温阳通督针法联合羌活胜湿汤与牵引治疗神经根型颈椎病风寒痹阻证临床研究  

Clinical Study on Wenyang Tongdu Acupuncture Method Combined with Qianghuo Shengshi Decoction and Traction for Cervical Spondylotic Radiculopathy with Wind-Cold Obstruction Syndrome

作　　者：张文合 席玉洁 何浩 ZHANG Wenhe;XI Yujie;HE Hao

机构地区：[1]开封市中医院,河南开封475000 [2]联勤保障部队第九八八医院开封医疗区,河南开封475003 [3]开封市人民医院,河南开封475000

出　　处：《新中医》2023年第2期132-138,共7页New Chinese Medicine

摘　　要：目的:观察温阳通督针法联合羌活胜湿汤加减方内服与牵引治疗神经根型颈椎病(CSR)风寒痹阻证的临床疗效。方法:选择110例CSR风寒痹阻证患者作为研究对象,运用随机数字表法分成观察组与对照组各55例。2组患者均予牵引治疗,对照组以羌活胜湿汤加减方内服治疗,观察组予羌活胜湿汤加减方内服联合温阳通督针法治疗。2组均治疗2周。治疗前后采用颈椎日本骨科协会(JOA)评分和颈椎病临床评价量表(CASCS)评价患者的颈椎功能状况,使用简化McGill疼痛问卷(SF-MPQ)评价疼痛程度,测量颈椎生理曲度与颈椎活动度,测定上肢体感诱发电位(SEP),检测血清白细胞介素(IL)-1β、内皮素-1(ET-1)、P物质(SP)水平。评价2组临床疗效,统计2组的不良反应发生情况。结果:治疗2周,观察组临床疗效总有效率98.18%,对照组总有效率85.45%,2组比较,差异有统计学意义(P<0.05)。2组颈椎JOA评分、CASCS评分均较治疗前升高(P<0.01),SF-MPQ评分均较治疗前降低(P<0.01);观察组颈椎JOA评分、CASCS评分均高于对照组(P<0.01),SF-MPQ评分低于对照组(P<0.01)。2组颈椎曲度、颈椎活动度均较治疗前增加(P<0.01);观察组颈椎曲度、颈椎活动度均大于对照组(P<0.01)。结论:温阳通督针法联合羌活胜湿汤加减方内服与牵引治疗CSR风寒痹阻证能更有效地抑制患者体内的炎症反应,促进局部血液循环,改善神经传导,从而增加颈椎曲度与活动度,改善颈椎功能,加快症状缓解,且安全性较好。Objective:To observe the clinical effect of Wenyang Tongdu acupuncture method combined with oral administration of modified Qianghuo Shengshi Decoction and traction for cervical spondylotic radiculopathy(CSR)with wind-cold obstruction syndrome.Methods:A total of 110 cases of CSR patients with wind-cold obstruction syndrome were selected as the study subjects and divided into the observation group and the control group according to the random number table method,with 55 cases in each group.Both groups were treated with traction;the control group was treated with oral administration of modified Qianghuo Shengshi Decoction,and the observation group was treated with oral administration of modified Qianghuo Shengshi Decoction combined with Wenyang Tongdu acupuncture method.Both groups were treated for 2 weeks.Before and after treatment,cervical spine function was evaluated by Japanese Orthopaedic Association(JOA)and Clinical Assessment Scale for Cervical Spondylosis(CASCS),the pain degree was evaluated by the Short-Form McGill Pain Questionnaire(SF-MPQ),the cervical physiological curvature and cervical range of motion were detected,upper-limb somatosensory evoked potential(SEP)was measured,and levels of interleukin-1β(IL-1β),endothelin-1(ET-1)and substance P(SP)in serum were detected.The clinical effects in the two groups were evaluated.The incidence of adverse reactions in the two groups was counted.Results:After two-week treatment,the total effective rate was 98.18% in the observation group and 85.45% in the control group,the difference being significant(P<0.05).The scores of JOA in cervical vertebrae and CASCS in the two groups were increased when compared with those before treatment(P<0.01),SF-MPQ scores were decreased(P<0.01);the scores of JOA in cervical vertebrae and CASCS in the observation group were higher than those in the control group(P<0.01),and SF-MPQ score was lower(P<0.01).The cervical physiological curvature and cervical range of motion in the two groups were increased when compared with those befo

关 键 词：神经根型颈椎病 风寒痹阻证 温阳通督针法 羌活胜湿汤 颈椎曲度 上肢体感诱发电位 

分 类 号：R274.9[医药卫生—中西医结合]