温通除痹汤结合电针“青灵组穴”对神经根型颈椎病临床疗效及血清炎性指标影响研究

Clinical Effect of Wentong Jibi Decoction Combined with Electroacupuncture at“QinglingPoints”on Cervical Spondylotic Radiculopathy and Serum Inflammatory Indexes

目的探究温通除痹汤结合电针"青灵组穴"对神经根型颈椎病临床疗效及血清炎性指标影响。方法将医院2017年1月-2018年8月收治的102例神经根型颈椎病患者纳入本次研究,以随机数字表法将其分为观察组和对照组各51例,对照组西医常规治疗,观察组西医常规治疗+温通除痹汤及电针"青灵组穴"治疗,比较两组患者治疗效果、治疗前后症状及体征(颈部疼痛、肢体麻木、颈项活动)积分变化、简化McGill疼痛检测量表评分变化、颈椎病临床评价量表(CASCS)及椎功能障碍指数量表(NDI)评分变化、血清炎症因子指标变化及血流动力学指标变化、血液黏度指标变化、SF-36生存质量量表评分变化,随访6个月,观察患者疾病反复情况。结果观察组治疗有效率98.04%(50/51)高于对照组86.27%(44/51)(P<0.05);治疗前,两组患者颈部疼痛、肢体麻木、颈项活动等临床症状与体征积分、McGill疼痛检测量表评分、CASCS及NDI评分、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)等血清炎症因子水平、血流高速峰值(Vm)、舒张期末峰值流速(Vd)、收缩期峰值流速(Vs)、搏动指数(PI)、阻力指数(RI)等血流动力学指标、还原低切及高切、高切全血黏度及低切全血黏度等血液黏度指标、SF-36评分比较(P>0.05),无显著统计学意义;治疗后各组患者颈部疼痛、肢体麻木、颈项活动等临床症状与体征积分、McGill疼痛检测量表评分、CASCS及NDI评分、血清炎症因子水平、血流动力学指标、血液黏度指标、SF-36评分均改善,且治疗后观察组以上指标优于对照组(P<0.05);观察组6个月疾病复发率(0.00%)低于对照组7.84%(4/51)(P<0.05)。结论温通除痹汤结合电针"青灵组穴"治疗神经根型颈椎病临床疗效显著,患者临床症状与体征显著改善,椎体功能恢复良好,血清炎症因子水平降低,疼痛缓解,6个月复发率低,值得推广与应用。

Objective To explore the clinical effect of Wentong Jibi Decoction combined with electroacupuncture at"Qinglingpoints"on cervical spondylotic radiculopathy and the influence on serum inflammatory indexes.Methods A total of 102 patients with cervical spondylotic radiculopathy admitted to our hospital from January 2018 to June 2019 were included in this study.They were divided into observation group and control group by random number table method.The control group was given routine Western medicine treatment.The observation group was additionally given Wentong Jibi Decoction combined with electroacupuncture at"Qinglingpoints".We compared two groups’effect,the patients’symptoms and signs(neckactivities,neck pain,numbness),changes of simplified McGill pain rating scale,changes of clinical assessment scale for cervical spondylosis(CASCS)and vertebral dysfunction index(NDI)scale,changes of serum inflammatory factor indexes and hemodynamic indexes,changes of blood viscosity indexes,changes of SF-36 quality rating scale.The patients were followed up for 6 months.Results The effective rate 98.04%(50/51)in the observation group was higher than that in the control group 86.27%(44/51)(P<0.05).Beforetreatment,two groups’neck pain,numbness and neck activities,McGill pain scale score,CASCS and NDI scores,interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),serum levels of proinflammatory factors,such as high speed peak(Vm),diastolic blood flow to the final peak velocity(Vd),systolic peak velocity(Vs),pulse index(PI),resistance index(RI),hemodynamic parameters and SF-36 scores had no significant difference(P>0.05).After treatment,clinical symptoms and signs such as neck pain,numbness and neck activities,McGill pain scale score,CASCS and NDI scores,serum levels of proinflammatory factors,hemodynamic indexes,blood viscosity indexes and SF-36 score were improved,and those of the observation group were better than those of the control group after treatment(P<0.05).The recurrence rate of the patients in the observation group at 6 months(0.00%)was lower than that in the control group 7.84%(4/51)(P<0.05).Conclusion Wentong Jibi Decoction combined with electroacupuncture at"Qinglingpoints"has a significant clinical effect in the treatment of radiculopathic cervical spondylotic disease.The clinical symptoms and signs of the patients have been significantly improved,the vertebral body function has been recovered well,the levels of serum inflammatory factors have been reduced,the pain has been alleviated,and the 6-month recurrence rate is low.It is worthy of promotion and application.