基于六经辨证理论以桂枝附子汤治疗神经根型颈椎病的疗效观察

Observation on Therapeutic Effect of Guizhi Fuzi Decoction(桂枝附子汤) on Cervical Spondylotic Radiculopathy Based on Six Meridian Syndrome Differentiation Theory

目的:观察桂枝附子汤治疗神经根型颈椎病(太阳病表阳虚证)的疗效。方法:纳入60例神经根型颈椎病(太阳病表阳虚证)患者,随机分为治疗组和对照组,每组30例。治疗组患者服用桂枝附子汤,对照组患者服用塞来昔布胶囊和甲钴胺片,治疗周期为2周;在治疗前、治疗2周后、治疗结束3个月,以视觉疼痛评分量表(VAS)评估疼痛,以中医主要证候分级量表积分评估临床症状,并评定疗效。结果:治疗组总有效率为90.00%(27/30),对照组总有效率为86.67%(26/30),治疗组总有效率高于对照组。治疗组患者临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗结束时VAS评分比较:两组患者VAS评分均降低,差异有统计学意义(P<0.05),两组患者VAS评分比较,差异无统计学意义(P>0.05)。治疗后3个月时VAS评分比较:治疗组患者VAS评分与治疗结束时比较,差异无统计学意义(P>0.05);对照组患者VAS评分高于治疗结束时,差异有统计学意义(P<0.05)。治疗结束时中医证候总积分比较:两组患者中医证候总积分均下降,差异有统计学意义(P<0.05),且治疗组患者中医证候总积分低于对照组,差异有统计学意义(P<0.05)。治疗后3个月时中医证候总积分比较:治疗组患者中医证候总积分与治疗结束时比较,差异无统计学意义(P>0.05);对照组患者中医证候总积分高于治疗结束时,差异有统计学意义(P<0.05)。结论:桂枝附子汤治疗神经根型颈椎病(太阳病表阳虚证)有较好疗效,可以明显缓解疼痛,改善神经根型颈椎病出现的颈、肩、上肢部位僵硬及疼痛、怕冷、汗出、肢体困重等症状。

Objective:To observe the efficacy of Guizhi Fuzi Decoction on cervical spondylotic radiculopathy(Taiyang disease syndrome with surface Yang deficiency).Methods:Totally 60 patients with cervical spondylotic radiculopathy(Taiyang disease syndrome with surface Yang deficiency)were randomly divided into treatment and control groups,30 cases in each group.Patients were treated with Guizhi Fuzi Decoction in treatment group,and celecoxib capsule and mecobalamin tablets in control group for two weeks.Before treatment,two weeks and three months after treatment,the pain was evaluated by visual pain score scale(VAS),and the clinical symptoms were evaluated by the score of TCM main syndrome classification scale.And the curative effect was evaluated.Results:The total effective rate was 90.00%(27/30)in treatment group and 86.67%(26/30)in control group.The treatment group showed higher effective rate than control group.The treatment group showed better clinical curative effect than control group,and the difference was statistically significant(P<0.05).According to the comparison of VAS score at the end of treatment,the VAS score decreased in the two groups,with statistically significant difference(P<0.05),but there was no significant difference in the VAS score between the two groups(P>0.05).According to the comparison of VAS score three months after treatment,there was no significant difference in VAS score between three months after treatment and the end of treatment in treatment group(P>0.05),but the VAS score in the control group was significantly higher than that at the end of treatment(P<0.05).According to comparison of the total scores of TCM syndrome at the end of treatment,the total scores of TCM syndrome decreased in the two groups(P<0.05),and the treatment group showed lower total scores of TCM syndrome than control group(P<0.05).According to comparison of the total scores of TCM syndrome three months after treatment,there was no significant difference in the total scores of TCM syndrome between three months after treatment and the end of treatment in treatment group(P>0.05),but the total scores of TCM syndrome in the control group was higher than that at the end of treatment(P<0.05).Conclusion:Guizhi Fuzi Decoction is effective in the treatment of cervical spondylotic radiculopathy(Taiyang disease syndrome with surface Yang deficiency).It can obviously relieve pain and improve the symptoms of cervical spondylotic radiculopathy,such as neck,shoulder,upper limb stiffness,pain,fear of cold,sweating,limb sleepiness and so on.