不同针灸方法联合独活寄生汤治疗神经根型颈椎病的疗效观察

Efficacy of Different Acupuncture-moxibustion Protocols Combined with Duhuo Jisheng Decoction on Cervical Spondylopathy of Nerve Root Type

目的:探究不同针灸方法联合独活寄生汤对神经根型颈椎病患者的疗效。方法:选取2021年9月至2022年6月阜阳市中医医院收治的神经根型颈椎病患者90例作为研究对象,按照治疗方式的不同分为针刺组、针刀组和温针灸组,每组30例,所有患者均给予医院统一制备的独活寄生汤治疗,在此基础上,针刺组给予穴位针刺治疗,针刀组给予针刀穴位刺入治疗,温针灸组给予艾灸联合针刺治疗,均持续治疗2周,比较3组的临床疗效、治疗前后的颈椎活动度、颈椎功能评分、疼痛评分、超敏C反应蛋白(hs-CRP)水平以及治疗期间的不良反应情况。结果:针刀组治疗总有效率(93.33%)高于温针灸组(73.33%)和针刺组(70.00%),差异均有统计学意义(均P<0.05);治疗后,3组患者的颈椎活动度评分均提高,且针刀组评分明显高于温针灸组和针刺组(P<0.05);治疗后,3组患者椎功能评分均提高,且针刀组评分明显高于温针灸组和针刺组(P<0.05);3组患者疼痛评分均降低,且针刀组疼痛评分明显低于温针灸组和针刺组(P<0.05)。治疗后,3组患者血清水平均下降,且针刀组明显低于针刺组和温针灸组(P<0.05);针刺组、针刀组、温针灸组的不良反应率分别为10.00%、6.67%、10.00%,3组差异无统计学意义(P>0.05)。结论:与针刺组和温针灸组比较,针刀联合独活寄生汤治疗神经根型颈椎病效果更加显著,可有效改善患者颈椎功能,提高颈椎活动度,对于减轻患者痛苦,调节炎症介质水平具有重要作用。

Objective:To explore the efficacy of different acupuncture-moxibustion protocols combined with Duhuo Jisheng Decoction on cervical spondylopathy of nerve root type in patients.Methods:Ninety patients with cervical spondylopathy of nerve root type admitted to Fuyangshi Hospital of TCM from September 2021 to June 2022 were selected and divided into an acupuncture group(n=30),an acupotomy group(n=30),and a warming acupuncture-moxibustion group(n=30)according to the different treatment methods.All patients were treated with Duhuo Jisheng Decoction uniformly prepared by this hospital.Additionally,the patients in the acupuncture group were treated with acupoint needling,those in the acupotomy group were with mini-scalpel needling at acupoints,and those in the warming acupuncture-moxibustion group were with moxibustion combined with acupuncture.After two weeks of treatment,the clinical efficacy,cervical activity,cervical function score,pain score,high-sensitivity C-reactive protein(hsCRP)level before and after treatment,and adverse reactions during the treatment were compared among the three groups.Results:The total effective rate of the acupotomy group was 93.33%,higher than 73.33%of the warming acupuncture-moxibustion group and 70.00%of the acupuncture group(P<0.05).After treatment,the scores of cervical activity in the three groups were improved,and the score in the acupotomy group was higher than those in the warming acupuncture-moxibustion group and the acupuncture group(P<0.05).After treatment,the vertebral function scores of the three groups were improved,and the score of the acupotomy group was higher than those of the warming acupuncture-moxibustion group and the acupuncture group(P<0.05).The pain scores of the patients in the three groups decreased,and the pain score in the acupotomy group was lower than those in the warming acupuncture-moxibustion group and the acupuncture group(P<0.05).After treatment,the serum levels of the patients in the three groups decreased,and serum levels in the acupotomy group were lower than those in the acupuncture group and the warming acupuncture-moxibustion group(P<0.05).The adverse reaction rates of the acupuncture group,the acupotomy group,and the warming acupuncture-moxibustion group were 10.00%,6.67%,and 10.00%respectively(P>0.05).Conclusion:Compared with acupuncture and warming acupuncture-moxibustion,the acupotomy combined with Duhuo Jisheng Decoction is more significant in the treatment of cervical spondylopathy of nerve root type,which can effectively improve the cervical function of patients,improve the range of motion of cervical vertebrae,and play an important role in relieving the pain of patients and regulating the level of inflammatory factors.