葛根祛湿合剂治疗脊髓型颈椎病(阴虚湿阻证)的临床研究

A clinical study on treating cervical spondylotic myelopathy(the Yin deficiency and dampness resistance syndrome) with the Gegen Qushi mixture

目的:探讨葛根祛湿合剂治疗脊髓型颈椎病(阴虚湿阻证)的临床疗效。方法:随机将100例脊髓型颈椎病(阴虚湿阻证)患者分为两组,西药组50例、中药组50例。经过4个疗程(2个月)的中西药治疗,使用疼痛视觉模拟评分法(Visual Analogue Scale,VAS)评分、日本骨科协会改良颈椎评分法(Japanese Orthopaedic Association,JOA)评分、颈椎功能障碍指数(Neck Disability Index,NDA)评分、颈椎生理曲度值评价葛根祛湿合剂的临床治疗效果。结果:中药组患者疼痛缓解程度(VAS评分)在治疗2个疗程后与西药组相比差异出现统计学意义(P <0.05),神经功能改善(JOA评分)在治疗3个疗程后与西药组差异有统计学意义(P <0.05),治疗4个疗程后中药组患者整体病情严重程度(NDA评分)较西药组轻,而治疗4个疗程后两组患者颈椎生理曲度值差异无统计学意义(P> 0.05)。结论:葛根祛湿合剂在治疗脊髓型颈椎病(阴虚湿阻证)临床疗效方面与目前主流西药止痛抗炎、营养神经治疗在短时间(1个月内)无明显差别,而在长期临床疗效方面存在差异,且优于西药效果,但对脊髓型颈椎病患者的颈椎生理曲度无明显的改善作用。

Objective:To investigate the clinical effect of the Gegen Qushi mixture(葛根祛湿合剂)on cervical spondylotic myelopathy of the Yin(阴)deficiency and dampness resistance syndrome.Methods:One hundred cases were randomly divided into two groups,with 50 cases in the Western medicine group and 50 cases in the TCM medicine group.The treatment lasted for 4 courses(2 months).Results:The pain relief degree(VAS score)in the TCM medicine group was significantly different from that in the Western medicine group after 2courses of treatment(P<0.05).There was a statistically significant difference in the improvement of neurological function(JOA score)after 3 courses of treatment between the Western medicine group and the TCM medicine group(P<0.05).After 4 courses of treatment,the overall disease severity(NDA score)in the TCM medicine group was lighter than the Western medicine group.There was no significant difference in the physiological curvature of the cervical spine between the two groups after 4 courses of treatment(P>0.05).Conclusion:The clinical efficacy of the Gegen Qushi mixture on cervical spondylotic myelopathy of the Yin deficiency and dampness resistance syndrome shows no significant difference in relieving pain,anti-inflammatory and nutritional nerve treatment in a short time(within 1 month)compared with the current mainstream Western medicines.There is a difference in the long-term clinical efficacy,and the effect of the Gegen Qushi mixture is better than that of Western medicine.The Gegen Qushi mixture shows no obvious ameliorative effect on the physiological curvature of cervical spine in patients.