黄芪桂枝五物汤联合推拿治疗神经根型颈椎病随机平行对照研究

Nerve Root Type Cervical Spondylosis Randomized Parallel Group Study Huang Qi Gui Zhi Soup Joint Massage Therapy

[目的]观察黄芪桂枝五物汤联合推拿治疗神经根型颈椎病疗效。[方法]使用随机平行对照方法,将135例门诊患者按住院病志号法简单随机分为两组。对照组53例推拿：坐位,在颈背部、斜方肌、背阔肌、竖脊肌,肩关节予以滚、按揉、一指禅、推拿等,手法由轻到重,再由重到轻反复多次;拇指在颈椎棘突两旁自上而下垂直肌纤维方向弹拨数次放松颈背部深部肌肉,再施以上法放松颈肩背部肌肉,颈部稍前屈,触诊偏歪的棘突,将颈部向患侧旋转,颈椎旋至最紧张时,顶住偏歪棘突的拇指轻巧地向对侧推,闻及弹响声;最后按揉、拍等放松颈肩背部,并搓抖患侧上肢3-5min,30min/次,1次/d。治疗组82例黄芪桂枝五物汤（黄芪30g,桂枝10g,葛根、芍药各30g,生姜6g,大枣6枚;疼痛剧烈加元胡20g,地龙10g;手臂麻木加片姜黄、桑枝各10g）,1剂/d,500m L武火煎30min后改文火,煎2次,早晚饭后服用;推拿治疗同对照组。连续治疗10d为1疗程。观测临床症状、颈肩强直、僵硬、不良反应。连续治疗4疗程,判定疗效。[结果]治疗组痊愈33例,显效31例,有效9例,无效9例,总有效率89.02%。对照组痊愈13例,显效16例,有效13例,无效11例,总有效率79.25%。治疗组疗效优于对照组（P〈0.05）。[结论]黄芪桂枝五物汤联合推拿治疗神经根型颈椎病效果显著,值得推广。

[Objective]Huang Qi Gui Zhi decoction combined massage therapy nerve root type cervical spondylosis. [Methods]Random parallel control method,135 cases of the disease in hospital outpatients by Law No. simple annals were randomly divided into two groups. The control group 53 cases of massage： sitting in the back of the neck,trapezius,latissimus dorsi,erector spinae,shoulder to be rolling,rubbing a finger,take,etc.,approach from light to heavy,and then from heavy to light repeatedly; thumb in cervical spine from top to bottom on both sides of the vertical direction of the muscle fibers plucked several deep muscle relaxation neck back,neck and shoulder Zaishi above method to relax the back muscles,neck slightly flexion,palpation of the spinous process skew,The rotation of the neck to the affected side,when cervical rotation to the most intense,withstood the spinous process skew thumb deftly pushed to the contralateral sound,smell and shells; finally rubbing,such as relaxing neck and shoulder shot back,shaking and rubbing suffering side of the upper 3 - 5min,30min/times,1 times/d. Treatment group 82 cases Huang Qi Gui Zhi soup（Astragalus 30 g,Gui 10 g,arrowroot,peony 30 g,ginger 6g,jujube 6; severe pain CAD Hu 20 g,earthworm 10g; arm numbness plus piece turmeric,mulberry branches each 10g）; 1/d,500 m L Wu simmer gently for change after 30 min,fried twice,morning and evening after meals. Massage therapy with the control group. 10 d is a continuous course of treatment. Observing clinical symptoms of adverse reactions. 4 continuous treatment regimen to determine efficacy. [Results] The cure 33 cases,effective in 31 cases,9 cases,9 cases,the total efficiency of 89.02%. Cured 13 cases in the control group,16 cases markedly effective in 13 cases,11 cases,the total efficiency of 79.25%. Treatment group than the control group（P〈0.05）.[Conclusion]Huang Qi Gui Zhi decoction combined massage therapy nerve root type cervical spondylosis effect is significant,it is worth promoting.