圣愈汤加减结合针刺对气血不足型神经根型颈椎病患者的临床疗效及对T淋巴细胞亚群的影响

Effect of Acupuncture Combined with Modified Shengyutang on Clinical Efficacy and T-lymphocyte Subsets in Patients with Cervical Spondylotic Radiculopathy of Qi-blood Deficiency

目的:探讨圣愈汤加减结合针刺治疗气血不足型神经根型颈椎病(cervical spondylotic radiculopathy,CSR)的临床疗效及对T淋巴细胞亚群的影响。方法:将201例气血不足型CSR患者随机分为3组,每组67例。A组给予圣愈汤加减治疗;B组针刺治疗;C组给予圣愈汤加减结合针刺治疗,观察各组治疗的有效率和中医气血不足证的治疗效果。比较各组患者治疗前后颈部伤残指数评分(neck disabilitv index,NDI),视觉模拟评分法(visual analogue score,VAS),健康调查量表心理部分(SF-36 mental component summary,SF-36MCS),健康调查量表生理部分(SF-36 physical component summary,SF-36PCS);检测各组治疗前后血清白细胞介素-1β(interleukin-1β,IL-1β),白细胞介素-6(interleukin-6)及降钙素相关肽(calcitonin generelated peptide,CGRP)的含量变化情况;比较各组治疗前后血清T淋巴细胞亚群CD3^+,CD4^+,CD8^+水平及CD4^+/CD8^+的变化;观察各组患者的治疗安全性指标。结果:与A组,B组治疗后比较,C组临床总有效率明显升高(P<0.05);NDI及VAS积分均有明显降低(P<0.05),SF-36MCS及SF-36PCS积分均明显升高(P<0.05);气血不足证评分明显降低(P<0.05);血清炎症因子指标IL-1β,IL-6及CGRP水平明显降低(P<0.05);T淋巴细胞CD3^+,CD4^+水平及CD4^+/CD8^+均有明显升高(P<0.05,P<0.01),CD8+水平明显降低(P<0.05,P<0.01);各组患者治疗过程中均无明显不良反应发生。结论:针刺结合圣愈汤加减对气血不足型CSR临床疗效明显,值得推广。

Objective:To investigate the clinical efficacy of acupuncture combined with modified Shengyutang in treatment of cervical spondylotic radiculopathy with Qi-blood deficiency and its effect on T-lymphocyte subsets.Method:Totally 201 cases of cervical spondylotic radiculopathy with blood deficiency were randomly divided into 3 groups,with 67 cases in each group.Group A was treated with modified Shengyutang.Group B was treated with acupuncture.Group C was treated with modified Shengyutang combined with acupuncture.The effective rate of each group and the therapeutic effect of deficiency of Qi and blood were observed.Neck disabilitv index(NDI),visual analogue score(VAS),SF-36 mental component summary(SF-36MCS)and SF-36 physical component summary(SF-36PCS)were compared before and after treatment.Serum levels of interleukin-1β(IL-1β),interleukin-6(IL-6)and calcitonin related peptide(CGRP)were measured before and after treatment.The levels of CD3^+,CD4^+,CD8^+and the ratio of CD4^+/CD8^+were compared before and after treatment.The therapeutic safety indexes of each group were observed.Result:After treatment,the total clinical effective rate of group C was significantly higher than that of group A and B(P<0.05).NDI and VAS scores were significantly reduced(P<0.05).The scores of SF-36MCS and SF-36PCS were significantly increased(P<0.05).The score of Qi-blood deficiency syndrome was significantly lower(P<0.05).Serum levels of IL-1β,IL-6 and CGRP were significantly lower(P<0.05).The levels of CD3^+,CD4^+and CD4^+/CD8^+were significantly increased(P<0.05,P<0.01),whereas CD8^+was significantly decreased(P<0.05,P<0.01).No significant adverse reactions occurred in each group during the treatment.Conclusion:acupuncture combined with Shengyutang has a significant clinical effect on cervical spondylosis with Qi-blood deficiency,and is worth popularizing.