挑刺拔罐配合针刺治疗C_(5-6)单节段神经根型颈椎病疗效观察

Observations on the Efficacy of Piercing-cupping Method plus Acupuncture in Treating C_(5-6) Single-segment Cervical Spondylotic Radiculopathy

目的观察挑刺拔罐配合针刺治疗C5-6单节段神经根型颈椎病患者的临床疗效。方法将56例C5-6单节段神经根型颈椎病患者按照就诊顺序随机分为治疗组和对照组,每组28例。对照组仅常规针刺,治疗组在对照组基础上,首日及后期每隔10 d均在常规针刺前先给予挑刺拔罐。采用Mc Gill疼痛问卷表(MPQ)记录疼痛评分,并观察肱二头肌和斜方肌上支等长收缩下的中位频率(median frequency,MF)及两组患者临床疗效与随访变化。结果治疗组和对照组总有效率分别为96.4%和71.4%,治疗组和对照组复发例数分别为0例和14例,组间差异均具有统计学意义(P<0.05)。两组治疗后MPQ的PRI、VAS、PPI疼痛评分较治疗前均明显下降(P<0.05),且治疗组降低较对照组更显著(P<0.05),随访时治疗组各项评分仍保持平稳或下降趋势。与治疗前相比,两组患者患侧肱二头肌和斜方肌上支MF值均有所升高(P<0.05);与对照组治疗后相比,治疗组患侧肱二头肌和斜方肌上支MF值上升更显著(P<0.05)。结论挑刺拔罐配合常规针刺治疗C5-6神经根型颈椎病在降低复发率、改善肌肉疲劳方面优于常规针刺法。

Objective To investigate the clinical efficacy of piercing-cupping method plus acupuncture in treating C5-6 single-segment cervical spondylotic radiculopathy. Method Fifty-six patients with C5-6 single-segment cervical spondylotic radiculopathy were allocated, in order of visits, to treatment and control groups, 28 cases each. The control group received conventional acupuncture. The treatment group received piercing-cupping therapy before conventional acupuncture at the first day and every 10 days after. The Mc Gill Pain Questionnaire（MPQ） score was recorded. The median frequency（MF） was measured during isometric contraction of the biceps brachii and the upper trapezius muscle. The clinical therapeutic effects were evaluated and followed up in the two groups of patients. Result The total efficacy rate was 96.4% in the treatment group and 71.4% in the control group and recurrence occurred in 0 case in the treatment group and 14 cases in the control group; there were statistically significant differences between the two groups（P0.05）. The MPQ-PRI,-VAS and-PPI scores decreased significantly in the two groups after treatment compared with before（P0.05） and decreased significantly more in the treatment group than in the control group（P0.05）. The scores kept stable or tended to decrease in the treatment group at follow-up. The MF in affected-side biceps brachii and upper trapezius muscle increased somewhat in the two groups of patients compared with before treatment（P0.05） and increased more in the treatment group than in the control group after treatment（P0.05）. Conclusion Piercing-cupping therapy plus conventional acupuncture for C5-6 cervical spondylotic radiculopathy is superior to conventional acupuncture in decreasing the recurrence rate and reducing muscle fatigue.