颈椎定点旋提法配合黄帝内针治疗神经根型颈椎病的临床疗效

Clinical effect of fixed-point rotation and lifting of cervical vertebra combined with Huangdi internal acupuncture in the treatment of radiculopathy of cervical vertebra

目的:回顾性分析2018年10月―2020年10月骨伤科门诊神经根型颈椎病患者50例,评价颈椎定点旋提法配合黄帝内针治疗神经根型颈椎病的临床疗效。方法:选取症状、体征及辅助检查诊断明确,且符合纳入标准的神经根型颈椎病患者50例,首先给予黄帝内针针刺治疗30 min,黄帝内针以“左病右治、右病左治,同气相求、阴阳倒换求”为原则,比如颈肩部疼痛伴左上肢手太阴肺经分布区域疼痛,以右上肢手太阴肺经经络取穴为主、手阳明大肠经取穴为辅。起针后首先给予颈肩部、胸背部放松手法,充分放松后予以颈椎定点旋提法治疗,每位患者每周治疗2次,连续4周。观察治疗前、治疗后、治疗后3个月的颈椎视觉模拟评分法(Visual Analogue Scale,VAS)评分、颈椎病疗效评分的差异。结果:收集50例患者治疗前、治疗后、治疗后3个月患者VAS评分、颈椎病疗效评分数据,并行统计学方法,根据《中医病证诊断疗效标准》疗效判定标准,治疗4周后的临床疗效:治愈19例,显效24例,有效7例,较治疗前相比,治疗效果显著,差异有统计学意义(P <0.05)。治疗后3个月随访,临床疗效:治愈17例,显效23例,有效9例,无效1例,与治疗前相比,P <0.05,差异有统计学意义,说明该方案疗效良好,与治疗后4周相比,P> 0.05,差异无统计学意义,说明该疗效稳定、持久。结论:颈椎定点旋提法配合黄帝内针治疗神经根型颈椎病,具有疗程短、疗效显著、安全性高、不易复发等特点,值得临床进一步推广。

Objective:To retrospectively analyze 50 patients with cervical spondylotic radiculopathy from October 2018 to October 2020 in the outpatient department of orthopedics and trauma,in order to evaluate the clinical efficacy of cervical spine fixed-point rotation and lifting combined with Huangdi internal acupuncture in the treatment of cervical spondylotic radiculopathy.Methods:A total of 50 patients with cervical spondylotic radiculopathy whose symptoms,signs and auxiliary examinations were clearly diagnosed and met the inclusion criteria were first treated by Huangdi internal acupuncture for 30 minutes.The Huangdi internal acupuncture was based on the principle of“treating the left disease on the right,treating the right disease on the left,seeking for the same Qi(气),and exchanging Yin and Yang(阴阳)”.For example,for neck and shoulder pain accompanied by pain in the area of the distribution of the left upper hand Taiyin(太阴)lung meridian,acupoints along the right upper hand Taiyin lung meridian are selected,and acupoints along the large intestine meridian of hand Yangming(阳明)are supplemented.After starting the needle,the neck,shoulder,chest and back should be relaxed first,and then the cervical spine should be treated by fixed-point rotation and lifting method after full relaxation.Each patient should be treated twice a week for 4 consecutive weeks.The difference of cervical vertebra VAS score and curative effect score of cervical spondylosis before treatment,after treatment and 3 months after treatment were observed.Results:The data of VAS score and curative effect score of 50 cervical spondylosis patients before treatment,after treatment and after 3 months treatment were collected,and the statistical differences were analyzed.According to the curative effect judgment standard of the Diagnostic Efficacy Standard of Traditional Chinese Medicine,the clinical curative effect after 4 weeks of treatment was as following:19 cases were cured,24 cases were significantly effective,and 7 cases were effective.Compared with before treatment,statistical analysis showed P<0.05,which is statistically significant,indicating a significant therapeutic effect.The clinical effect of follow-up after 3 months of treatment was as following:17 cases were cured,23 cases were significantly effective,9 cases were effective,and 1 case was ineffective.Compared with before treatment,P<0.05 was statistically significant,indicating good therapeutic effect of this regimen.Compared with 4 weeks after treatment,P>0.05 was not statistically significant,indicating stable and long-lasting therapeutic effect.Conclusion:The treatment of cervical spondylotic radiculopathy by cervical spine fixed-point rotation and lifting combined with Huangdi internal acupuncture has the characteristics of short course of treatment,significant curative effects,high safety,and it is not easy to relapse,which is worthy of further clinical promotion.