关刺、输刺法针刺联合益肾活血汤治疗神经根型颈椎病临床观察

Clinical Efficacy of Guan Acupuncture and Shu Acupuncture Combined with Yishen Huoxue Decoction in the Treatment of Cervical Spondylotic Radiculopathy

目的观察关刺、输刺法针刺联合益肾活血汤治疗神经根型颈椎病(CSR)的疗效。方法选择CSR患者98例,按照随机数字表法分为两组各49例。对照组给予消炎镇痛、营养神经药物治疗,同时予以中药益肾活血汤口服;观察组在对照组治疗基础上予以针刺治疗,关刺风池、天柱、后溪、肩胛部激痛点、阳陵泉,输刺夹脊、大杼。比较两组治疗前后胸锁乳突肌、上斜方肌的肌肉张力和硬度;并比较两组治疗前后疼痛情况[包括疼痛视觉模拟量表评分(VAS)、疼痛分级指数(PRI)评分、现有疼痛强度(PPI)评分]、颈椎功能量表评分[包括田中靖久颈椎症状量表(CSR20)评分、颈椎功能残障指数(NDI)评分、颈椎病临床评价量表(CASCS)评分];比较两组治疗前后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平。结果治疗后观察组胸锁乳突肌、上斜方肌张力和硬度均低于对照组(P<0.01),疼痛VAS、PRI、PPI评分均低于对照组(P<0.01),CSR20、CASCS评分低于对照组(P<0.01),NDI评分高于对照组(P<0.01);血清TNF-α、IL-1β、IL-6水平均低于对照组(P<0.01)。结论关刺、输刺法针刺联合益肾活血汤可减轻局部炎症反应,改善颈肩部肌肉性能和功能,缓解疼痛,治疗CRS效果显著。

Objective:To investigate the efficacy of Guan acupuncture and Shu acupuncture combined with Yishen Huoxue Decoction in the treatment of cervical spondylotic radiculopathy(CSR).Methods:A total of 98 pa⁃tients with CSR were randomly divided into two groups,with 49 cases in each group.The control group was treat⁃ed with anti-inflammatory,analgesic and neurotrophic drugs,and the traditional Chinese medicine Yishen Huoxue Decoction was taken orally;on the basis of the control group,the observation was given acupuncture,including Guan cervical spondylotic radiculopathy Fengchi,Tianzhu,Houxi,pain stimulating point of scapula,Yanglingquan point,Jiaji point and Dazhu point.The muscle tension and hardness of sternocleidomastoid muscle and superior trapezius muscle were compared between the two groups before and after treatment;the pain[including pain visual analogue scale score(VAS),pain grading index(PRI)score,existing pain intensity(PPI)score],cervical spine function scale score[including Tanaka Yasuhisa cervical spine symptom scale(CSR20),cervical spine functional neck disability index(NDI)score and clinical assessment scale for cervical spondylosis(CASCS)score]of the two groups before and after treatment were compared;the serum tumor necrosis TNF-α,IL-1β,IL-6 levels were com⁃pared between the two groups before and after treatment.Results:The tension and hardness of sternocleidomas⁃toid muscle and superior trapezius muscle of the observation group were lower than those of the control group(P<0.01),the scores of pain VAS,PRI and PPI were lower than those of the control group(P<0.01),the scores of CSR20 and CASCS were lower than those of the control group(P<0.01),and the score of NDI was higher than those of the control group(P<0.01);serum TNF-α,IL-1β,IL-6 levels were lower than those of the control group(P<0.01).Conclusion:Guan acupuncture and Shu acupuncture combined with Yishen Huoxue Decoction can re⁃duce local inflammatory reaction,improve neck and shoulder muscle performance and function,relieve pain,so it has a significant effect on CRS.