改良弧刃针刀联合羌活胜湿汤治疗风寒痹阻型神经根型颈椎病临床研究  

Clinical Study on Modified Arc-Blade Needle Knife Combined with Qianghuo Shengshi Decoction for Cervical Spondylotic Radiculopathy of Wind-Cold Obstruction Type

作　　者：杨阳 王会丽 李金明 岳宗进[2] YANG Yang;WANG Huili;LI Jinming;YUE Zongjin(Zhumadian Traditional Chinese Medicine Hospital,Zhumadian Henan 463000,China;Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou Henan 450002,China)

机构地区：[1]驻马店市中医院,河南驻马店463000 [2]河南省中医院,河南郑州450002

出　　处：《新中医》2025年第5期107-112,共6页New Chinese Medicine

基　　金：河南省中医药科学研究专项课题(2019ZY2041)。

摘　　要：目的:观察改良弧刃针刀联合羌活胜湿汤治疗风寒痹阻型神经根型颈椎病(CSR)的临床疗效。方法:选取2019年12月—2021年12月驻马店市中医院收治的79例风寒痹阻型CSR患者为研究对象,按随机数字表法分为研究组40例和对照组39例。2组均给予羌活胜湿汤治疗,对照组于羌活胜湿汤基础上给予传统针刀治疗,研究组于羌活胜湿汤基础上给予改良弧刃针刀治疗,2组均治疗3周。比较2组临床疗效、症状评分、血清炎症因子[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]水平、疼痛因子[P物质(SP)、前列腺素E2(PEG2)]水平、椎动脉(VA)和基底动脉(BA)平均流速、颈椎活动度(屈伸、旋转)、颈椎功能障碍指数(NDI)评分、视觉模拟评分法(VAS)评分。治疗结束随访6个月,统计比较复发率。结果:研究组总有效率为97.50%(39/40),高于对照组79.49%(31/39)(P<0.05)。2组治疗1周、治疗3周后颈肩背部不适、上肢麻木疼痛、手指麻木疼痛评分均呈降低趋势(P<0.05);研究组治疗1周、治疗3周后颈肩背部不适、上肢麻木疼痛、手指麻木疼痛评分均低于对照组(P<0.05)。2组治疗1周、治疗3周后血清IL-1β、TNF-α、SP、PGE2水平均呈降低趋势(P<0.05);研究组治疗3周后血清IL-1β、TNF-α、SP、PGE2水平均低于对照组(P<0.05)。2组治疗1周、治疗3周后VA和BA平均流速均呈升高趋势(P<0.05);研究组治疗1周、治疗3周后VA和BA平均流速均高于对照组(P<0.05)。2组治疗1周、治疗3周后颈椎屈伸、旋转活动度均呈升高趋势(P<0.05);研究组治疗1周、治疗3周后颈椎屈伸、旋转活动度均高于对照组(P<0.05)。2组治疗1周、治疗3周后NDI评分和VAS评分均呈降低趋势(P<0.05);研究组治疗1周、治疗3周后NDI评分和VAS评分均低于对照组(P<0.05)。研究组复发率为5.13%(2/39),低于对照组29.03%(9/31)(χ^(2)=7.451,P<0.05)。结论:改良弧刃针刀联合羌活胜湿汤能改善风寒痹阻证�Objective:To observe the clinical effect of the modified arc-blade needle knife combined with Qianghuo Shengshi Decoction in the treatment of cervical spondylotic radiculopathy(CSR)of wind-cold obstruction type.Methods:A total of 79 CSR patients of wind-cold obstruction type admitted to Zhumadian Traditional Chinese Medicine Hospital from December 2019 to December 2021 were selected as the research subjects;they were randomly divided into a study group and a control group according to the random number table method,with 40 and 39 cases in each group respectively.Both groups were treated with Qianghuo Shengshi Decoction.The control group received traditional needle knife treatment based on Qianghuo Shengshi Decoction,while the study group received modified arcblade needle knife treatment based on Qianghuo Shengshi Decoction.Both groups were treated for three weeks.Clinical effects,symptom scores,levels of serum inflammatory factors[interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)],pain factors[substance P(SP)and prostaglandin E2(PEG2)],average flow velocity of vertebral artery(VA)and basilar artery(BA),cervical range of motion(flexion-extension and rotation),Neck Disability Index(NDI)scores,and Visual Analogue Scale(VAS)scores were compared between the two groups.After a sixmonth follow-up after treatment,the recurrence rates were compared.Results:The total effective rate in the study group was 97.50%(39/40),which was higher than the control group's 79.49%(31/39)(P<0.05).Both groups showed a decreasing trend in the scores of neck,shoulder,and back discomfort,upper limb numbness and pain,and finger numbness and pain after one week of treatment,and after three weeks of treatment(P<0.05);the scores of neck,shoulder,and back discomfort,upper limb numbness and pain,and finger numbness and pain in the study group were lower than those in the control group after one week and three weeks of treatment(P<0.05).The levels of serum IL-1β,TNF-α,SP,and PGE2 showed a decreasing trend after one week of treatment,and

关 键 词：神经根型颈椎病 风寒痹阻证 弧刃针刀 羌活胜湿汤 颈椎活动度 炎症-疼痛因子 复发率 

分 类 号：R681.55[医药卫生—骨科学]