内热针治疗慢性非特异性颈痛的疗效观察

Effect of inner heating dry needle therapy on nonspecific chronic neck pain

目的观察内热针治疗慢性非特异性颈痛(nonspecific chronic neck pain,NCNP)的临床疗效。方法将2017年1月-2018年12月于解放军总医院海南医院康复理疗科就诊并确诊为NCNP的60例慢性非特异性颈痛的患者,随机分为治疗组和对照组,治疗组(n=30)使用内热针治疗,对照组(n=30)使用热磁治疗。治疗前、治疗后2周及治疗后3个月随访,分别采用疼痛视觉模拟量表(visual analogue scale,VAS)和颈部残损指数量表(neck disability index scale,NDI)进行疗效评定。结果治疗前两组患者性别、年龄、病程、VAS及NDI评分差异无统计学意义(P>0.05)。重复测量方差分析显示VAS评分、NDI评分在组间、时间、交互作用上均有统计学差异(P<0.05)。治疗后2周和3个月,治疗组VAS评分、NDI评分均持续下降,任意两时间点比较差异均有统计学意义(VAS:5.3±1.4 vs 2.0±1.2和1.7±0.8;NDI:14.6±4.6 vs 8.1±3.9和7.7±3.6;P均<0.05),说明患者疼痛程度持续减轻,颈部功能持续恢复;治疗组VAS评分、NDI评分均显著低于对照组(P均<0.05)。治疗后2周,对照组VAS评分、NDI评分下降,与治疗前比较差异有统计学意义(VAS:4.8±1.6 vs 3.3±1.3;NDI:15.9±4.4 vs 11.9±3.7;P均<0.05);治疗后3个月,VAS评分(4.9±1.5)及NDI评分(16.1±4.4)均上升,与治疗前比较差异无统计学意义(P>0.05),说明对照组远期治疗效果不佳。结论内热针治疗可缓解慢性非特异性颈痛患者的疼痛并改善颈椎的功能,且与常规理疗相比具有更好的远期效果。

Objective To observe the clinical effect of inner heating dry needle on chronic nonspecific neck pain.Methods From January 2017 to December 2018,60 patients diagnosed as chronic nonspecific neck pain(NCNP)in Hainan Hospital of Chinese PLA General Hospital were randomly divided into treatment group and control group.Patients in the treatment group(n=30)were treated with inner heating dry needle therapy,while patients in the control group(n=30)were treated with thermomagnetic therapy.The pain visual analogue scale(VAS)and the neck disability index scale(NDI)were used to evaluate the effect at 2 weeks and 3 months after treatment.Results There was no significant difference in age,gender,BMI,VAS and NDI scores between the two groups before treatment(all P>0.05).Two way repeated-measures ANOVA showed VAS and NDI scores in the treatment group differed significantly between the three time points(VAS,5.3±1.4 vs 2.0±1.2 and 1.7±0.8;NDI,14.6±4.6 vs 8.1±3.9 and 7.7±3.6;all P<0.05),and significantly lower than those in the control group at 2 weeks and at 3 months after treatment(all P<0.05).The VAS and NDI scores in the control group decreased significantly at 2 weeks after treatment(VAS,4.8±1.6 vs 3.3±1.3;NDI,15.9±4.4 vs 11.9±3.7;P<0.05,respectively);but increased to(4.9±1.5)and(16.1±4.4)at 3 months,respectively,with no significant improvement when compared with before treatment(P>0.05).Conclusion Inner heating dry needle therapy can relieve pain and improve cervical function in patients with chronic nonspecific neck pain,and the long-term effect is better when compared with conventional physiotherapy.