针刺联合穴位注射对神经根型颈椎病颈椎功能恢复的影响

Effect of Acupuncture Combined with Acupoint Injection on the Recovery of Cervical Function in Patients with Cervical Spondylosis of Nerve Root Type

目的探究针刺联合穴位注射对神经根型颈椎病患者颈椎功能恢复的影响及其作用机制。方法将纳入的100例神经根型颈椎病患者按照随机数字表法分为穴位注射组和联合组,每组50例。穴位注射组采用单纯穴位注射治疗,联合组在穴位注射组治疗基础上联合针刺治疗。观察两组患者治疗前后视觉模拟量表(VAS)评分、Northwick Park颈痛量表(NPQ)评分和36项生活质量调查问卷(SF-36)评分的变化;观察两组治疗前后颈动脉收缩峰值血流速度(Vp)、平均血流速度(Vm)和颈椎活动度的变化,以及血清肿瘤坏死因子(TNF)-a含量、肿瘤坏死因子Ⅰ型受体(TNFRⅠ)水平和天冬氨酸特异性半胱氨酸蛋白酶(Caspase)-8蛋白表达量的变化。比较两组临床治愈率。结果两组治疗后各项观察指标均优于治疗前(P<0.05);联合组治疗后VAS和NPQ评分均低于穴位注射组(P<0.05),SF-36评分、Vp、Vm和颈椎活动度均高于穴位注射组(P<0.05),联合组治疗后TNF-a含量、TNFRI水平和Caspase-8蛋白表达量均低于穴位注射组(P<0.05)。联合组治愈率高于穴位注射组,组间差异具有统计学意义(P<0.05)。结论针刺联合穴位注射治疗神经根型颈椎病可有效缓解疼痛,改善患者颈部活动度及缓解颈部紧张,促进颈部生物力学平衡的恢复,降低炎性介质水平。

Objective To investigate the effect of acupuncture plus acupoint injection in restoring the cervical function in patients with cervical spondylosis of nerve root type and its action mechanism.Method One hundred patients with cervical spondylosis of nerve root type were allocated to an acupoint injection group and an integrated group using random number table method,with 50 cases in each group.The acupoint injection group was treated with acupoint injection alone,while the integrated group was given additional acupuncture treatment.The visual analogue scale(VAS),Northwick park neck pain questionnaire(NPQ)and 36-item short-form health survey(SF-36)scores were observed before and after treatment in the two groups;the peak systolic velocity(Vp)and mean velocity(Vm)of carotid artery and cervical range of motion,as well as the serum tumor necrosis factor(TNF)-αcontent,TNF receptorⅠ(TNFRⅠ)level,and Caspase-8 protein expression were also observed before and after treatment in both groups.The clinical recovery rate was compared between the two groups.Result All of the parameters were improved after treatment in the two groups(P<0.05).After treatment,the VAS and NPQ scores were lower in the integrated group than in the acupoint injection group(P<0.05);the SF-36 score,Vp and Vm,and cervical range of motion were higher in the integrated group than in the acupoint injection group(P<0.05);the TNF-αcontent,TNFRⅠlevel and Caspase-8 protein expression were lower in the integrated group than in the acupoint injection group(P<0.05).The integrated group had a higher recovery rate compared with the acupoint injection group,and the between-group difference was statistically significant(P<0.05).Conclusion Acupuncture plus acupoint injection can effectively reduce pain,improve the cervical range of motion,ease cervical tension,boost the recovery of cervical biomechanical balance,and reduce the levels of inflammation mediators in treating cervical spondylosis of nerve root type.