独活寄生汤加减治疗神经根型颈椎病

Exploration on the clinical efficacy of modified Duhuo Jisheng Decoction in the treatment of cervical spondylotic radiculopathy

目的探讨独活寄生汤加减治疗神经根型颈椎病患者临床疗效。方法选取184例神经根型颈椎病患者作为研究对象,以随机数表法分为对照组与观察组,各92例。对照组采用针刺疗法,观察组在对照组的基础上采用独活寄生汤加减进行治疗,2组均以6 d为1个疗程,持续治疗2个疗程。比较2组临床疗效,治疗前后中医症状评分、神经根损伤程度及疾病相关因子水平。结果治疗后,观察组治疗总有效率(96.74%,89/92)高于对照组(86.96%,80/92)(P<0.05)。与治疗前比较,2组治疗后眩晕、心悸、肢体麻木、头痛、中医症状总分、血清P物质(SP)、白介素-1β(IL-1β)、肿瘤坏死因子(TNF-α)水平均降低,观察组低于对照组(P<0.05);颈神经支配区域C_(5)~C_(8)评分均升高,观察组高于对照组(P<0.05)。结论独活寄生汤加减治疗可明显降低神经根型颈椎病患者血清SP、IL-1β、TNF-α水平,降低机体炎症反应,改善中医症状,减轻神经根损伤程度,提高临床疗效。

Objective To explore the clinical efficacy of modified Duhuo Jisheng Decoction in the treatment of cervical spondylotic radiculopathy.Methods A total of 184 patients with cervical spondylotic radiculopathy were selected as the research subjects,and they were randomly divided into a control group and an observation group,with 92 cases in each group.The control group was treated with acupuncture,while the observation group was treated with Duhuo Jisheng Decoction on the basis of the control group,both with 6 days as a course of treatment and continuously for 2 courses.The clinical efficacy,TCM symptom score,nerve root injury degree and disease-related factor levels were compared between the two groups before and after treatment.Results After treatment,the total effective rate of the observation group(96.74%,89/92)was higher than that of the control group(86.96%,80/92)(P<0.05).Compared with before treatment,scores of vertigo,palpitations,limb numbness,headache,total scores of TCM symptoms,levels of serum substance P(SP),interleukin-1β(IL-1β),and tumor necrosis factor(TNF-α)were decreased in the two groups,and the observation group was lower than the control group(P<0.05),while the cervical nerve innervation area C_(5)-C_(8)scores were all increased,and the observation group was higher than the control group(P<0.05).Conclusion Modifi ed Duhuo Jisheng Decoction can signifi cantly reduce the serum SP,IL-1βand TNF-αlevels in patients with cervical spondylotic radiculopathy,reduce the body’s inflammatory response,improve the TCM symptoms,alleviate the degree of nerve root injury,and improve the clinical efficacy.