筋骨通脉汤联合刺络放血治疗颈肩痛临床观察

Clinical observation of Jin'gu Tongmai decoction combined with and blood-letting therapy on neck and shoulder pain

目的观察筋骨通脉汤联合刺络放血治疗颈肩痛的临床疗效。方法将120例颈肩痛患者随机分为2组。对照组60例予筋骨通脉汤治疗;治疗组60例在对照组治疗基础上加刺络放血治疗。2组均2周为1个疗程,2个疗程后统计临床疗效,并观察2组治疗前后疼痛视觉模拟评分法(VAS)评分、Barthel指数(BI)评分、Fugl-Meyer评分变化,以及血液流变学指标变化。结果治疗组总有效率93.3%,对照组总有效率83.3%,治疗组疗效优于对照组(P<0.05)。2组治疗后疼痛VAS评分均较本组治疗前降低(P<0.05),BI评分及Fugl-Meyer评分均较本组治疗前升高(P<0.05);治疗后治疗组VAS评分低于对照组(P<0.05),BI评分及Fugl-Meyer评分均高于对照组(P<0.05)。2组治疗后全血黏度(低切)、全血黏度(高切)、血浆黏度、红细胞比容及纤维蛋白原均较本组治疗前降低(P<0.05),治疗后治疗组全血黏度(低切)、全血黏度(高切)、血浆黏度、红细胞比容及纤维蛋白原均低于对照组(P<0.05)。结论筋骨通脉汤联合刺络放血治疗颈肩痛疗效优于单纯应用筋骨通脉汤治疗,并能进一步提高患者日常生活活动能力,改善血液流变学指标,安全可靠。

Objective To observe the clinical effects of Jin'gu Tongmai decoction combined with blood-letting therapy on neck and shoulder pain.Methods 120 cases with neck and shoulder pain were randomly divided into two groups.60 cases in control group were treated by Jin'gu Tongmai decoction,and 60 cases in treatment group were treated by blood-letting therapy on the basis of control group treatment,continuously treatment for four weeks.The changes of visual analogue scales(VAS) scores,Barthel index(BI),Fugl-Meyer scores,and changes of hemorheology index before and after treatment were observed in two groups,and the clinical effects were compared.Results The total effective rate in treatment group(93.3%) was superior to that in control group(83.3%,P <0.05).The VAS scores after treatment were decreased in two groups(P < 0.05),and BI index,Fugl-Meyer scores were higher than those before the treatment(P < 0.05).After treatment,the VAS scores in the treatment group was lower than that in the control group(P < 0.05),BI index and Fugl-Meyer scores were higher than those in the control group(P < 0.05).After treatment,whole blood viscosity(low cut),whole blood viscosity(high cut),plasma viscosity,hematocrit,and fibrinogen were lower than before treatment in the two groups(P < 0.05).The blood viscosity(low cut),whole blood viscosity(high cut),plasma viscosity,hematocrit,and fibrinogen after treatment in the treated group were lower than those in the control group(P< 0.05).Conclusion Jin'gu Tongmai decoction combined with blood-letting therapy in treating neck and shoulder pain is more effective than simple application of Jin'gu Tongmai decoction.It is safe and reliable,and it can further improve the ability of daily living activities of patients and improve the hemorheological indexes.