中药热奄包、针刺联合手法推拿对神经根型颈椎病患者血液流变学和颈椎活动度的影响  

Impact of Traditional Chinese Medicine Reyan Bag,Acupuncture Com⁃bined with Manipulation on Hemorheology and Cervical Motion in Patients with Cervical Spondylotic Radiculopathy

作　　者：范鹏 刘冬银 张学新 王雷[4] 刘伯辉 杨涛 王珊 赵家仪 郭凤红 FAN Peng;LIU Dongyin;ZHANG Xuexin;WANG Lei;LIU Bohui;YANG Tao;WANG Shan;ZHAO Jiayi;GUO Fenghong(Department of Rehabilitation,Qinhuangdao Hospital,Beijing University of Traditional Chinese Medicine/Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei 066000,China;Department of Intensive Medicine,Qinhuangdao Hospital,Beijing University of Traditional Chinese Medicine/Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei 066000,China;Department of Internal Medicine,Qinhuangdao Hospital,Beijing University of Traditional Chinese Medicine/Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei 066000,China;Department of Acupuncture and Moxibustion,Qinhuangdao Hospital,Beijing University of Traditional Chinese Medicine/Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei 066000,China;Department of Science and Education,Qinhuangdao Hospital,Beijing University of Traditional Chinese Medicine/Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei 066000,China)

机构地区：[1]北京中医药大学东方医院秦皇岛医院康复科(秦皇岛市中医医院),河北秦皇岛066000 [2]北京中医药大学东方医院秦皇岛医院重症医学科(秦皇岛市中医医院),河北秦皇岛066000 [3]北京中医药大学东方医院秦皇岛医院内科(秦皇岛市中医医院),河北秦皇岛066000 [4]北京中医药大学东方医院秦皇岛医院针灸科(秦皇岛市中医医院),河北秦皇岛066000 [5]北京中医药大学东方医院秦皇岛医院科教科(秦皇岛市中医医院),河北秦皇岛066000

出　　处：《临床误诊误治》2024年第14期90-94,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省中医药管理局科研计划项目(2020371);秦皇岛市科学技术局2019年市级科技计划自筹经费项目(201902A123)。

摘　　要：目的探究中药热奄包、针刺联合手法推拿治疗对神经根型颈椎病患者血液流变学和颈椎活动度的影响。方法选取2022年4月至2023年3月就诊的80例神经根型颈椎病患者,据随机数字表法分为观察组和对照组各40例,对照组予针刺联合手法推拿治疗,观察组在此基础上联合中药热奄包治疗,2组均治疗20 d。观察比较2组临床疗效,治疗前后视觉模拟评分法(VAS)评分、颈椎功能障碍指数(NDI)、颈椎病临床评价量表(CASCS)评分、颈椎活动度、血液流变学指标和血清炎性因子水平。结果治疗后,观察组总有效率为95.00%高于对照组的77.50%(P<0.05);治疗后,观察组VAS评分和NDI均显著低于对照组,CASCS评分显著高于对照组(P<0.05,P<001);治疗后,观察组颈椎前屈、后伸、左侧屈和右侧屈活动度均高于对照组(P<001);治疗后,观察组血浆黏度、全血低切黏度、全血高切黏度均显著低于对照组(P<001);治疗后,观察组血清白细胞介素-6、白细胞介素-8和肿瘤坏死因子-α水平均低于对照组(P<001)。结论中药热奄包、针刺联合手法推拿可有效缓解神经根型颈椎病患者临床症状,改善颈椎活动度和血液流变学指标,减轻机体炎症反应。Objective To explore the effects of traditional Chinese medicine(TCM)Reyan bag,acupuncture com-bined with manipulation on hemorheology and cervical motion in patients with cervical spondylotic radiculopathy(CSR).Methods A total of 80 patients with CSR admitted from April 2022 to March 2023 were divided into the experimental group(n=40)and the control group(n=40)according to random number table method.The control group was treated with acu-puncture combined with manipulation,and the experimental group was supplemented with TCM Reyan bag.Both groups were treated for 20 d.The clinical efficacy,visual analogue scale(VAS)score,neck disability index(NDI),Clinical Assessment Scale of Cervical Spondylosis(CASCS)score,cervical motion,hemorheology index and serum inflammatory factors before and after treatment were observed and compared between the two groups.Results After treatment,the total effective rate of the experimental group was 95.00%,which was higher than that of the control group(77.50%)(P<0.05).After treatment,VAS score and NDI score of experimental group were significantly lower than those of control group,while CASCS score was significantly higher than that of control group(P<0.05,P<0.01).After treatment,cervical flexion,posterior extension,left flexion and right flexion in experimental group were higher than those in control group(P<0.01).After treatment,the plasma viscosity,whole blood low shear viscosity and whole blood high shear viscosity of experimental group were significantly lower than those of control group(P<0.01).After treatment,serum levels of interleukin-6,interleukin-8 and tumor necrosis factor-αin experimental groups were lower than those in control group(P<0.01).Conclusion TCM Reyan bag,acupunc-ture combined with manipulation can effectively relieve the clinical symptoms of patients with CSR,improve cervical motion and hemorheology indexes,and reduce the inflammatory response of the body.

关 键 词：神经根型颈椎病 中药热奄包 针刺 手法推拿 血浆黏度 颈椎活动度 白细胞介素-6 肿瘤坏死因子-α 

分 类 号：R681.5[医药卫生—骨科学]