计学意义(P<0.05)。两组不良反应率比较差异无统计学意义(P>0.05)。结论:针刺“五输穴”联用黄芪桂枝五物汤加减治疗CSR可减轻患者疼痛,改善颈椎功能,疗效较好。Objective:To observe the curative effect of acupuncture at“Wushu points”combined with Huangqi Guizhi Wuwu decoction in the treatment of cervical radiculopathy(CSR).Methods:100 CSR patients were divided into control group and observation group by random number table method.The control group was treated with Huoxue Zhitong soft capsule combined with acupuncture at“Wushu points”,while the observation group was treated with modified Huangqi Guizhi Wuwu decoction combined with acupuncture at“Wushu points”.The cervical spine function,hemodynamics,Mc Gill pain questionnaire scores,serum factors,efficacy and safety were compared between the two groups.Results:Before treatment,there was no difference in cervical spine function between the two groups of CSR patients(P>0.05).After treatment,the cervical spine activity and curvature of the CSR patients in the two groups increased,and the cervical spine function of the CSR patients in the observation group was better than that in the control group(P<0.05).Before treatment,there was no difference in serum factors and vertebral-basilar artery hemodynamics between the two groups of CSR patients(P>0.05).IL-6,TNF-α,IgG,IgM and vertebrobasilar resistance index(RI)all decreased,while vertebrobasilar systolic peak velocity(Vs)and peak mean blood flow velocity(Vm)increased.The serum factors and vertebrobasilar artery RI in the group were lower than those in the control group,while the vertebral-basilar artery Vs and Vm were higher than those in the control group(P<0.05).Before treatment,there was no difference in the McGill pain questionnaire scores between the two groups of CSR patients(P>0.05).Pain intensity(PPI)scores decreased,and the overall Mc Gill score of CSR patients in the observation group was lower than that in the control group(P<0.05).The total effective rate of CSR patients in the observation group was 92.00%,which was higher than that in the control group 76.00%,and the difference was statistically significant(P<0.05).There was no difference in the adverse

关 键 词：神经根型颈椎病 针刺 五输穴 黄芪桂枝五物汤 颈椎功能 

分 类 号：R658.53[医药卫生—外科学]