针刺加灸贴治疗神经根型颈椎病疗效观察

Acupuncture combined with moxibustion plaster for nerve-root type cervical spondylosis

目的:比较针刺加灸贴和电针对神经根型颈椎病的临床疗效差异。方法:将60例神经根型颈椎病患者随机分为灸贴组和电针组,每组30例。灸贴组采用常规针刺以夹脊穴和阿是穴为主,并联合膏肓穴灸贴治疗;电针组采用电针治疗,取穴同灸贴组,均每天1次,5次为一疗程,疗程间休息2天,共治疗2个疗程。观察两组患者治疗前后疼痛积分和各项症状体征量化评分,并比较两组的临床疗效。结果:灸贴组总有效率为96.7%(29/30),电针组总有效率为93.3%(28/30),差异无统计学意义(P>0.05)。两组治疗后疼痛分级指数(PRI)、视觉模拟量表(VAS)、疼痛强度(PPI)评分均较治疗前降低(均P<0.01),治疗后两组间比较差异有统计学意义(均P<0.05);两组治疗后各症状体征量化评分均较治疗前增加(P<0.01),灸贴组治疗后工作与生活能力、手的功能、感觉、肌力评分较电针组增加(均P<0.05),电针组治疗后颈肩部疼痛不适评分高于灸贴组(P<0.05)。结论:针刺联合灸贴和电针对神经根型颈椎病患者均有较好的临床疗效;在缓解患者的疼痛症状方面,电针优于常规针刺联合灸贴;在改善患者生活能力、肌力感觉功能方面,灸贴组较电针组有明显优势。

Objective To compare the clinical efficacy differences between acupuncture combined with moxibustion plaster and electroacupuncture（EA）for nerve-root type cervical spondylosis.Methods A total of 60 cases of nerve-root type cervical spondylosis were randomly divided into a plaster group and an EA group,30 cases in each one.Patients in the plaster group were treated with regular acupuncture at Jiaji（EX-B 2）points and ashi points,combined with moxibustion plaster at Gaohuang（BL 43）;patients in the EA group were treated with EA at identical acupoints as plaster group.The treatment was given once a day,and 5days were taken as one course;there was an interval of 2 days between courses and totally 2 courses were performed.The pain questionnaires and quantitative score of signs and symptoms were observed before and after treatment in the two groups.The clinical efficacy of the two groups was compared.Results The total effective rate was 96.7%（29/30）in the plaster group,which was not significantly different from 93.3%（28/30）in the EA group（P〈0.05）.After treatment,PRI,VAS and PPI were all reduced in the two groups（all P〈0.01）,which were also significantly different between the two groups（all P〈0.05）.The quantitative score of each sign and symptom was increased after treatment in the two groups（all P〈0.01）.Compared with the EA group,the work and life ability,function,feeling and strength of hand were increased in the plaster groups（all P〈0.05）.Pain score of neck and shoulder after treatment in the EA group was higher than the plaster group（all P〈0.05）.Conclusion Acupuncture combined with moxibustion plaster and EA both have superior clinical efficacy for nerve-root type cervical spondylosis;EA is superior to acupuncture combined with moxibustion plaster on relieving pain,while acupuncture combined with moxibustion plaster is superior to EA on improving life quality,muscle strength and feeling.