颈神经不同支配区合谷刺治疗神经根型颈椎病(气滞血瘀证)的临床研究

Clinical Observation on the Treatment of Cervical Spondylotic Radiculopathy(Syndrome of Qi stagnation and blood stasis)by Hegu Acupuncture in Different Cervical Nerve Innervated Regions

目的观察颈神经不同支配区合谷刺治疗神经根型颈椎病(气滞血瘀证)的临床疗效。方法64例神经根型颈椎病(气滞血瘀证)患者纳入最终统计,观察组与对照组各32例。两组均根据颈神经支配区加减配穴,对照组采用常规针刺,观察组采用合谷刺法。两组分别于治疗前、初次治疗后、治疗2疗程、4疗程评估简式McGill疼痛量表、颈痛量表(NPQ)及中医证候积分,于治疗结束后1个月随访,并比较两组的临床疗效。结果初次治疗后对照组PRI、VAS、SF-MPQ评分较治疗前明显降低,观察组PRI、VAS、PPI、SF-MPQ评分较治疗前明显降低,且观察组VAS评分改善优于对照组(P<0.05)。治疗2疗程、4疗程、随访时,两组PRI、VAS、PPI、SF-MPQ、NPQ、中医证候积分较治疗前均降低(P<0.05);观察组治疗2疗程时PRI、VAS、PPI、SF-MPQ、NPQ、中医证候积分均低于对照组(P<0.05);治疗4疗程及随访时,PPI评分组间差异无统计学意义(P>0.05),PRI、VAS、SF-MPQ、NPQ、中医证候积分观察组均低于对照组(P<0.05);观察组愈显率显著高于对照组(P<0.05);观察组总有效率高于对照组。结论合谷刺立时止痛效果优于常规针刺,在缓解神经肌肉不适症状,改善疼痛及相关日常功能障碍、心理障碍等方面具有优势。

Objective:To observe the clinical efficacy of Hegu acupuncture in different cervical nerve innervat-ed areas in the treatment of cervical spondylotic radiculopathy of syndrome of qi stagnation and blood stasis.Meth-ods:A total of 64 patients with cervical spondylotic radiculopathy(syndrome of Qi-stagnation and blood-stasis)were included in the final statistics,32 cases in each group.They were randomly divided into the observation group and control group at initial enrollment.The acupoints in the two groups were modified according to the cervi-cal nerve innervation area.The control group was treated with conventional acupuncture,and the observation group was treated with Hegu acupuncture.McGill Pain Scale,Neck Pain Scale(NPQ)and TCM syndrome scores were evaluated before treatment,after initial treatment,after 2 courses and 4 courses of treatment,respectively.The pa-tients were followed 1 month after treatment.The clinical efficacy of the two groups was compared.Results:After initial treatment,the PRI,VAS and SF-MPQ scores in the control group were significantly lower than before treat-ment,while PRI,VAS,PPI and SF-MPQ scores in the observation group were significantly lower than before treat-ment,and the VAS score of the observation group was better than that of control group(P<0.05).PRI,VAS,PPI,SF-MPQ,NPQ and TCM syndrome scores in both groups were lower than before treatment at 2 courses,4 courses and in the follow-up(P<0.05).PRI,VAS,PPI,SF-MPQ,NPQ and TCM syndrome scores in the observation group were all lower than those in control group(P<0.05).After 4 courses of treatment and in the follow-up,there was no significant difference in PPI scores among groups(P>0.05),and the PRI,VAS,SF-MPQ,NPQ and TCM syndrome scores in the observation group were all lower than those in control group(P<0.05).The healing rate of the observation group was significantly higher than that of the control group(P<0.05).The total effective rate of the observation group was higher than that of control group.Conclusion:The immediate analgesic effect of Hegu acupuncture is superior to that of conventional acupuncture,which has advantages in relieving neuromuscu-lar discomfort symptoms,improving pain and related daily dysfunction and psychological disorders.