中医联合疗法治疗神经根型颈椎病临床观察

Clinical observation on combined Chinese medicine therapy for the treatment of cervical spondylotic radiculopathy

目的观察中医联合疗法治疗神经根型颈椎病的临床疗效。方法将146例患者随机分为治疗组与对照组,每组73例。对照组予西医常规药物治疗(双氯芬酸钠+甲钴胺片),治疗组予中医联合疗法治疗(小针刀疗法+推拿手法+血府逐瘀汤内服)。两组疗程均为1个月,观察临床疗效及复发情况,比较疼痛VAS评分、特异性体征的变化情况。结果 1治疗组、对照组总有效率分别为89.04%、73.97%;组间临床疗效比较,差异有统计学意义(P<0.05)。2治疗2周后与治疗前组内比较,治疗组疼痛VAS评分差异有统计学意义(P<0.05);治疗前后组内比较,两组疼痛VAS评分差异均有统计学意义(P<0.05)。组间治疗2周后及治疗后比较,疼痛VAS评分差异均有统计学意义(P<0.05)。3治疗2周后、治疗后与治疗前组内比较,两组头顶叩击试验、臂丛神经牵拉试验、椎间孔挤压试验转阴情况差异均有统计学意义(P<0.05);组间治疗2周后及治疗后比较,头顶叩击试验、臂丛神经牵拉试验、椎间孔挤压试验转阴情况差异均有统计学意义,治疗组优于对照组(P<0.05)。4治疗组复发率为13.64%,对照组复发率为35.29%;两组复发率比较,差异有统计学意义(P<0.05)。结论中医联合疗法治疗神经根型颈椎病,可显著缓解患者颈肩疼痛,且起效较快、复发率较低。

Objective To observe the clinical efficacy of combined Chinese medicine therapy for the treatment of cervical spondylotic radiculopathy. Methods One hundred and forty- six cases were randomized into treatment group and control group, with 73 cases in each group. Control group was treated with conventional therapy （diclofenae sodium plus mecobalamine）, and treatment group was treated with combined Chinese medicine therapy （small needle-knife, tuina and ＂Xuefu Zhuyu Decoction＂ ） , with the course of 1 month. The clinical efficacy, recurrence rate VAS score, and specific sign were observed. Results （1） The total effective rate was 89.04% in the treatment group and 73.97% in the control group, with a difference between the two groups （P 〈0.05 ）. （2） In the treatment group, there were significant differences in VAS scores between before treatment and after 2 weeks treatment （ P 〈 0.05 ） ; in each group, there were significant differences in VAS scores between before and after 4 weeks treatment （ P 〈 0.05 ）. After 4 weeks treatment, there were significant differences in VAS between the two groups （ P 〈 0.05 ）. （3） In each group, there were significant differences in the negative conversion ratio of the head taps test, Eaten test, Spurling test between before and after 2 weeks treatment, and between before and after treatment （ P 〈 0.05 ）. there were both significant differences in the negative conversion ratio of the head taps test, Eaten test, Spurling test between the two groups after treatment and after 2 weeks treatment between the two groups （P 〈 0.05）. （4） The recurrence rate was 13.64% in the treatment group and 35.29% in the control group, with a difference between the two groups （ P 〈 0.05 ）. Conclusion Combined Chinese medicine therapy can obviously alleviate shoulder and neck pain, with a lower ratio of recurrence.