温通针法联合桂枝附子汤治疗风寒湿型神经根型颈椎病43例临床观察  

Clinical Observation of 43 Cases of Wind-cold-damp Cervical Spondylotic Radiculopathy Treated by Warming-dredging Acupuncture and Guizhi Fuzi Tang(桂枝附子汤)

作　　者：张曼 ZHANG Man

机构地区：[1]开封市中医院,河南开封475000

出　　处：《风湿病与关节炎》2022年第10期24-27,共4页Rheumatism and Arthritis

摘　　要：目的:观察温通针法联合桂枝附子汤治疗风寒湿型神经根型颈椎病的疗效及对疼痛、症状体征的影响。方法:将86例风寒湿型神经根型颈椎病患者按照随机数字表法分为治疗组和对照组,每组43例。对照组患者给予桂枝附子汤治疗,治疗组给予温通针法联合桂枝附子汤治疗。2组疗程均为1个月。观察2组临床疗效,以及治疗前后白三烯B4(LTB4)、脂质过氧化物(LPO)、β内啡肽因子、白细胞介素-1β(IL-1β)水平,采用现时疼痛强度评分(PPI)评价2组患者疼痛情况,采用颈椎病临床评价量表(CASCS)评价2组患者临床症状、体征及生活质量。结果:治疗组显效31例,有效11例,无效1例,总有效率为96.67%;对照组显效20例,有效15例,无效8例,总有效率为81.40%。2组比较,差异有统计学意义(P<0.05)。治疗后,2组IL-1β、LPO、LTB4、β内啡肽因子水平,以及PPI评分、CASCS评分较治疗前均有改善(P<0.05),且治疗组优于对照组(P<0.05)。结论:温通针法联合桂枝附子汤治疗风寒湿型神经根型颈椎病患者,可提高临床疗效,抑制患者炎症状态,调节LTB4水平,调节氧自由基代谢紊乱,升高患者β内啡肽因子水平,缓解疼痛,改善临床症状、体征及生活质量。Objective:To observe the therapeutic effect of warming-dredging acupuncture combined with Guizhi Fuzi Tang(桂枝附子汤)on wind-cold-damp cervical spondylotic radiculopathy,and its effect on pain,symptoms and signs.Methods:Eighty-six cases of wind-cold-damp cervical spondylotic radiculopathy were randomly divided into a treatment group and a control group,43 cases in each group.The patients in the control group were treated with Guizhi Fuzi Tang,while those in the treatment group were treated with warming-dredging acupuncture combined with Guizhi Fuzi Tang.The course of treatment was one month for both groups.The clinical effects of the two groups were observed,as well as the leukotriene B4(LTB4),lipid peroxide(LPO),βendorphin factor,and IL-1β.The PPI was used to evaluate the pain situation of the patients in the two groups,and the clinical symptoms,signs and quality of life of the patients in both groups were evaluated with CASCS.Results:In the treatment group,31 cases were markedly effective,11 cases were effective,1 case was ineffective,and the total effective rate was 96.67%;In the control group,20 cases were markedly effective,15 cases were effective,8 cases were ineffective,and the total effective rate was 81.40%.The difference between the two groups was statistically significant(P<0.05).After treatment,the levels of IL-1β,LPO,LTB4 andβendorphin factor,as well as PPI score and CASCS score in both groups were improved compared with those before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).Conclusion:The combination of warming-dredging acupuncture and Guizhi Fuzi Tang can improve the clinical efficacy,inhibit the inflammatory state,regulate the level of LTB4,regulate the metabolic disorder of oxygen free radicals,increase the level of endorphin factor,relieve pain,and improve clinical symptoms,signs and quality of life of patients with wind-cold-damp cervical spondylotic radiculopathy.

关 键 词：神经根型颈椎病 风寒湿型 温通针法 桂枝附子汤 临床疗效 

分 类 号：R274.9[医药卫生—中西医结合]