牵引、手法配合中药熏蒸治疗神经根型颈椎病的效果及对颈臂疼痛及颈椎屈伸活动度的影响

Effect of traction,manipulation combined with traditional Chinese medicine fumigation in the treatment of cervical spondylotic radiculopathy and its influences on neck-arm pain and cervical flexion-extension range of motion

目的探讨牵引、手法配合中药熏蒸治疗神经根型颈椎病(CSR)的效果。方法选取2019年2月至2021年2月我院收治的120例CSR患者作为研究对象,根据治疗方案不同分为对照组(60例,牵引+手法)和观察组(60例,牵引+手法+中药熏蒸)。比较两组临床疗效、椎-基底动脉血流动力学、颈臂疼痛及颈椎屈伸活动度、实验室指标和生活质量。结果观察组的治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。治疗2个疗程后,观察组的椎-基底动脉收缩期峰值流速、平均血流速度高于对照组,阻力指数(RI)、搏动指数(PI)低于对照组,差异具有统计学意义(P<0.05)。治疗1、2个疗程后,两组的视觉模拟评分法(VAS)评分降低,颈椎前屈、后伸活动度增加,且观察组优于对照组,差异具有统计学意义(P<0.05)。治疗2个疗程后,两组的内皮素(ET)、丙二醛(MDA)、P物质(SP)水平降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。随访6个月后,观察组的心理功能、社会功能、躯体功能、物质生活状态评分高于对照组,差异具有统计学意义(P<0.05)。结论牵引、手法配合中药熏蒸治疗CSR能够缓解患者颈臂疼痛,提高颈椎屈伸活动度,改善生活质量,疗效确切。

Objective To explore the effect of traction,manipulation combined with traditional Chinese medicine fumigation in the treatment of cervical spondylotic radiculopathy(CSR).Methods A total of 120 patients with CSR admitted in our hospital from February 2019 to February 2021 were selected as the research objects,and the patients were divided into control group(60 cases,traction+manipulation)and observation group(60 cases,traction+manipulation+traditional Chinese medicine fumigation)according to different treatment schemes.The clinical efficacy,vertebrobasilar hemodynamics,neck-arm pain and cervical flexion-extension range of motion,laboratory indexes and quality of life were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After 2 courses of treatment,the vertebral-basilar artery peak systolic velocity and mean value in the observation group were higher than those in the control group,the resist index(RI)and pulsatility index(PI)were lower than those in the control group,and the differences were statistically significant(P<0.05).After 1,2 courses of treatment,the scores of Visual Analogue Score(VAS)in the two groups decreased,the cervical flexion-extension range of motion increased,and those in the observation group were better than the control group,the differences were statistically significant(P<0.05).After 2 courses of treatment,the endothelin(ET),malonaldehyde(MDA)and substance P(SP)levels in the two groups decreased,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05).After 6 months of follow-up,the scores of psychological function,social function,physical function and material living in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Traction,manipulation combined with traditional Chinese medicine fumigation in the treatment of CSR can relieve patients neck-arm pain,increase cervical flexion-extension range of motion,improve quality of life,and has definite therapeutic effect.