颈部联合腰部疗法治疗颈椎病的临床意义

Clinical value of acupuncture in both neck and waist regions and conventional neck acupuncture in treatment of cervical spondylosis of neck type

目的探索"颈部联合腰部"针灸治疗颈型颈椎病的长期疗效,进而对比常规颈部针灸治疗颈型颈椎病的长期疗效。方法选取2015年8~12月诊断为颈型颈椎病患者52例为A组,采用常规颈部针灸治疗2周;选取2016年1~5月的颈型颈椎病患者53例为B组,采用"颈部联合腰部"针灸治疗2周,治疗结束后对2组进行为期45d的随访。记录并采用重复测量方差分析评定2组患者治疗前、治疗2周后、随访结束时的颈痛量表评分(NPQ)、颈椎活动度评分(ROM)、颈部症状积分,同时采用秩和检验评定2组于治疗2周后,随访结束时的总有效率差异,作生存曲线分析2组45 d随访复发率的差异。结果 2组在测量前、治疗2周后、治疗45 d后的NPQ、ROM以及颈部症状积分均呈先下降后上升的趋势,差异具有统计学意义(P<0.05)。而2组比较,B组在结束治疗后45 d的三项指标评分均显著低于A组,差异有统计学意义(P<0.05)。治疗2周后,B组的总有效率略低于A组,但差异无统计学意义(P>0.05);而治疗结束45 d,B组总有效率显著高于A组(83.33%VS 67.39%),差异有统计学意义(P<0.05)。随访45 d后,A组复发率著低于B组,差异有统计意义(F=5.109 P=0.024)。结论 "颈部联合腰部"针灸治疗颈型颈椎病的长远疗效优于常规颈部针灸,有望作为临床上治疗颈型颈椎病的方案之一。

Objective To observe the long-term effects of acupuncture in both neck and waist regions on cervical spondylosis of neck type,as compared with those by conventional neck acupuncture. Methods Fifty-two patients with cervical spondylosis of neck type who were diagnosed and treated in our hospital from August 2015 to December 2015 were emrolled as group A,and these patients were treated by conventional acupuncture for 2 weeks. And the other 53 patients with cervical spondylosis of neck type who were diagnosed and treated in our hospital from January 2016 to May 2016 were enrolled as group B,and these patients were treated by acupuncture in both neck and waist regions for 2weeks,with 45-day follow up after treatment for both groups. The scores of NPQ,ROM and cervical symptoms were recorded and analyzed by repeated measurement analysis of variance before treatment,at the end of 2-week treatment and at end of 45-day follow up. Meanwhile,the total effective rates in both groups were evaluated by rank test at end of 2-week treatment and at end of 45-day follow up.The relapse rates after 45-day follow up were observed and compared between two groups by means of survival curves. Results The scores of NPQ,ROM and neck symptoms before treatment,at end of 2-week treatment and at end of 45-day follow up showed that a significant decrease at first and then obvious increase tendency（ P 〈0. 05）. The scores of three indexes in group B at end of 45-day follow up were significantly lower than those in group A（ P 〈0. 05）. The total effective rates after 2-week treatment in group B were slightly lower than those in group A,but there were no significant differences between two groups（ P 〈0. 05）. However the total effective rates at end of 45-day follow up were significantly higher than those in group A（ 83. 33% vs 67. 39%,P 0. 05）. Moreover the relapse rates in group A after 45-day follow up were significantly lower than those in group B（ F = 5. 109,P 0. 05）. Conclusion The long-term effects of acupuncture in both neck and waist regions in treatment of cervical spondylosis of neck type are superior to those of conventional neck acupuncture,therefor,which is expected to be regarded as one of means in clinical treatment of cervical spondylosis of neck type.