羌活胜湿汤加减联合臭氧注射、射频热凝靶点穿刺术治疗神经根型颈椎病风寒痹阻型临床观察  

Modified Qianghuo Shengshitang Combined with Ozone Injection and Radiofrequency Thermocoagulation Target Puncture in Treatment of Cervical Spondylotic Radiculopathy with Wind-cold Blockage Type

作　　者：张攀 王勤俭 徐冬康 姜幸福 李泊泊 ZHANG Pan;WANG Qinjian;XU Dongkang;JIANG Xingfu;LI Bobo(Henan Province Hospital of Traditional Chinese Medicine/Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450002,China)

机构地区：[1]河南省中医院/河南中医药大学第二附属医院,郑州450002

出　　处：《中国实验方剂学杂志》2023年第1期91-96,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家中医临床研究基地科研专项(2019JDZX055);河南省中医药科学研究专项(20-21ZY2055,20-21ZY3017,2016ZY3015)。

摘　　要：目的:观察羌活胜湿汤加减联合臭氧注射、射频热凝靶点穿刺术治疗神经根型颈椎病(风寒痹阻型)的临床疗效。方法:选择2020年8月至2021年5月于河南省中医院治疗的68例神经根型颈椎病患者,以随机数字表法分组,34例患者为观察组,患者为对照组,对照组给予羌活胜湿汤安慰剂颗粒,同时予臭氧注射、射频热凝靶点穿刺术治疗,观察组给予羌活胜湿汤加减联合臭氧注射、射频热凝靶点穿刺术治疗,治疗前后检测两组患者肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、白细胞介素-2(IL-2)、白细胞介素-1β(IL-1β)、6-酮前列腺素E1α(6-keto-PGE1α)、血浆P物质(SP)、β内啡肽(β-EP)、脂质过氧化物(LPO)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平,给予患者疼痛视觉量表(VAS)、颈椎功能障碍指数量表(NDI)、颈椎病临床评价量表(CASCS)评价,观察临床疗效。结果:与本组治疗前比较,治疗后两组患者IL-1β、PCT、TNF-α水平降低,IL-2水平升高(P<0.05);治疗后与对照组比较,观察组IL-1β、PCT、TNF-α、IL-2改善更明显(P<0.05)。与本组治疗前比较,治疗后两组患者SOD水平升高,LPO、MDA水平降低(P<0.05);治疗后与对照组比较,观察组SOD、LPO、MDA改善更明显(P<0.05)。与本组治疗前比较,治疗后两组患者SP、6-keto-PGE1α水平降低,β-EP水平升高(P<0.05);治疗后与对照组比较,观察组SP、6-keto-PGE1α、β-EP改善更明显(P<0.05)。与本组治疗前比较,治疗后观察组VAS、NDI评分降低,CASCS评分升高(P<0.05);治疗后与对照组比较,观察组VAS、NDI、CASCS评分改善更明显(P<0.05)。治疗后,观察组患者总有效率高于对照组(Z=2.018,P<0.05)。结论:羌活胜湿汤加减联合臭氧注射、射频热凝靶点穿刺术治疗神经根型颈椎病(风寒痹阻型)患者,可抑制患者炎症,清除氧自由基,改善疼痛介质水平,缓解患者疼痛,提升颈椎功能及临床疗效。Objective:To observe the clinical efficacy of Qianghuo Shengshitang combined with ozone injection and radiofrequency thermocoagulation target puncture in the treatment of cervical spondylotic radiculopathy(wind-cold blockage type).Method:Sixty-eight patients with cervical spondylotic radiculopathy who were treated in Henan Province Hospital of Traditional Chinese Medicine from August 2020 to May 2021were included and grouped into a control group and a research group by random number table,with 34 patients in each group.The control group was administrated with placebo granules of Qianghuo Shengshitang,and treated with ozone injection and radiofrequency thermocoagulation target puncture at the same time.The research group was given modified Qianghuo Shengshitang combined with ozone injection and radiofrequency thermocoagulation target puncture.Before and after treatment,patients in two groups were tested for the levels of tumor necrosis factor-α(TNF-α),procalcitonin(PCT),interleukin-2(IL-2),interleukin-1β(IL-1β),6-ketoprostaglandin E1α(6-keto-PGE1α),plasma substance P(SP),β-endorphin(β-EP),lipid peroxide(LPO),malondialdehyde(MDA),and superoxide dismutase(SOD).The pain visual scale(VAS),cervical dysfunction index(NDI),and clinical evaluation scale for cervical spondylosis(CASCS)were given to patients to evaluate the clinical efficacy.Result:Compared with those before treatment,the levels of IL-1β,PCT,and TNF-αin two groups were decreased,and the level of IL-2 was increased(P<0.05).The improvement of IL-1β,PCT,TNF-α,and IL-2 was more obvious in the research group as compared with the control group(P<0.05).After treatment,the levels of SOD in two groups were increased,while the levels of LPO and MDA were decreased(P<0.05).After treatment,the improvement of SOD,LPO,and MDA was more obvious in the research group as compared with the control group(P<0.05).Compared with those before treatment,the levels of SP and 6-keto-PGE1αin two groups were decreased after treatment,and the level ofβ-EP was increased(P<0.

关 键 词：羌活胜湿汤加减 神经根型颈椎病 炎症 氧自由基 疼痛介质 颈椎功能 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学] R2-031R287