小针刀神经根管直接松解术治疗根型颈椎病随机双盲对照临床研究

Clinical study of direct neurolysis on radicular canal with acupotomy in treating radicular cervical spondylosis

目的在前期探索基础上进一步研究小针刀神经根管直接松解术治疗根型颈椎病临床疗效及安全性。方法将50例根型颈椎病患者按随机双盲对照法分为治疗组及对照组各25例,两组均给予针灸、推拿、牵引及中药辨证施治内服治疗,治疗组加载小针刀神经根管直接松解术,对照组加载神经根管假松解术。以无效、疗效不佳而要求结束试验为观察终点,试验中进行症状体征积分及MPQ量表评定、不良事件调查并记录,并随访半年。结果治疗组疗效率明显优于对照组(P<0.05),两组总疗程、总体治疗时间差异无统计学意义(P>0.05),治疗组小针刀操作中2例出现神经根损伤,出现患肢麻木疼痛,未经特殊处理后分别于10、15d症状体征消失。结论小针刀神经根管直接松解术治疗神经根型颈椎病在总体疗效上有一定优势,但其不良反应较重,潜在风险较高,尚需进一步探索更安全有效的技术方案。

Objective To research further effect and security of direct neurolysis on radicular canal with acupotomy treating the radicular type cervical spondylosis on the basis of early observation. Methods 50 cases of the radicular type cervical spondylosis were randomly divided into two groups of the treatment group and the control group. On the basis of two groups treated with acupuncture, massage, traction and traditional Chinese drugs based on differentiation, the treatment group was treated with DNRCA and the control group with pseudo aeupotomy. The study was end when the patients felt no effect or aggravated. All patients were evaluated with the cumulative score of the symptoms and signs, MPQ and adverse event during the treatment and visiting period. Return visit was lasted half a year after treatment. Results The effect of treatment group was obviously superior to that of the control group （P 〈 0.05）. The period of treatment had no significant difference between the two groups （P ~ 0.05）.Nerve damages had occurred in two cases of treatment group with pain and numbness of ill limb, and disappeared without any treatment within 10 or 15 days. Conclusion The DNRCA treating the radicular cervical spondylosis had better therapeutic effect, but more adverse reactions and potential risks, so it need further improvement.