透刺电针对神经根型颈椎病患者疼痛综合评分的影响

Influence of electroacupuncture with penetration needling method on comprehensive pain score in patients with cervical spondylotic radiculopathy

目的:比较透刺电针、夹脊电针、颈复康治疗神经根型颈椎病(CSR)的疗效差异,探讨最佳治疗方法。方法:将160例CSR患者随机分为3组,透刺电针组60例,采用透刺电针治疗,穴取患侧C4夹脊透C7夹脊、肩外俞透曲垣、天宗透臑俞、手三里透下廉,每日1次;夹脊电针组60例,采用电针C4～C7夹脊治疗,每日1次;颈复康组40例,予口服颈复康治疗,每次1袋,每日2次。3组均治疗6日为一疗程,治疗2个疗程。采用国际公认的描述与测量疼痛的简化MPQ(SF-MPQ)量表评定疼痛改善情况。结果:治疗后透刺电针组、夹脊电针组对疼痛分级指数(PRI)评分、目测类比定级法(VAS)评分、现有疼痛强度(PPI)评分、疼痛总分(PRI+VAS+PPI总分)较治疗前均有显著改善(均P<0.01),颈复康组对PRI、VAS、PPI、疼痛总分亦有改善(均P<0.05)。透刺电针组对各项评分的改善均优于颈复康组(均P<0.01),夹脊电针组对PRI感觉、VAS、PPI及疼痛总分的改善亦优于颈复康组(均P<0.05),且透刺电针组对各项评分的改善均优于夹脊电针组(P<0.05,P<0.01)。结论:透刺电针法治疗神经根型颈椎病能迅速缓解疼痛,对患者疼痛综合评分的改善优于夹脊电针和口服颈复康治疗。

Objective To compare the efficacy differences among electroacupuncture with penetration needling method. Jiaji electroacupuncture and Jingfukang granule for cervical spondylotic radiculopathy （CSR） and to explore the best therapeutic method. Methods One hundred and sixty patients with CSR were randomly divided into 3 groups. Sixty patients in electroacupuncture with penetration needling method group （group A） were treated by electroacupuneture with penetration needling method, and C4 Jiaji to-C7 Jiaji, Jianwaishu （SI 14）-to-Quyuan （SI 13）, Tianzong （SI ll）-to-Naoshu （SI 10）, Shousanli （LI 10）-to-Xialian （LI 8） were selected, once a day. Sixty patients in Jiaji electroacupuncture group （group B） were treated by Jiaji electroacupuncture at C4 Jiaji-to-C7 Jiaji, once a day. Fourty patients in Jingfukang granule group （group C） were treated by oral administration of Jingfukang granule, 1 bag each time, twice each day. Six days as a course, the 3 groups were all treated for two courses. The simplified MPQ （SF-MPQ） scale which was internationally accepted was adopt to evaluate the improving situations in pain. Results After treatment, pain rating idex （PRI）, visual analogue scale （VAS）, present pain intensity （PPI） and the total pain score were significantly improved in the group A and B compared with those before treatment （all P〈0.01）, which was also improved in the group C （all P〈0.05）. Compared with the group C, all the scores were significantly improved in the group A （all P〈0.01）, the improvement of PRI, VAS, PPI and total pain score in the group B was superior to those in the group C （all P〈0.05）, and all the improvements in the group A were superior to those in the group B （P〈0.05, P〈0.01 ）. Conclusion Electroacupuncture with penetration needling method can relive pain rapaidly in patients with CSR, which is superior to Jiaji electroacupuncture and Jingfukang granule in improving the comprehensive pain scores.