短刺结合电针对神经根型颈椎病患者血清IL-6作用效能的临床研究

Efficacy of Short-Thrust Needling Combined with Electroacupuncture on Serum IL-6 in Patients with Cervical Spondylotic Radiculopathy

目的探讨短刺结合电针对神经根型颈椎病(CSR)患者血清IL-6作用效能。方法选取60例CSR患者纳入CSR组,另选择42例健康体检者纳入健康对照组,对比CSR组和健康对照组的血清IL-6水平不同,分析不同视觉模拟评分(VAS)分级和颈部残障指数量表(NDI)分级的血清IL-6水平变化,并分析血清IL-6水平与不同VAS评分分级和NDI指数分级的相关性,并评估血清IL-6水平诊断CSR的诊断效能,然后再将60例CSR患者随机分为对照组和观察组,每组30例,对照组给予普通电针治疗,观察组给予短刺法电针治疗,对比两组治疗前后的VAS评分、NDI指数显著及血清IL-6水平变化。结果CSR组的血清IL-6水平显著高于健康对照组(P<0.05);CSR患者血清IL-6水平随着不同VAS评分分级和NDI指数分级而存在显著性变化(P<0.05),且不同分级之间两两对比,差异有统计学意义(P<0.05);CSR患者血清IL-6水平与VAS评分、NDI评分呈正相关(r=0.781、0.799,P<0.001);对血清IL-6水平作ROC曲线分析,AUC为0.997,诊断CSR的灵敏度为100.00%,特异度为97.62%;治疗后,两组VAS评分、NDI指数显著及血清IL-6水平均低于治疗前(P<0.05),观察组显著低于对照组(P<0.05)。结论CSR患者血清IL-6水平呈明显升高,随着疼痛及颈部功能障碍越严重,其血清IL-6水平越高,与VAS评分、NDI指数呈正相关,血清IL-6水平诊断CSR的诊断价值确切,经短刺结合电针治疗后能明显降低VAS评分、NDI指数和血清IL-6水平。

Objective To investigate the efficacy of short-thrust needling combined with electroacupuncture on serum interleukin 6(IL-6)in patients with cervical spondylotic radiculopathy(CSR).Methods Sixty patients with CSR were selected as CSR group,and another 42 healthy subjects with physical examination were included into the healthy control group.The levels of serum IL-6 were compared between CSR group and healthy control group,and the changes in serum IL-6 level were analyzed among the different visual analogue scale(VAS)grades and neck disability index(NDI)grades.The correlation between serum IL-6 level and different VAS grades and NDI grades was analyzed,and the diagnostic efficacy of serum IL-6 level in the diagnosis of CSR was assessed,and 60 patients with CSR were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with ordinary electroacupuncture,and the observation group was treated with short-thrust needling and electroacupuncture.The VAS score,NDI index and serum IL-6 level were compared between the two groups before and after treatment.Results The level of serum IL-6 of CSR group was significantly higher than that of healthy control group(P<0.05).The level of serum IL-6 of patients with CSR was significantly changed with different VAS grades and NDI grades(P<0.05),and there was a statistically significant difference between the any two of different grades(P<0.05).The serum IL-6 level of CSR patients was positively correlated with VAS score and NDI score(r=0.781,0.799,P<0.001).ROC curve analysis of serum IL-6 level showed the AUC was 0.997,and the sensitivity and specificity of diagnosing CSR were 100.00%and 97.62%.After treatment,the VAS score,NDI index and serum IL-6 level in the two groups were lower than those before treatment(P<0.05),and the scores and level of the observation group were significantly lower than those of the control group(P<0.05).Conclusion The serum IL-6 level in CSR patients is significantly increased.As the pain and neck disability become severer,the serum IL-6 level is higher,and the level is positively correlated with VAS score and NDI index.The serum IL-6 level has a definite diagnostic value in diagnosing CSR,and short-thrust needling combined with electroacupuncture can significantly reduce VAS score,NDI index and serum IL-6 level.