加味二仙汤联合电针刺激治疗神经根型颈椎病的临床疗效及机制  

Clinical effects and mechanism of the Modified Erxian Decoction plus electroacupuncture in the treatment of cervical spondylotic radiculopathy

作　　者：闫康 黄汝芹 李爽 王银歌 乔欢欢 李二亮 胥云 赵宁侠 廖博 YAN Kang;HUANG Ruqin;LI Shuang;WANG Yin'ge;QIAO Huanhuan;LI Erliang;XU Yun;ZHAO Ningxia;LIAO Bo(The Second Affiliated Hospital,Air Force Military Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院,西安710038

出　　处：《中华中医药杂志》2023年第8期3935-3939,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81372045);陕西省创新能力支撑计划-创新人才推进计划-科技创新团队(No.2021TD-45);空军军医大学科技发展基金资助项目(No.2019XB039);空军军医大学第二附属医院临床研究项目重大项目(No.2021LCYJ014)。

摘　　要：目的:探讨加味二仙汤联合电针刺激治疗神经根型颈椎病的临床疗效及其作用机制。方法:选取92例神经根型颈椎病患者,随机分为对照组和观察组,每组46例。对照组给予基础治疗及西医药物治疗;观察组在基础治疗基础上给予加味二仙汤联合电针刺激治疗。治疗前及治疗后1个月,观察临床疗效(有效率)、视觉模拟量表(VAS)评分、Northwick Park颈痛量表(NPQ)评分、颈椎活动度(CROM)评分、颈椎病临床评价量表(CASCS)评分、36项生活质量调查问卷(SF-36)评分、不良反应发生率等指标;检测治疗前后关键肌肉表面肌电信号中位频率;并分析治疗前后血清炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β及IL-6]表达水平。结果:治疗后,观察组临床疗效、临床症状及功能评分显著优于对照组(P<0.05)。与对照组比较,观察组治疗过程中不良反应发生率更低,但差异无统计学意义;观察组患者治疗后肌肉表面肌电信号中位频率显著升高(P<0.05);观察组治疗后患者血清中炎症因子TNF-α、IL-1β及IL-6水平显著降低(P<0.05)。结论:与传统西医药物治疗比较,加味二仙汤联合电针刺激治疗神经根型颈椎病临床疗效更好,可能具有更低的药物相关并发症发生率,该治疗方案的作用机制可能与降低相关肌肉的损伤和疲劳程度、减轻机体炎症反应,改善神经根炎症刺激以及提高其痛觉阈值等有关。Objective:To study the clinical efficacy and mechanism of Modified Erxian Decoction plus electroacupuncture in the treatment of cervical spondylotic radiculopathy.Methods:A total of 92 patients with radiculopathy of cervical spondylosis were selected as the study objects,and the patients were randomly divided into the control group and the observation group,with 46 cases in each group.The control group was given basic treatment with western medicine,and the observation group was given the Modified Erxian Decoction combined with electroacupuncture based on the basic treatment.1 month before and after treatments,the clinical efficacy(effective rate),visual analogue scale(VAS)score,Northwick Park neck pain questionnaire(NPQ)score,cervical range of motion(CROM)score,clinical evaluation scale for cervical spondylosis(CASCS)score,36-item short-form health survey(SF-36)scores,and adverse reaction rate of the two groups were observed.The median frequency of muscle surface electromyography signals and expression of serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin(IL)-iβand IL-6]were analyzed before and after treatments.Results:After treatment,the clinical efficacy,clinical symptoms,and function score in the observation group is significantly higher than the that in the control group(P<0.05).Although the adverse reaction rate in observation group was lower than that of the control group,the small sample size of the study was underpowered to show statistical difference between groups.After treatment,the media frequency of muscle surface electromyography signals in the observation group is significantly higher than that in the control group(P<0.05).After treatment,the level of the serum inflammatory factors TNF-α,IL-1βand IL-6 was significantly lower than that in the control group(P<0.05).Conclusion:In comparison with the traditional western medicines,Modified Erxian Decoction combined with electroacupuncture in the treatment of cervical spondylotic radiculopathy has better clinical efficacy with a

关 键 词：神经根型颈椎病 加味二仙汤 电针 炎症因子 肌肉表面肌电信号中位频率 

分 类 号：R274.9[医药卫生—中西医结合]