毫火针结合正骨推拿治疗神经根型颈椎病近远期疗效分析

The curative effect analysis of milli fire needle combined with bone setting massage on treatment of cervical spondylotic radiculopathy

目的探讨毫火针结合正骨推拿在神经根型颈椎病中的治疗效果,分析近远期疗效。方法前瞻性选取门诊就诊的神经根型颈椎病患者98例,根据随机数字表分成对照组与观察组各49例。对照组予以常规西药(乙酰氨基酚片)治疗,观察组采用毫火针联合正骨推拿治疗。比较两组疗程结束时及随访6个月的临床疗效,并分析治疗前后不同时段的症状积分、颈椎疼痛评级指数(PRI)以及颈椎屈曲度,记录两组不良事件发生率。结果观察组疗程结束时的总有效率为95.9%,较对照组的93.9%,差异无统计学意义(P>0.05),观察组治疗后6个月的总有效率为85.7%,显著高于对照组的67.3%,组间比较有统计学意义(P<0.05);观察组治疗后6个月的上肢麻木、眩晕、颈椎疼痛、神经根压迫积分分别为(1.53±0.16)分、(1.49±0.13)分、(1.58±0.17)分、(1.38±0.17)分,显著低于同时段对照组(1.82±0.58)分、(1.75±0.25)分、(1.90±0.38)分、(1.55±0.57)分(P<0.05);观察组治疗后6个月的牵扯痛、胀痛、撕裂痛、跳痛、热灼痛评分分别为(1.14±0.08)分、(1.07±0.06)分、(1.02±0.14)分、(0.93±0.21)分、(0.93±0.21)分,低于同时段对照组(1.53±0.50)分、(1.46±0.63)分、(1.53±0.52)分、(1.34±0.37)分、(1.48±0.41)分,差异有统计学意义(P<0.05);观察组治疗后6个月的颈椎屈曲度为(10.35±0.43)°,显著高于对照组(9.71±0.37)°(P<0.05);观察组不良事件发生率为4.1%,较对照组的6.1%差异无统计学意义(P>0.05)。结论毫火针结合正骨推拿能改善神经根型颈椎病患者的临床症状,降低疼痛指数,提高颈椎屈曲度,远期疗效显著,值得临床推广。

Objective To investigate the curative effect analysis of milli fire needle combined with bone setting massage on treatment of cervical spondylotic radiculopathy. Methods 98 patients with radicular cervical spondylosis were selected,and they were divided into control group and observation group according to the random number table,with 49 cases in each group. The control group was treated with conventional western medicine（ acetaminophen tablets）,and the observation group was treated with femoral acupuncture combined with orthopechial massage.At the end of treatment and follow-up of 6 months,the clinical curative effect were compared,and the symptom score,cervical pain rating index（ PRI） and cervical flexion degrees,the incidence of adverse events were analyzed. Results The total effective rate of the observation group was95. 9%,compared with 93. 9% in the control group without significant difference（ P〉0. 05）. 6 months after treatment,the total effective rate of the observation group was 85. 7%,significantly higher than that of control group 67. 3%,the difference between groups was statistically significant（ P〈0. 05）. 6 months after treatment,upper limb numbness,dizziness,neck pain,nerve root compression of observation group respectively were（ 1. 53 ± 0. 16） points,（ 1. 49 ± 0. 13） points,（ 1. 58 ± 0. 17） points,（ 1. 38 ± 0. 54） points,significantly lower than those at the same time period of the control group（ P〈0. 05）. 6 months after treatment,pain,tenderness,tearing pain,pain,heat burning pain score of observation group were（ 1. 14 ± 0. 08） points,（ 1. 07 ± 0. 06） points,（ 1. 02 ± 0. 14） points,（ 0. 93 ± 0. 21） points,（ 0. 93 ± 0. 21） points,respectively,lower than those at the same time period of the control group,the difference was statistically significant（ P〈0. 05）. 6 months after treatment,cervical flexion degree of observation group for（ 10. 35 ± 0. 43） °. It was significantly higher than that of control group（ P〈0. 05）. The incidence of adverse events in the observation group was 4. 1%,compared with 6. 1% in the control group,the difference was not statistically significant（ P〉0. 05）. Conclusion The combination of the femoral needle and the orthopaicular bone massage can improve the clinical symptoms of patients with radicular cervical spondylosis,reduce the pain index,improve the curvature of the cervical vertebra,and the long-term effect is remarkable. Therefore,it is worth the clinical promotion.