皮部引流法治疗神经根型颈椎病临床疗效观察

Therapeutic Effect of Meridian Skin Region Drainage Therapy for Nerve Root Type of Cervical Spondylosis

【目的】通过与常规针刺手法比较,观察皮部引流法治疗神经根型颈椎病的临床疗效。【方法】将84例神经根型颈椎病患者随机分为皮部组和针刺组,每组各42例。皮部组给予皮部引流法治疗,包括:刮痧、刺血联合"工"字型针刺法(风池透风府、C3~C6棘突下、大椎穴、肩中俞、肩外俞),针刺组给予普通针刺(取局部阿是穴、颈夹脊为主穴,配天柱、大椎、后溪)治疗,2组均7次为1个疗程,共治疗3个疗程。观察2组患者主要症状和体征的缓解时间,采用视觉模拟评分法(VAS)评价2组治疗前后疼痛指数,比较2组的总体疗效及安全性,并随访观察其复发率。【结果】(1)疗效方面,皮部组和针刺组的总有效率分别为95.2%和83.3%,皮部组的疗效优于针刺组,差异有统计学意义(P<0.05)。(2)治疗过程中,2组患者的压痛缓解时间、疼痛缓解时间、活动度改善时间比较,皮部组均明显短于针刺组(P<0.01)。(3)治疗后,2组患者的VAS评分均较治疗前显著降低(P<0.01),且皮部组对VAS评分的降低作用优于针刺组(P<0.05)。(4)治疗后2个月随访,皮部组的复发率为17.6%,针刺组为38.1%,皮部组的复发率低于针刺组(P<0.05)。(5)安全性评价:治疗过程中,2组患者均无明显不良事件发生。【结论】皮部引流法治疗神经根型颈椎病疗效显著。

Objective To observe the clinical curative effect of meridian skin region drainage therapy for nerve root type of cervical spondylosis by comparing to the conventional acupuncture. Methods A total of 84 cases of cervical spondylosis were randomly divided into acupuncture group and drainage group,42 cases in each group.The drainage group was given meridian skin region drainage therapy including skin scraping, bloodletting combining with I-shaped acupuncture（acupuncture on Fengchi penetrating Fengfu,C3-C6 spinous process,Dazhui, Jianzhongshu, Jianwaishu）, once a day. The acupuncture group was given conventional acupuncture mainly on Ashi points, cervical Jiaji acupoints, combining with Tianzhu, Dazhui, and Houxi, once a day.Seven times constituted one treatment course and the treatment for the two groups lasted 3 courses. During the treatment,time for the relief of the primary symptoms and signs of the two groups was observed,and pain index was evaluated with Visual Analogue Scale（VAS）. After treatment,the total clinical efficacy and safety were evaluated,and the recurrence rate was investigated during the follow-up. Results（1） The total clinical efficacy of the drainage group was 95.2% and that of the acupuncture group was 83.3%, and there were significant differences between the two groups（P 0.05）.（2） During the treatment, time for the relief of tenderness,time for the relief of pain, and time for the improvement of range of motion in the drainage group were much shorter than those in the acupuncture group（P 0.01）.（3）After treatment,VAS scores of the two groups were decreased（P 0.01 compared with those before treatment）,and the decrease in the drainage group was superior to that in the acupuncture group（P 0.05）.（4） The 2-month follow-up showed that the recurrence rate of the drainage group was 17.6%,and that of the acupuncture group was 38.1%,the difference being significant（P 0.05）.（5）During the treatment,no obvious adverse event occurred in the two groups. Conclusion Meridian skin region drainage therapy exerts certain therapeutic effect for nerve root type of cervical spondylosis.