椎针力敏穴治疗神经根、椎动脉混合型颈椎病的临床疗效观察  

Clinical Observation of Mallet-needle Manipulation at Limin Point for the Treatment of Cervical Spondylosis of Radiculopathy and Vertebral Artery Mixed Type

作　　者：叶文国 杨易 洪恩四[1] 胡秀武[3] 唐淑静 邓玲[1] 程紫良 黄长军[1] YE Wen-Guo;YANG Yi;HONG En-Si;HU Xiu-Wu;TANG Shu-Jing;DENG Ling;CHENG Zi-Liang;HUANG Chang-Jun(The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006 Jiangxi,China;Graduate School of Jiangxi University of Chinese Medicine,Nanchang 330004 Jiangxi,China;Hongdu Hospital of Traditional Chinese Medicine,Nanchang 330013 Jiangxi,China;Guangxin District Traditional Chinese Medicine Hospital,Shangrao 334116 Jiangxi,China)

机构地区：[1]江西中医药大学附属医院,江西南昌330006 [2]江西中医药大学研究生院,江西南昌330004 [3]江西省南昌市洪都中医院,江西南昌330013 [4]江西省上饶市广信区中医院,江西上饶334116

出　　处：《广州中医药大学学报》2023年第3期630-635,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81660817);江西省科技厅重点研发项目(编号:20192BBGL70038);江西省中医区域优势病种(中风病—脑梗死)防治中心建设项目(编号:YWB2021120703);江西省中医药管理局临床研究基地(第二批)建设项目(编号:2021ZGJ05)。

摘　　要：【目的】探讨椎针力敏穴治疗神经根、椎动脉混合型颈椎病的临床疗效。【方法】将120例神经根、椎动脉混合型颈椎病患者随机分为试验组和对照组,每组各60例。试验组给予椎针力敏穴治疗,对照组给予常规针刺联合推拿治疗,每日1次,10次为1个疗程,共治疗1个疗程。观察2组患者治疗前后颈痛量表评分、 McGill疼痛量表(MPQ)评分[包括疼痛分级指数(PRI)的感觉项、情感项评分和视觉模拟量表(VAS)评分]以及血流动力学相关指标的变化情况,并评价2组患者的临床疗效。【结果】(1)经过1个疗程治疗后,试验组的总有效率为91.67%(55/60),对照组为75.00%(45/60),组间比较,试验组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的颈痛量表评分均较治疗前明显降低(P<0.05),且试验组的降低幅度明显优于对照组(P<0.05)。(3)治疗后,2组患者MPQ量表的PRI感觉项、 PRI情感项评分和VAS评分均较治疗前明显降低(P<0.05);组间比较,试验组在PRI感觉项评分方面的降低幅度明显优于对照组(P<0.05),而在改善PRI情感项、VAS评分方面,试验组和对照组无显著性差异(P>0.05)。(4)经颅多普勒检查结果显示,治疗后,2组患者的左、右椎动脉(LVA、RVA)及基底动脉(BA)的收缩峰血流速度(Vp)、舒张末血流速度(Vd)、平均血流速度(Vm)等血流动力学指标均较治疗前明显改善(P<0.05),且试验组的改善幅度均明显优于对照组(P<0.05)。【结论】椎针力敏穴治疗神经根、椎动脉混合型颈椎病疗效确切,相较常规针刺联合推拿治疗,椎针力敏穴能更有效缓解患者颈部疼痛和上肢麻木情况,改善血流动力学指标,提高患者生活质量。Objective To investigate the clinical efficacy of mallet-needle manipulation at Limin point for the treatment of cervical spondylosis of radiculopathy and vertebral artery mixed type. Methods One hundred and twenty patients with cervical spondylosis of radiculopathy and vertebral artery mixed type were randomly divided into the trial group and the control group,with 60 cases in each group. The trial group was treated with malletneedle manipulation at the Limin point, while the control group was treated with conventional acupuncture combined with massage therapy. Ten times constituted a course of treatment and both groups were treated once daily for one course of treatment. The changes in neck pain scale scores, McGill Pain Questionnaire(MPQ) scores including the scores of pain rating index sensory qualities(PRI-S),pain rating index affective qualities(PRI-A) and visual analogue scale(VAS),and hemodynamic parameters before and after treatment in the two groups were observed. Meanwhile,the clinical efficacy of the two groups was also evaluated. Results(1)After one course of treatment,the overall effective rate of the trial group was 91.67%(55/60)and that of the control group was 75.00%(45/60),and the intergroup comparison showed that the efficacy of the trial group was significantly superior to that of the control group(P<0.05).(2)After treatment,the neck pain scale scores of both groups were significantly decreased compared with those before treatment(P<0.05), and the reduction degree in the trial group was significantly superior to that in the control group(P<0.05).(3)After treatment, the PRI-S scores, PRI-A scores and VAS scores of the MPQ scale in the two groups were significantly decreased compared with those before treatment(P<0.05). The intergroup comparison showed that the reduction degree of PRI-S scores in the trial group was significantly superior to that in the control group(P<0.05),but no significant differences of PRI-A scores and VAS scores were present between the trial group and the control group(P

关 键 词：椎针力敏穴 混合型颈椎病 颈痛量表评分 McGill疼痛量表评分 血流动力学 

分 类 号：R681.5*5[医药卫生—骨科学]