“王之派”曲旋直提法联合神经根阻滞治疗神经根型颈椎病的疗效观察

Observation on the Efficacy of"Wang Zhipai"Combined with Nerve Root Block on Cervical Spondylotic Radiculopathy

目的:观察“王之派”曲旋直提法联合神经根阻滞治疗神经根型颈椎病(CSR)的疗效及对炎症指标的影响。方法:将124例神经根型颈椎病患者随机分为对照组与治疗组,每组62例。对照组患者予神经根阻滞治疗,治疗组患者予“王之派”曲旋直提法联合神经根阻滞治疗,均连续治疗3周。两组患者治疗前后均进行颈椎功能障碍指数(NDI)、颈椎病临床评价量表(CASCS)评分、简化McGill疼痛问卷调查,包括疼痛视觉模拟评分(VAS)、疼痛分级指数(PRI)、疼痛分级强度评分(PPI);评价两组患者的临床疗效;检测两组患者治疗前后血清C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果:治疗组治愈率为61.29%,总有效率为95.16%,对照组治愈率为37.10%,总有效率为79.03%;治疗组治愈率、总有效率均高于对照组,差异有统计学意义(P<0.05);治疗组患者治疗后DNI、VAS、PPI、PRI评分较治疗前降低(P<0.05),且治疗组患者治疗后DNI、VAS、PPI、PRI评分低于对照组(P<0.05);治疗组患者治疗后CASCS评分较治疗前升高(P<0.05),血清CRP、IL-6、TNF-α水平较治疗前降低(P<0.05),且治疗组患者治疗后CASCS评分高于对照组(P<0.05),血清CRP、IL-6、TNF-α水平低于对照组(P<0.05)。结论:“王之派”曲旋直提法联合神经根阻滞可以显著改善神经根型颈椎病患者的临床症状,提高患者生活质量,减轻炎症反应。

Objective:To observe the curative effect of"Wang Zhipai"and the treatment of nerve root type cervical spondylosis(CSR)and its influence on inflammation index.Methods:Totally 124 patients with cervical spondylotic radiculopathy were randomly divided into the control and treatment groups,62 cases in each group.Patients were treated with nerve root block in control group,and"Wang Zhipai"combined with nerve root block in treatment group,for three weeks.The patients in both groups were assessed with cervical dysfunction index(NDI),cervical spondylosis clinical evaluation scale(CASCS)score,and simplified McGill pain questionnaire,including pain visual analogue scale(VAS),pain grade index(PRI)and Pain Grading Intensity Score(PPI);the clinical efficacy of the two groups after treatment was evaluated;serum C-reactive protein(CRP),interleukin 6(IL-6)and tumor necrosis factorα(TNF-α)level were measured before and after treatment.Results:The cure rate of the treatment group was 61.29%,and the total effective rate was 95.16%.The cure rate of the control group was 37.10%,and the total effective rate was 79.03%.The treatment group showed higher cure rate and total effective rate than control group,with significant difference(P<0.05).After treatment,The DNI,VAS,PPI and PRI scores decreased in treatment group(P<0.05),and the treatment group showed lower DNI,VAS,PPI and PRI scores than control group(P<0.05).The CASCS scores were significantly increased in treatment group(P<0.05)and the levels of serum CRP,IL-6 and TNF-αwere significantly decreased in treatment group(P<0.05).The treatment group showed higher CASCS scores than control group(P<0.05),while lower levels of serum CRP,IL-6 and TNF-αthan control group(P<0.05).Conclusion:"Wang Zhipai"combined with nerve root block can significantly improve the clinical symptoms of patients with CSR,improve patients'quality of life and reduce inflammation.