针刺、推拿手法治疗神经根型颈椎病研究进展  

Research Progress of Treating Cervical Spondylosis of Nerve Root Type with Acupuncture and Massage

作　　者：郭建萍 GUO Jian-ping(Tianjin Hongqiao District Hospital of Traditional Chinese Medicine,Tianjin,China,300131)

机构地区：[1]天津市红桥区中医医院,天津300131

出　　处：《河南中医》2023年第1期141-145,共5页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局中医药循证建设项目(2019XZZX-GK006)。

摘　　要：针刺治疗颈椎病的机制研究多以椎动脉型为主,重点在于神经电生理以及血液循环等方面,在神经根型颈椎病、颈型颈椎病等方面的探索相对较少,分子基因学研究有所欠缺,颈椎病的不同辨证分型缺少大量数据加以论证。神经根型颈椎病的常用针刺方法有电针、毫针、浮针,常用推拿手法有理筋手法、整骨手法、理筋结合整骨手法。针刺治疗神经根型颈椎病时,穴位的选择可能存在一定程度主观性,这也是针刺治疗安全性的潜在隐患。故临床应用针刺治疗神经根型颈椎病时,应考虑到颈椎病的分型、各穴位的功效、患者个人因素差异等,实施个性化治疗。在多样本、多指标基础上尽可能减小取穴误差,提升针刺安全性。相较于针刺操作而言,推拿更容易让患者接受。采用针刺配合推拿手法治疗时需注意推拿手法的科学性,当前不少推拿手法操作取决于医者的操作习惯以及个人经验,在客观比较与科学分析方面相对不足。临床应用推拿治疗时应进一步对治疗的禁忌证及适应症加以规范,避免不当推拿造成神经功能受到负性影响。The mechanism research of acupuncture treatment of cervical spondylosis is mainly based on vertebral artery type, focusing on the aspects of nerve electrophysiology and blood circulation, etc.The exploration of nerve root type cervical spondylosis, cervical spondylosis of cervical type and other aspects is relatively small, there is lack of molecular genetics research, and the different syndrome differentiation types of cervical spondylosis are lack of a large number of data to demonstrate.The commonly used acupuncture methods for cervical spondylosis of nerve root type include electroacupuncture, acupuncture with filiform needle, and superficial needling.The commonly used massage techniques include tendon-regulating, osteopathic manipulation, combination of tendon-regulating technique and osteopathic manipulation.When acupuncture is used to treat cervical spondylosis of nerve root type, the selection of acupoints may be subjective to a certain extent, which is also a potential hidden danger in the safety of acupuncture treatment.Therefore, in clinical practice, it is necessary to take into account the classification of cervical spondylosis, the efficacy of various acupoints, and the differences of patients′ personal factors, and implement personalized treatment.On the basis of multiple samples and indicators, the error of acupoint selection should be minimized to improve the safety of acupuncture.Compared with acupuncture operation, massage is easier for patients to accept.It is necessary to pay attention to the scientificity of massage manipulation when using acupuncture combined with massage manipulation.At present, many massage manipulations depend on the doctors′ operating habits and personal experience, and are relatively insufficient in objective comparison and scientific analysis.That′s why the contraindications and indications of clinical application of massage should be further standardized to avoid negative effects on neural function caused by improper massage.

关 键 词：神经根型颈椎病 针刺疗法 电针 毫针 浮针 推拿手法 理筋手法 整骨手法 理筋结合整骨手法 

分 类 号：R274.981.55[医药卫生—中西医结合]