腹针配合McKenzie疗法对颈型颈椎病的镇痛效果

Clinical observation on analgesic effect of abdominal acupuncture combined with McKenzie therapy on cervical spondylosis of neck type

目的:观察腹针针刺、麦肯基(McKenzie)疗法及二者配合对颈型颈椎病的疼痛的疗效,为临床治疗颈型颈椎病颈痛提供依据。方法:按照纳入排除标准严格纳入颈型颈椎病患者90例,随机分为A、B、C组,分别接受腹针针刺治疗、麦肯基疗法治疗及腹针配合麦肯基疗法治疗。观察镇痛效果及治疗简化McGill量表总分、疼痛分级指数(PRI)、视觉模拟评分法(VAS)、现有疼痛强度(PPI)评分的变化。结果:三组的镇痛效果总有效率分别为63.3%、96.7%和100%,三组间具有显著性差异(χ2=35.596,P<0.001);三种治疗方法均可显著降低颈型脊椎病患者的颈痛评分,且组间差异具有显著性意义(F=19.452,P<0.001);三组患者简化McGill量表在PRI、VAS、PPI方面评分治疗前后均有显著差异(P<0.001),组间比较显示单纯腹针与腹针配合麦肯基疗法的各项目减分显著大于单纯麦肯基疗法(P<0.05),而腹针组与腹针配合麦肯基组之间,PRI、VAS、PPI的减分差异无显著性差异(P>0.05)。结论:麦肯基疗法与腹针疗法均能显著缓解颈型颈椎病的颈痛症状;二者结合,能够提高镇痛的总有效率。

Objective： To observe the improvement of neck pain treated by abdominal acupuncture, McKenzie therapy and combination with each other, and provide evidence for clinical treatment on cervical spondylosis of neck type. Method： According to inclusion and exclusion criteria, 90 patients were randomized to A, B and C groups accepted the treatments of abdominal acupuncture, McKenzie therapy and abdominal acupuncture combined with McKenzie therapy respectively. Analgesic effect and the change of McGill scores [including pain rating index （PRI）, visual analogue scale（VAS） and present pain intensity（PPI）] were observed. Result： The overall response rates of analgesic effect were 63.3%, 96.7% and 100% respectively with significant differences among three groups（x 2=35.596, P〈0.001）. All 3 therapies could obviously decrease the scores of neck pain, and inter-groups comparison analyses revealed significant differences （F--19.452, P〈0.001）. The McGill scores were obviously significant different in aspects of PRI, VAS and PPI among three groups （P〈0.001）. Inter-groups comparison analyses revealed that there was no significant difference in all aspects of reduction after abdominal acupuncture and abdominal acupuncture combined with McKenzie therapy（P〉0.05）, but both were obvi ously more than that after McKenzie therapy （P〈0.05）. Conclusion： Both McKenzie therapy and abdominal acupuncture could reduce the pain symptoms of neck type cervical spondylosis. The combination with McKenzie therapy and abdominal acupuncture could increase overall reponse rates of analgesia significantly, but its＇ analgesic effect was better than that of abdominal acupuncture.