针刺推拿综合方案治疗椎动脉型颈椎病的多中心随机对照研究

Multicenter randomized controlled study on acupuncture-massage comprehensive program for treatment of cervical spondylosis of arterial type

目的:探讨治疗椎动脉型颈椎病(CSA)的针刺推拿综合方案的临床价值。方法:采用3中心、单盲、随机、对照研究方法,将合格受试者随机纳入针推组、针刺组、推拿组,每组60例,分别给予针刺推拿综合方案、单纯针刺、单纯推拿治疗,建立多维评价指标,对其疗效及安全性进行评价。结果:3组一般资料基线一致,组问可比;3组临床疗效,针推组痊愈显效率68.3%、总有效率88.3%,针刺组51.7%、75.0%,推拿组50.0%、76.7%,针推组疗效优于其余两组的疗效,P<0.05;治疗后3组症状总积分均降低,均P<0.01,针推组积分降低程度优于其余两组,均P<0.05;治疗后3组体征均有显著改善,P<0.01,但组间变化无差异,P>0.05;3组治疗起效时间,针推组短于其余两组,P<0.05或P<0.01;未发现所采用治疗方法的不良反应。结论:本研究所采用的针刺推拿综合疗法治疗CSA,疗效肯定,使用安全;针刺、推拿综合疗法治疗CSA较之单纯采用针刺或推拿疗法具有优势。

Objective To probe into clinical value of the acupuncture-massage comprehensive program for treatment of cervical spondylosis of arterial type (CSA). Methods By using three-center, single-blind, randomized) controlled method, the eligible subjects were randomly divided into an acupuncture-massage group, an acupuncture group, a massage group, 60 cases in each group. They were treated with acupuncture-massage comprehensive program, simple acupuncture and simple massage, respectively. And multiple-dimensional indexes were established to evaluate the therapeutic effect and safety. Resnlts The baselines of the general data were no different among the 3 groups. The cured-markedly effective rate and the effective rate were 68. 3% and 88. 3% in the acupuncture-massage group, 51. 7% and 75. 0% in the acupuncture group, and 50. 0% and 76. 7% in the massage group, respectively, the acupuncture-massage group being better than the other 2 groups (P<0. 05) ; after treatment, the total cumulative scores for symptoms in the 3 groups decreased significantly (all P<0. 01), the acupuncture-massage group being superior to the other 2 groups (P<0. 05); and the physical signs in the 3 groups improved significantly (P< 0. 01), with no significant differences among the 3 groups (P>0. 05); the time inducing the effect in the acupuncture-massage group was shorter than that in the other 2 groups (P<0. 05 or P<0. 01) ; and no adverse effects were found in the 3 groups. Conclusion This acupuncture-massage comprehensive therapy has a definite therapeutic effect on CSA with safety, and it is of superiority as compared with the simple acupuncture or the simple massage.