基于腋神经走行针刀联合穴位注射治疗神经根型颈椎病临床研究

Clinical Study of Acupotomy Combined with Acupoint Injection on Cervical Spondylotic Radiculopathy Based on Axillary Nerve Distribution

目的:探究于腋神经走行的肩背部痛点行针刀联合穴位注射治疗神经根型颈椎病(CSR)的疗效。方法:按照随机数字表法将60例CSR患者分为两组,对照组30例予常规针刺疗法;观察组30例每7 d于腋神经走行的肩背部痛点行针刀联合穴位注射治疗。两组患者均治疗3周。治疗前后,对两组MRI椎间盘突出指数、血液流变学指标、视觉模拟评分法(VAS)评分及麻木评分进行评判,并对比两组疗效。结果:治疗后两组MRI椎间盘突出指数无明显变化(P>0.05),VAS评分、麻木评分、血液流变学水平均降低(P<0.05),且观察组表现均优于对照组(P<0.05);观察组总有效率83.3%,对照组66.7%,观察组疗效优于对照组(P<0.05)。结论:基于腋神经走行于肩背部的痛点给予针刀联合穴位注射治疗CSR,疗效确切且优于常规针刺,值得进一步研究。

Objective:To investigate the effect of acupotomy combined with acupoint injection on cervical spondylotic radiculopathy(CSR)based on tender points of shoulder and back in the axillary nerve distribution.Methods:Using a random number table,60 CSR patients were included and randomly divided into observation group and control group,30 patients in each group.The control group was given routine acupuncture treatment;the observation group was given acupotomy combined with acupoint injection every 7 days on the tender points in the axillary nerve distribution.Both groups were treated for 3 weeks.Before and after the treatment,magnetic resonance imaging(MRI)intervertebral disc herniation index,hemorheology changes,visual analogy scale(VAS)score and numbness score were measured,and the effectiveness rates between two groups were compared.Results:After the treatment,there was no significant change in MRI intervertebral disc herniation index in both groups(P>0.05);hemorheology level,VAS and numbness scores all decreased in both groups(P<0.05),and in the observation group were lower than those in the control group(P<0.05);the effectiveness rate in the observation group was 83.3%,in the control group was 66.7%,indicating that observation group was better than control group on the effectiveness rate(P<0.05).Conclusion:Acupotomy combined with acupoint injection on tender points of shoulder and back in the axillary nerve distribution is more effective and better than conventional acupuncture in the treatment of CSR,and it should be further explored.