针刺大柕-间使、风池-风府联合四藤一仙汤治疗寒湿痹阻型神经根型颈椎病的临床研究  

Clinical study of acupuncture at Da Mao-Jianying,Fengchi-Fengfu duo combined with Siteng-Yixian Decoction in Treating Cervical spondylopathy with Cold-dampness Blockage

作　　者：李华一 白晓涵 吕玉娥 LI Huayi;BAI Xiaohan;LYU Yu(Shanxi University of Chinese MedicineShanxi Acupuncture Hospital,Taiyuan 030000,China;Shaxi Acupuncture and moxibustion Hostpital,Taiyuan 03000,China)

机构地区：[1]山西中医药大学,山西太原030000 [2]山西针灸医院,山西太原030000

出　　处：《四川中医》2025年第2期186-191,共6页Journal of Sichuan of Traditional Chinese Medicine

基　　金：山西省科技人才创新团队建设项目(编号:202204051002011);中国中医科学院科技创新工程(编号:CI2022E010XB);针药对法中医骨伤传承创新团队(编号:zyytd2024013);山西中医药大学创新团队项目(编号:2022TD1006,2019TD-003);山西省中医药管理局科研课题(编号:2020ZYYC040、2022ZYYZ063)。

摘　　要：目的:观察针刺大柕-间使、风池-风府联合四藤一仙汤治疗寒湿痹阻型神经根型颈椎病的临床疗效及安全性。方法:选自2023年1月~2024年1月就诊于山西省针灸医院针灸二科门诊及收住入院的CRS患者120例作为研究对象,在本研究中,参与者通过随机数字表法按照1:1的比例均等地分配至两个研究组,即治疗组和对照组。对照组患者将接受西医药物的对症支持治疗。而在观察组中,除了给予与对照组相同的西医药物对症支持治疗外,还将额外实施针刺治疗,具体为针刺大柕-间使穴、风池-风府穴,并结合四藤一仙汤的中药治疗方案。记录两组治疗前、治疗1疗程、2疗程前后疼痛程度SF-MPQ评分、颈椎功能NDI评分、血清疼痛介质、中医证候积分,评估两组疗效,记录治疗期间不良反应。结果:治疗前两组患者SF-MPQ评分、NDI评分、中医证候评分、血清PGE2、SP和5-HT水平比较无统计学差异(P>0.05),随着治疗疗程增加,两组VAS评分、PPI评分、PRI指数、NDI评分、中医证候评分、血清PGE2、SP和5-HT水平明显下降,此外,治疗组的低发生率具有统计学意义(P<0.05),在完成两个疗程的治疗后,治疗组的总有效率达到了95.00%,显著优于对照组的75.00%(P<0.05)。在治疗过程中,两组受试者的血液学指标和肝肾功能检测结果显示,治疗前后均未观察到显著性差异。结论:针刺对穴大柕-间使、风池-风府联合四藤一仙汤治疗寒湿痹阻型CSR临床疗效突出,颈椎功能和减轻疼痛改善更显著,且安全性高,值得推广。Objective To observe the clinical efficacy and safety of acupuncture at Da Mao-Jianying,Fengchi-Fengfu duo combined with Siteng-Yixian Decoction in treating cervical spondylopathy with cold-dampness blockage.Methods A total of 80patients with CRS who were admitted to the second Department of Acupuncture and Moxibustion Hospital of Shanxi Province from January 2022to January 2022were selected as the study objects.A random number table was used to randomly divide them into treatment group and control group at a ratio of 1:1.The control group received symptomatic treatment with Western medicine.On the basis of the control group,the observation group was treated with acupuncture at Da Mao-Jianliang,Fengchi-Fengfu acupoint combined with four tengyixian decoction.The pain degree(SF-MPQ score),cervical spine function(NDI score),serum pain mediators and TCM syndrome scores were recorded before and after treatment of the two groups.The efficacy of the two groups was evaluated,and the adverse reactions during treatment were recorded.Results There were no significant differences in SF-MPQ score,NDI score,TCM syndrome score,serum PGE2,SP and 5-HT levels between the two groups before treatment(P>0.05).VAS score,PPI score,PRI index,NDI score,TCM syndrome score,serum PGE2,SP and 5-HT levels were significantly decreased in both groups,and lower in the treatment group(P<0.05).After 2courses of treatment,the total effective rate of the treatment group was 95.00%,which was significantly higher than 75.00%in control group(P<0.05).There were no significant changes in blood routine,liver and kidney function before and after treatment.Conclusion acupuncture at Da Mao-Jianying,Fengchi-Fengfu duo combined with Siteng-Yixian Decoction has significant clinical effect in the treatment of cervical spondylopathy radiculopathy with cold-dampness blockage,which can significantly improve cervical spine function and relieve painand is safe and worthy of promotion.

关 键 词：神经根型颈椎病 寒湿痹阻型 针刺 四藤一仙汤 

分 类 号：R245[医药卫生—针灸推拿学]