耳针沿皮透穴刺法与耳针直刺法对颈型、神经根型颈椎病快速镇痛效应的比较研究

Comparison of the Analgesic Effect of Acupuncture Between Otopoint-penetrative Needling and Otopoint-straight Needling for Cervical Type and Nerveroot Type Cervicospondylopathy

目的:对比耳针沿皮透穴刺法与耳针直刺法对颈型、神经根型颈椎病的镇痛效应。方法:患者按性别、年龄和病情3个重要的预后因素一一配对,将每对受试对象按随机的原则分到试验组和对照组。试验组采用耳针沿皮透穴刺法,对照组采用耳穴直刺法。采用单盲法以简化McGill疼痛评分表(简化MPQ)对入选的全部病例进行治疗前和治疗后5 min3、0 min疼痛程度评分,将获得的透穴刺法和直刺法治疗前与治疗后的疼痛积分分别采用质反应序贯试验和配对t检验的统计方法进行分析。结果:序贯试验结果:透刺组与直刺组在针刺后5 min时镇痛效应无显著性差别(P>0.05);透刺组在针刺后30 min时的镇痛效应优于直刺组(P<0.05)。配对t检验结果:透刺组与直刺组在针刺后5 min和30 min对颈型和神经根型颈椎病的镇痛效应均有显著性差别(P<0.001)。结论:耳针沿皮透穴刺法对颈型和神经根型颈椎病的快速镇痛效应优于耳针直刺法。

Objective： To confirm the better analgesic effect of otopoint-penetrative needling for cervical type and nerveroot type cervicospondylopathy. Methods. A total of 98 cervicospondylopathy outpatients （50 cases of cervical type and 48 cases of nerve-root type） were randomly divided into treatment group （otopoint-penetrative needling） and control group （otopointstraight needling） in the light of paring method of comprehensive factors of sexes, ages and the state of disease. The main otopoints used were bilateral Jingzhui Area （AH 13） in combination with Jian-Jianguanjie-Suogu （Shoulder- Shoulder-joint-Collarbone） Area, etc. The simplified McGill Pain Scaling was used to give the score of patient＇s pain before the treatment, 5 min and 30 min after the treatment. Results： Results of sequential trial indicated that the analgesic effect of otopoint-penetrative needling was significantly superior to that of otopoint-straight needling 30 rain after the treatment （P〈0.05）. Findings of matched-pair t test showed that no marked differences were found between two groups in the pain scores before the treatment, while after the treatment, the pain scores of otopoint-penetrative needling group were significantly lower than those of otopoint-straight needling group （P〈0. 001, 0. 01）, meaning that the analgesic effect of otopoint-penetrative needling was significantly better than that of otopoint-straight needling 5 rain and 30 rain after the treatment in both men and women, in both cervical type and nerve-root type patients, and in both young and older patients. Conclusion ： The analgesic effect of otopoint-penetrative needling is obviously superior to that of otopoint-straight needling.