针刺联合穴位贴敷治疗风寒阻络型神经根型颈椎病的疗效观察  

Clinical Observation on the Efficacy of Acupuncture Combined with Acupoint Application in the Treatment of Cervical Spondylotic Radiculopathy of Collateral Obstruction by Wind-Cold Type

作　　者：岳凤杰 岳宗进[1] 张留巧[1] YUE Fengjie;YUE Zongjin;ZHANG Liuqiao(Henan Provincical Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China)

机构地区：[1]河南省中医院,河南郑州450002

出　　处：《中医药信息》2024年第12期48-54,共7页Information on Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(2023ZY2094)。

摘　　要：目的:观察针刺联合穴位贴敷治疗风寒阻络型神经根型颈椎病的临床疗效。方法:选择符合纳入标准的风寒阻络型神经根型颈椎病患者94例,依据随机数字表随机分为对照组和观察组,每组各47例,研究期间对照组脱落4例、观察组脱落1例。对照组口服塞来昔布,观察组给予针刺联合穴位贴敷,两组均治疗30 d。观察两组McGill疼痛量表、颈椎活动度(前后屈伸、左右弯屈、左右旋度数)、脊柱侧弯夹角、肌电-诱发电位(正中神经肌电波传导速度、尺神经肌电波传导速度、臂丛段诱发电位峰潜伏期、颈髓段诱发电位峰潜伏期),检测两组动脉血流指数[颈椎动脉阻力指数(VARI)、基底动脉平均血液流速(MBA-FV)、椎动脉的平均血液流速(MVA-FV)、椎基底动脉内径(VAD)]、血清炎性因子[白介素(IL)-1β、IL-4、巨噬细胞移动抑制因子(MMI)、肿瘤坏死因子-α(TNF-α)]的水平。结果:观察组治疗后及随访3、6、12个月的总有效率分别为97.8%(45/46)、91.3%(42/46)、80.4%(37/46)、71.7%(33/46),高于对照组的83.7%(36/43)、72.1%(31/43)、51.2%(22/43)、39.5%(17/43)(均P<0.05)。与治疗前比较,两组McGill疼痛量表各维度积分和总积分降低(P<0.05),颈椎活动度、脊柱侧弯夹角增加(P<0.05);正中神经肌电波传导速度、尺神经肌电波传导速度加快(P<0.05),臂丛段诱发电位峰潜伏期、颈髓段诱发电位峰潜伏期缩短(P<0.05),VARI、TNF-α、MMI、IL-1β、IL-4水平降低(P<0.05),MBA-FV、MVA-FV、VAD水平增加(P<0.05);且与对照组治疗后比较,观察组上述指标均明显改善。结论:针刺联合穴位贴敷可明显缓解风寒阻络型神经根型颈椎病患者颈肩疼痛,提高颈椎功能,促进神经肌电波传导,增加椎动脉血流量,减轻机体炎性反应。Objective:To observe the clinical efficacy of acupuncture combined with acupoint application in the treatment of cervical spondylotic radiculopathy of collateral obstruction by wind-cold type.Methods:A total of 94 patients with cervical spondylotic radiculopathy of collateral obstruction by wind-cold type,meeting the inclusion criteria,were randomly divided into a control group and an observation group,with 47 patients in each group.During the study,4 patients from the control group and 1 patient from the observation group dropped out.The control group received oral celecoxib,while the observation group was treated with acupuncture combined with acupoint application,both for 30 days.The McGill Pain Questionnaire,cervical range of motion(flexion,extension,lateral bending,and rotation),spinal scoliosis angle,electromyography-evoked potentials(median and ulnar nerve conduction velocities,brachial plexus evoked potential peak latency,and cervical spinal cord evoked potential peak latency)were observed in both groups.Arterial blood flow indices,including vertebral artery resistance index(VARI),mean blood flow velocity of the basilar artery(MBA-FV),mean blood flow velocity of the vertebral artery(MVA-FV),vertebrobasilar artery diameter(VAD),and serum inflammatory factors[interleukin(IL)-1β,IL-4,macrophage migration inhibitory factor(MMI),and tumor necrosis factor-α(TNF-α)]were also measured.Results:The total effective rates in the observation group at post-treatment and at 3,6,and 12 months follow-ups were 97.8%(45/46),91.3%(42/46),80.4%(37/46),and 71.7%(33/46),respectively,significantly higher than those in the control group at 83.7%(36/43),72.1%(31/43),51.2%(22/43),and 39.5%(17/43)(all P<0.05).Compared with pre-treatment,the McGill Pain Questionnaire scores,cervical range of motion,and spinal scoliosis angle improved significantly in both groups(P<0.05).Median and ulnar nerve conduction velocities increased,brachial plexus and cervical spinal cord evoked potential peak latencies shortened,and levels of VARI,TNF-α

关 键 词：针刺 穴位贴敷 风寒阻络证 神经根型颈椎病 

分 类 号：R246.9[医药卫生—针灸推拿学]