筋骨通脉汤联合刺络拔罐对120例颈肩疼痛的随机对照研究

A randomized controlled study of Bones Tongmai decoction combined with pricking therapy in the treatment of 120 cases with neck and shoulder pain

目的探讨筋骨通脉汤联合刺络放血对颈肩疼痛患者的疗效。方法选取120例颈肩疼痛患者,按随机数字表法分为观察组和对照组,各60例,观察组采用中药筋骨通脉汤联合刺络放血治疗,对照组采用口服维生素B_1、B_(12)片以及吲哚美辛肠溶片进行治疗。治疗前后采用日常生活能力量表(ADL)进行评分并统计疗效,比较2组治疗前后血清炎性因子及椎动脉血流动力学指标变化。结果治疗后2组ADL评分均有所升高,观察组高于对照组(P<0.01)。观察组治疗总有效率(92%)显著高于对照组(78%)(P<0.05)。治疗后2组C反应蛋白、白细胞介素(IL)-1β、前列腺素E_2、5-羟色胺水平显著低于治疗前,IL-10高于治疗前,且2组间差异有统计学意义(P<0.05)。治疗后2组左椎动脉、右椎动脉和基底动脉血流速度均有所升高(P<0.05),且观察组明显高于对照组(P<0.05)。结论筋骨通脉汤联合刺络放血治疗颈肩疼痛,改善了机体慢性炎症状态和椎动脉血流动力学,疗效确切,不良反应少,值得临床推广。

Objective To study the effect of Bones Tongmai decoction combined with pricking therapy in the treatment of neck and shoulder pain.Methods One hudred and twenty cases with neck and shoulder pain were randomly divided into observation group and control group, 60 cases in each group.The observation group were treated with Bones Tongmai decoction combined with pricking therapy, the control group were treated with vitamin B1, B12 and indometacin enteric-coated tablets,.The ability of daily living scale （ADL） was used to evaluate the curative effect before and after treatment, the serum inflammatory factors and vertebral artery hemodynamic parameters were compared before and after treatment in 2 groups.Results After treatment, the ADL scores of 2 groups were higher than those before treatment, and the observation group was higher than the control group （P〈0.01）.The total effective rate of observation group （92%） was significantly higher than 78% of the control group （P〈0.05）.After treatment, the levels of CRP, IL-1, PGE2 and 5-HT in 2 groups were significantly lower than those before treatment, IL-10 was higher than that before treatment, and the difference between 2 groups was significant （P〈0.05）.After treatment, blood flow velocity of left vertebral artery, right vertebral artery and basilar artery in 2 groups were increased （P〈0.05）, and the observation group was significantly higher than the control group （P〈0.05）.Conclusion Bones Tongmai decoction combined with pricking therapy in the treatment of shoulder and neck pain can improve chronic inflammatory state and vertebral artery hemodynamics, and has curative effect, less side effects, be worthy of promotion.