针刺配合关节松动术治疗神经根型颈椎病临床研究

Clinical Study on Acupuncture Combined with Joint Mobilization for Cervical Spondylosis with Radiculopathy

目的:观察针刺配合关节松动术治疗神经根型颈椎病的临床效果。方法:选择神经根型颈椎病患者106例,随机分为观察组和对照组各53例。对照组采用关节松动术治疗,观察组在对照组的基础上联合针刺治疗。2组均以10 d为1个疗程,治疗3个疗程后进行疗效评价。于治疗前后观察比较2组颈椎疼痛、颈椎活动度、颈椎功能障碍及颈椎病临床评价量表(CASCS)评分情况。结果:观察组总有效率为90.57%,对照组为75.47%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组简化McGill疼痛问卷量表(SF-MPQ)中疼痛分级指数(PRI)、视觉模拟评分法(VAS)评分、现在疼痛状况(PPI)评分比较,差异均无统计学意义(P>0.05)。治疗后,2组SF-MPQ各项疼痛评分均较治疗前降低(P<0.05),且观察组SF-MPQ各项疼痛评分均低于对照组(P<0.05)。治疗前,2组颈椎前屈、后伸、左侧屈、右侧屈、左旋、右旋活动度比较,差异无统计学意义(P>0.05);治疗后,2组颈椎活动度指标均较治疗前增加(P<0.05),且观察组颈椎活动度指标均大于对照组(P<0.05)。治疗前,2组上述颈部功能障碍情况比较,差异无统计学意义(P>0.05);治疗后,2组颈部功能障碍情况均较治疗前改善(P<0.05),观察组颈部功能障碍情况改善优于对照组(P<0.05)。治疗前,2组CASCS中主观症状、适应能力、临床体征评分及总分比较,差异无统计学意义(P>0.05);治疗后,2组CASCS各维度评分及总分均较治疗前升高(P<0.05),且观察组各项评分高于对照组(P<0.05)。结论:针刺配合关节松动术治疗神经根型颈椎病疗效显著,在改善患者疼痛、颈椎活动度、颈椎功能障碍等方面效果优于单纯关节松动术治疗。

Objective: To observe the clinical effect of acupuncture combined with joint mobilization for cervical spondylosis with radiculopathy. Methods:A total of 106 cases of cervical spondylosis with radiculopathy were selected and randomly divided into the observation group and the control group,53 cases in each group. The control group was treated with joint mobilization,and the observation group was additionally treated with acupuncture based on the treatment of the control group. Both groups were treated for three treatment courses,10 days being a course. After treatment,the curative effect was evaluated. Before and after treatment,pain,range of motion of cervical spine,cervical dysfunction and Clinical Assessment Scale for Cervical Spondylosis(CASCS) score were observed, analyzed and compared in the two groups.Results:The total effective rate was 90.57% in the observation group,and 75.47% in the control group,the difference being significant(P<0.05). Before treatment,when compared scores of Pain Rating Index(PRI),Visual Analogue Scale(VAS),and present pain intensity(PPI) of Short-form McGill Pain Questionnaire(SF-MPQ) between the two groups,there was no significance in the difference(P>0.05). After treatment,each pain score of SF-MPQ in the two groups was decreased when compared with that before treatment(P<0.05),and each score in the observation group was lower than that in the control group(P<0.05). Before treatment,when compared the range of motion of cervical anteflexion,back extension,left flexion,right flexion,left rotation and right rotation,there was no significant difference being found in the comparison between the two groups(P>0.05). After treatment,each index of range of motion of cervical spine in the two groups was increased when compared with that before treatment(P<0.05),and each index in the observation group was larger than that in the control group(P<0.05). Before treatment,there was no significant difference being found in the comparison of cervical dysfunction between the two groups(P>0.05). After treatment,the condition of cervical dysfunction in the two groups was improved when compared with that before treatment(P<0.05),and the improvement in the observation group was better than that in the control group(P<0.05). Before treatment, when compared scores of subjective symptoms, adaptability, and clinical physical signs, as well as the total score of CASCS, there was no significant difference being found in the comparison between the two groups(P>0.05). After treatment,scores of each dimension and the total score of CASCS in the two groups were increased when compared with those before treatment(P<0.05),and the scores in the observation group were higher than those in the control group(P<0.05). Conclusion: The therapy of acupuncture combined with joint mobilization has a significant curative effect in the treatment of cervical spondylosis with radiculopathy, which is better than simple joint mobilization in relieving pain,and improving cervical range of motion and cervical dysfunction.