揿针疗法结合推拿手法及主动功能锻炼治疗颈型颈椎病疗效观察  

Clinical observation on the efficacy of ringheaded thumb-tack needle therapy combined with tuina and active functional exercise in the treatment of neck-type cervical spondylosis

作　　者：张智龙 陈天鑫 张韩瑜嘉 信天翔 朱瑜琪[1] 杨胜平 ZHANG Zhi-long;CHEN Tian-xin;ZHANGHAN Yu-jia;XIN Tian-xiang;ZHU Yu-qi;YANG Sheng-ping(Department of Orthopedics,Eye Hospital of China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院骨科,北京100040

出　　处：《针刺研究》2025年第2期197-203,共7页Acupuncture Research

基　　金：国家中医药管理局中医药国际合作专项(中心类项目,No.0610-2040NF020931);中国中医科学院眼科医院院级科研启动基金项目(No.201704)。

摘　　要：目的:观察揿针疗法结合推拿手法及主动功能锻炼治疗颈型颈椎病的临床疗效。方法:将60例颈型颈椎病患者按照随机数字表法分为对照组和试验组,每组30例。对照组予以推拿手法结合主动功能锻炼治疗,推拿每次10~15 min,每周2次;功能锻炼每天早晚各1次,每次约10 min,共治疗4周。试验组在对照组基础上加用揿针疗法治疗,揿针选穴为压痛明显的阿是穴,每次针刺5个阿是穴,留针3 d休息1 d,共治疗4周。记录并比较两组治疗前、治疗2周和治疗4周的颈椎功能障碍指数量表(NDI)和简化McGill疼痛量表(SF-MPQ)中的疼痛视觉模拟量尺评分(VAS)、现在疼痛状况评分(PPI)、疼痛评级指数(PRI),运用改良Macnab疗效评价标准评价疗效,并进行安全性评价。结果:与治疗前相比,两组患者的NDI、VAS、PPI和PRI评分在治疗2周和4周后均显著下降(P<0.01),且试验组各评分的改善程度优于对照(P<0.05)。试验组临床疗效优良率为60.0%(18/30),对照组临床疗效优良率为30.0%(9/30),试验组的临床疗效优于对照组(P<0.05)。试验过程中未发生不良反应。结论:揿针结合推拿手法及主动功能锻炼能够改善颈型颈椎病患者的颈部功能障碍和颈部疼痛等症状和体征,在推拿手法及主动功能锻炼基础上联用揿针疗法能够显著提高临床疗效,该联合疗法治疗颈型颈椎病疗效肯定且具有良好的安全性。Objective To explore the clinical efficacy of acupressure therapy combined with Tuina and active functional exercise in the treatment of neck-type cervical spondylosis.Methods Sixty patients with cervical spondylosis were randomly divided into a control group and an experimental group,with 30 cases in each group.The control group was treated with Tuina and active functional exercise.Tuina therapy lasted 10–15 min per session,twice a week for 4 weeks.Functional exercises were performed once in the morning and once in the evening,each session lasting about 10 min,for a total of 4 weeks.The experimental group received the same treatment as the control group combined with ringheaded thumb-tack needle therapy which was applied to 5 Ashi points,with needle retention for 3 days followed by 1 day of rest,for a total of 4 weeks.The neck disability index(NDI)and the short-form of McGill pain questionnaire(SF-MPQ)including visual analog scale(VAS),present pain intensity(PPI)and pain rating index(PRI)were used before treatment,after 2 weeks and after 4 weeks of treatment.The modified Macnab efficacy evaluation criteria were used to assess treatment outcomes,and safety was also evaluated.Results Compared with baseline,both groups showed significant reductions in NDI,VAS,PPI,and PRI scores after 2 and 4 weeks of treatment(P<0.01).The improvement in the experimental group was significantly greater than that in the control group(P<0.05).The clinical efficacy rate(excellent and good)was 60.0%(18/30)in the experimental group,compared to 30.0%(9/30)in the control group,with the experimental group showing better clinical outcomes(P<0.05).No adverse reactions were reported during the study.Conclusion Acupressure therapy combined with Tuina and active functional exercise can effectively improve symptoms such as neck dysfunction and pain in patients with cervical spondylosis with neck syndrome.The addition of acupressure therapy significantly enhances the clinical efficacy of Tuina and functional exercise,with confirmed therapeutic b

关 键 词：揿针 颈型颈椎病 推拿手法 主动功能锻炼 

分 类 号：R246.9[医药卫生—针灸推拿学]