经椎间孔体外冲击波治疗神经根型颈椎病的临床研究

Effect of transforaminal extracorporeal shock wave in the treatment of patients with cervical spondylosis radiculopathy

目的:探索经椎间孔体外冲击波治疗神经根型颈椎病的疗效。方法:选取平湖市第一人民医院2018年4月至2019年4月诊治的神经根型颈椎病患者84例,按照随机数字表法分为对照组和观察组,各42例。对照组采用常规康复治疗,观察组在对照组基础上结合经椎间孔体外冲击波治疗。两组疗程均为3周。比较两组治疗前后视觉痛觉评分量表(VAS)评分、田中靖久颈椎病症状量表评分、颈椎功能障碍指数量表(NDI)评分和颈椎活动度评分及疗效。结果:观察组治疗3周VAS评分(1.11±0.21)分,低于对照组的(3.13±0.75)分(t=16.808,P<0.05);观察组治疗后颈椎病症状评分(17.67±2.16)分,高于对照组的(14.28±2.31)分,而NDI评分(7.54±2.66)分,低于对照组的(12.44±4.08)分(t=6.947、6.520,均P<0.05);观察组治疗后颈椎前屈(46.52±3.25)°和后伸活动度(47.32±2.61)°,高于对照组的(41.02±2.65)°和(42.36±2.80)°(t=8.500、8.398,均P<0.05);观察组总有效率(85.71%)高于对照组(64.29%)(χ2=5.143,P<0.05)。结论:经椎间孔体外冲击波治疗能够降低神经根型颈椎病患者疼痛感,改善患者颈椎病症状及颈椎功能,临床疗效较好。

Objective To explore the effect of extracorporeal shock wave(ESW)through intervertebral foramen on cervical spondylotic radiculopathy.Methods From April 2018 to April 2019,84 cases of cervical spondylotic radiculopathy diagnosed and treated in the First People's Hospital of Pinghu were divided into two groups according to the random number table method,with 42 cases in each group.The control group was treated with conventional rehabilitation,and the observation group was treated with ESW.The course of treatment in both two groups was 3 weeks.Before and after treatment,the visual pain scale(VAS)score,Tanaka Jingjiu cervical syndrome scale score,cervical dysfunction index scale(NDI)score and cervical activity score were compared between the two groups.Results After treatment for 3 weeks,the VAS score of the observation group was(1.11±0.21)points,which was lower than that of the control group[(3.13±0.75)points](t=16.808,P<0.05).After treatment,the symptom score of cervical spondylosis in the observation group[(17.67±2.16)points]was higher than that in the control group[(14.28±2.31)points],while the NDI score in the observation group[(7.54±2.66)points]was lower than that in the control group[(12.44±4.08)points],the differences were statistically significant(t=6.947,6.520,all P<0.05).After treatment,the cervical flexion[(46.52±3.25)°]and extension activity[(47.32±2.61)°]in the observation group were higher than those in the control group[(41.02±2.65)°and(42.36±2.80)°](t=8.500,8.398,all P<0.05).The total effective rate of the observation group(85.71%)was higher than that of the control group(64.29%)(χ2=5.143,P<0.05).Conclusion Transforaminal ESW therapy can reduce the pain of patients with cervical spondylotic radiculopathy,improve the symptoms of cervical spondylotic radiculopathy and cervical function.It has good clinical efficacy and is suitable for clinical application.