射频电极针与温针灸治疗颈椎病患者慢性软组织损伤疼痛的效果比较

Comparison of the effects of radiofrequency electrode needle and warm acupuncture on chronic soft tissue pain in patients with cervical spondylopathy

目的比较射频电极针与温针灸治疗颈椎病患者慢性软组织损伤疼痛的效果。方法收集2016年2月至2017年1月在河北省张北县中医院康复疼痛科就诊的颈椎病患者120例,性别不限,年龄45~65岁,按照随机数字表法分为温针灸治疗组(WA组)和射频电极针组(RFN组),每组60例。WA组辨证选穴行温针灸治疗,每日1次,7d为1个疗程,根据病情治疗2~3个疗程。RFN组行射频电极针靶点热效应治疗,3d治疗1次,两次为1个疗程,根据病情治疗2~3个疗程。观察患者治疗前与治疗结束后即刻,治疗结束后3、6、12个月时的疼痛视觉模拟评分(VAS)和现实疼痛强度(PPI),统计每一观察时点VAS<3的例数,并观察不良反应与并发症发生情况。根据治疗前后疼痛变化程度进行治疗结束后各观察时点的疗效评估,同时比较两组患者的总有效率。结果与治疗前比较,两组患者治疗后各评价时点的VAS和PPI均降低,差异均有统计学意义(P均<0.05)。与WA组比较,RFN组治疗后各评价时点的VAS与PPI均更低,差异均有统计学意义(P均<0.05);与WA组比较,RFN组治疗后各观察时点VAS<3的例数较多,差异均有统计学意义(P均<0.05);与WA组比较,RFN组治疗后6、12个月总有效率较高(60.0%比86.7%,58.3%比81.7%),差异均有统计学意义(P均<0.05)。结论温针灸与射频电极针均可安全、有效地治疗颈椎病软组织损伤疼痛,且疗效稳定,后者效果更好。

Objective To compare the effects of radiofrequency electrode needle therapy and warm acupuncture on chronic soft tissue injury pain in patients with cervical spondylopathy. Methods One hundred and twenty patients with cervical spondylopathy, both sexes, 45-65 years old, admitted to Traditional Chinese Medicine Hospital of Zhangbei County from February 2016 to January 2017, were randomly divided into warm acupuncture group (group WA) and radiofrequency electrode needle group (group RFN) with 60 cases in each group. The patients of group WA were treated by moxibustion, and the points were selected according to syndrome differentiation, once a day, 7 days as a course of treatment, according to the condition for 2 to 3 courses. The patients were treated with target heat effect of radiofrequency electrode needle in group RFN, once 3 days, 2 times as a course of treatment, 2 to 3 courses of treatment according to the condition of the disease. Visual analogue scale (VAS) and present pain intensity (PPI) were observed before and immediately after the treatment, 3, 6, 12 months after the treatment. And adverse reactions and complications were also observed in all patients. According to the degree of pain changes before and after the treatment, the efficacy was evaluated at each observation point after the treatment, and the total effective rate of the two groups was compared. Results Compared with pretreatment, the VAS and PPI were all significantly decreased in the two groups at each time point after the treatment (all P<0.05). Compared with the group WA, the VAS and PPI were significantly low at each evaluation time point in the group RFN after the treatment (all P<0.05). Compared with the group WA, the total effective rate was significantly high in the group RFN at 6 and 12 months after the treatment (60.0% vs. 86.7%, 58.3% vs. 81.7%, all P<0.05). Conclusion Radiofrequency electrode needle and warm acupuncture are both safe and effective methods in the treatment of patients with soft tissue injury pain in cervical spondylopathy, and the latter is better.