真实世界研究神经根型颈椎病非药物疗法的临床应用

Application of Non-pharmacotherapy Treating Cervical Radiculopathy in Real-world Study

目的:了解临床真实世界中神经根型颈椎病(cervical radiculopathy,CR)非药物疗法的使用情况,为CR提供临床借鉴。方法:利用中医医疗与临床科研信息共享系统获取CR临床数据,研究对象为2012年12月至2014年7月在中国中医科学院望京医院就诊的628例CR住院与门诊患者。采用描述性统计方法分析应用非药物疗法人群的基本特征,利用liquorice软件分析全部患者、门诊患者、住院患者非药物疗法应用的节点度和互信息值,并绘制复杂网络图。结果:47%的CR患者使用非药物疗法(294/628),男性67例,女性227例,患者平均年龄为49岁,45-65岁年龄段患病比例最高。全部患者人群分析,手法与颈椎牵引临床应用较多,手法与针灸治疗联合应用最多;门诊患者人群分析,颈椎牵引临床应用较多,手法与针灸治疗联合应用最多;住院患者人群分析,颈椎牵引与手法临床应用较多,综合物理治疗与运动疗法联合应用最多。结论:非药物疗法是临床治疗CR常用方法,颈椎牵引、手法应用最多,综合治疗在临床实践中应用广泛,未来研究应增加不同地域的CR患者样本量,逐渐提高非药物疗法的临床研究证据等级。

This study was aimed to analyze the application of non-pharmacotherapy in treating cervical radiculopathy（CR） in real-world, and to provide clinical reference for CR non-pharmacotherapy. The clinical real-world data of CR was extracted by using information sharing system of traditional Chinese medicine（TCM） and clinical research. Six hundred and twenty-eight inpatients and outpatients with CR were enrolled from December 2012 to July 2014 in the information system database of Wangjing Hospital. Basic characteristics of the non-pharmacotherapy groups were analyzed by statistical description method. The node degree and mutual information value were recorded for nonpharmacotherapy application of all patients by using liquorice software. Complex network diagrams were generated. The results showed that 47% of CR patients received non-pharmacotherapy（294/628）, including 67 males and 227 females.The average age of patients was 49 years old, and the prevalence of the disease was the highest from 45 to 65 years old. In all patients, the usage of manipulation and cervical traction was higher, and the combination of manipulation and acupuncture was the most. Within outpatients, the proportion of cervical traction was higher, and the combination of manipulation and acupuncture was the most frequently. Within inpatients, the proportion of manipulation and cervical traction was higher, and the combination of comprehensive physical therapy and exercise therapy was the most frequently. It was concluded that non-pharmacotherapy has been commonly used in clinical treatment of CR. Cervical traction and manipulation was the widest applications. The combination treatment was in wide application. Future studies should increase the sample size of CR patients from different regions, and enhance gradually the level of evidence of clinical research for non-pharmacotherapy treating CR.