肌肉缩短致病原理指导下无热银质针松解术治疗神经根型颈椎病的临床研究

Clinical Investigation of Non-heated Silver Needle Decompression under the Guidance of Pathogenic Principle of Muscle Shortening on Patients with Nerve Root-type Cervical Vertebra Disease

目的观察肌肉缩短致病原理指导下的无热银质针松解术治疗神经根型颈椎病的临床疗效。方法选取2007年4月-2009年6月诊断为神经根型颈椎病的患者60例,随机分为2组。治疗组30例,采用肌肉缩短致病原理指导下的无热银质针松解术治疗;对照组30例,采用物理康复治疗。治疗结束后3个月、6个月、1年及2年观察总有效率、阳性体征变化及电生理变化。结果治疗组治疗后3个月、6个月、1年及2年总有效率分别为96.7%、93.3%、93.3%、86.7%,对照组分别为80.0%、63.3%、60.0%、50.0%,治疗组在各观察时点总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后3个月、6个月及1年两组压顶试验及臂丛牵拉试验较治疗前阳性率明显下降,差异有统计学意义(P<0.05);2年时治疗组较治疗前阳性率明显下降,差异有统计学意义(P<0.05),对照组阳性率较治疗前差异无统计学意义(P>0.05)。椎旁压痛治疗组各时间点较治疗前阳性率均明显下降,差异有统计学意义(P<0.05),而对照组阳性率略下降,差异无统计学意义(P>0.05)。治疗组治疗后各时间点体感诱发电位N9-N13峰间潜伏期均较治疗前明显缩短,差异有统计学意义(P<0.05),而对照组仅治疗后3、6个月较治疗前明显缩短,差异有统计学意义(P<0.05);治疗组治疗后各时间点F波潜伏期均较治疗前明显缩短,差异有统计学意义(P<0.05),而对照组仅治疗后6个月较治疗前明显缩短,差异有统计学意义(P<0.05)。结论肌肉缩短致病原理指导下的无热银质针松解术治疗神经根型颈椎病是一种疗效较好的方法。

Objective To investigate the effect of non-heated silver needle decompression under the guidance of pathogenic principle of muscle shortening on patients with cervical vertebra disease of the nerve root type. Methods Sixty patients diagnosed with cervical vertebra disease of the nerve root type between April 2007 and June 2009 were divided randomly into therapy group（n=30）, treated with non-heated silver needle decompression, and control group（n=30）, treated with physical therapy. Then, we observed the total effective rate, positive physical signs and electrophysiological indexes of the patients 3, 6, 12, and 24 months after treatment. Results The total effective rate was 96.7%, 93.3%, 93.3% and 86.7% in the therapy group 3, 6, 12, and 24 months after treatment, while it was 80.0%, 63.3%, 60.0%, and 50.0% in the control group, and the difference between the two groups in each time point was significant（P〈0.05）. The rate of positive sign in the top pressure test and Brachial plexus traction test lowered significantly 3, 6, and 12 months after treatment in both the two groups（P〈0.05）, while the rate lowered significantly only in the therapy group 2 years after treatment（P〈0.05）. Paraspinal tenderness lowered significantly at each time point in the therapy group after treatment（P〈0.05）, while the decrease in the control group had no significance（P〈0.05）. Theinterpeak latency of somatosensory evoked potential N9-N13 got significantly shorter at each time point after treatment in the therapy group（P〈0.05）, while this only happened at the time points of 3 and 6 months after treatment in the control group（P〈0.05）. The latency of wave F got significantly shorter at each time point after treatment in the therapy group（P〈0.05）, while the shortening only occurred 6 months after treatment in the control group（P〈0.05）. Conclusion Non-heated silver needle decompression under the guidance of pathogenic principle of muscle shortening is an effective treatment for patients with cervical vertebra disease of the nerve root type.