针刀联合痛点注射治疗神经根型颈椎病临床观察

Clinical observation of acupotomy combined with pain point injection in the treatment of radiculopathy of cervical spondylopathy

目的:探讨针刀联合痛点注射治疗神经根型颈椎病的临床效果。方法:选取2019年2月―2021年12月北京市第一中西医结合医院骨科门诊60例神经根型颈椎病患者,随机分为治疗组(30例)和对照组(30例)。对照组采用针刀治疗,治疗组采用颈部压痛点注射即引起上肢麻木疼痛的责任节段关节突关节旁注射联合针刀治疗。观察两组临床疗效指标。结果:治疗组总有效率显著高于对照组,P <0.01。治疗后两组症状、体征、工作和生活能力评分均降低,治疗组评分明显低于对照组,P <0.01。结论:痛点注射所用药物腺苷钴胺可调节神经功能,修复受损神经;盐酸利多卡具有局部麻醉作用且有利于炎性介质吸收;鹿瓜多肽具有止痛抗炎消肿作用,可减少炎性渗出,促进局部血运障碍的恢复,还能抑制前列腺素的释放。针刀能疏通经络,调整颈部肌力平衡,促进颈椎力学平衡,改善微循环障碍,有利于血液循环,转运炎性物质,从而止痛。针刀联合痛点注射治疗神经根型颈椎病有良好的临床效果,两者有机结合,相互补充,能快速有效缓解颈部疼痛,改善神经功能,促进受损神经修复,且能解除颈部软组织对神经根的机械性压迫,恢复颈椎动态平衡,其疗效肯定,值得临床推广。

Objective:To investigate the clinical effect of acupotomy combined with pain point injection in the treatment of radiculopathy of cervical spondylosis.Methods:From February 2019 to December 2021,60 patients with cervical spondylotic radiculopathy were selected from the Department of Orthopedics of Beijing First Hospital of Integrated Traditional Chinese and Western Medicine,and randomly divided into the treatment group(30 cases) and the control group(30 cases).The control group was treated with acupotomy,and the treatment group was treated by neck tenderness point injection,i.e,para-articular injection at the responsible segment facet that caused numbness and pain in the upper limb,combined with acupotomy.The clinical efficacy indexes in the two groups were observed.Results:The total effective rate in the treatment group was significantly higher than the control group,P<0.01.The symptoms,signs,work and life scores in both groups were decreased after treatment.The score in the treatment group was significantly lower than the control group,P<0.01.Conclusion:The drug adenosine cobalamin used for pain point injection can regulate nerve function and repair damaged nerves.Ridoca hydrochloride has the effect of local anesthesia and is conducive to the absorption of inflammatory mediators.Cervus and melon polypeptides have analgesic,anti-inflammatory and detumescence effects,which can reduce inflammatory exudation,promote the recovery of local blood circulation disorders and inhibit the release of prostaglandin.Acupotomy can dredge meridians,adjust neck muscle balance,promote cervical mechanical balance,improve microcirculation disorders,facilitate blood circulation,transport inflammatory substances,and thus relieve pain.Acupotomy combined with pain point injection has good clinical effects in the treatment of radiculopathy of cervical spondylopathy.The organic combination and mutual complement of the two can quickly and effectively relieve neck pain,improve nerve function,promote the repair of damaged nerves,relieve the mechanical compression of cervical soft tissue on nerve root,and restore the dynamic balance of the cervical spine.The efficacy is positive,and it is worthy of clinical promotion.