活血化瘀汤联合颈椎牵引治疗神经根型颈椎病临床观察

Clinical Observation of Huoxue Huayu Tang Combined with Cervical Traction for Nerve Root Cervical Spondylosis

目的:观察活血化瘀汤联合颈椎牵引治疗神经根型颈椎病的临床疗效。方法:选取63例神经根型颈椎病患者为研究对象,随机分为对照组30例和治疗组33例。对照组给予颈椎牵引治疗,治疗组在对照组基础上加用活血化瘀汤。观察2组治疗前后中医证候积分、颈肩疼痛、颈椎功能及炎症因子的改善情况,对比2组临床疗效。结果:治疗组总有效率93.94%,高于对照组70.00%,差异有统计学意义(P <0.05)。治疗后,2组颈部压痛、颈肩疼痛、肢体麻木、颈部活动障碍积分均较治疗前降低(P <0.05),治疗组4项中医证候积分均较对照组下降更明显(P <0.05)。治疗后,2组现有疼痛强度(PPI)、疼痛分级指数(PRI)、疼痛视觉模拟评分法(VAS)评分和颈椎功能障碍指数量表(NDI)评分均较治疗前降低(P <0.05),治疗组4项评分均比对照组下降更明显(P<0.05)。治疗后,2组白细胞介素-6 (IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)水平均较治疗前下降(P <0.05),治疗组3项炎症因子水平均低于对照组(P <0.05)。结论:活血化瘀汤联合颈椎牵引治疗神经根型颈椎病可显著改善患者的症状,促进颈椎功能恢复,控制炎症反应,效果优于单纯颈椎牵引治疗。

Objective： To observe the clinical effect of Huoxue Huayu tang combined with cervical traction for nerve root cervical spondylosis. Methods：Selected 63 cases of patients with nerve root cervical spondylosis as study subjects,and divided them into two groups randomly,30 cases in the control group and 33 cases in the treatment group. The control group was received cervical traction for treatment, while the treatment group additionally received Huoxue Huayu tang. Observed Chinese medicine syndrome scores and improvements of neck and shoulder pain, cervical function and inflammatory factors in both groups before and after treatment, and compared the clinical effect in both groups. Results： The total effective rate was 93.94% in the treatment group, being higher than 70.00% in the control group, difference being significant（P〈0.05）. After treatment, scores of neck tenderness, neck and shoulder pain,limb numbness and obstacle of neck movement in both groups were all lower than those before treatment（P〈0.05）,and each Chinese medicine syndrome score in the treatment group was decreased more evidently than that in the control group（P〈0.05）. After treatment,scores of present pain intensity（PPI）,pain rating index（PRI）,visual analogue scale（VAS） and neck disability index（NDI） in both groups were all lower than those before treatment（P〈0.05）,and each score in the treatment group was decreased more evidently than that in the control group（P〈0.05）. After treatment, levels of interleukin-6（IL-6）, tumour necrosis factor-α（TNF-α） and interleukin-1β（IL-1β） in both groups were all lower than those before treatment（P〈0.05）,and each level of inflammatory factors in the treatment group was respectively lower than that in the control group（P〈0.05）. Conclusion： Huoxue Huayu tang combined with cervical traction for nerve root cervical spondylosis can significantly improve symtom of patients, promote the recovery of cervical function and control inflammatory reactions,which has better clinical effect than the simple application of cervical traction.