输刺治疗神经根型颈椎病上肢麻痛的疗效观察及对肌电图F波传导速度的影响

Observation on the efficacy of Shu-needling in the treatment of upper limb numbness and pain in cervical spondylotic radiculopathy and its effect on the F-wave conduction velocity of electromyography

目的观察在CT定位基础上行输刺治疗神经根型颈椎病上肢麻痛的临床疗效及对患者正中神经和尺神经肌电图F波传导速度的影响。方法将98例神经根型颈椎病上肢麻痛患者作为研究对象,用随机数字表法分为对照组和研究组,每组49例。研究组在CT定位基础上采用输刺治疗,对照组采用常规针刺治疗。比较两组患者治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、颈椎病功能障碍指数(neck disability index,NDI)评分和颈椎活动度以及血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-8(interleukin-8,IL-8)和白介素-1β(interleukin-1β,IL-1β)水平的变化。通过肌电图检查,比较两组治疗前后正中神经和尺神经的F波传导速度以及F波出现率的变化。比较两组临床疗效。结果研究组总有效率高于对照组(P<0.05)。治疗后,两组VAS和NDI评分降低(P<0.05),颈椎前屈、后伸、左屈、右屈、左旋、右旋活动度增大(P<0.05),正中神经和尺神经的F波传导速度以及F波出现率提高(P<0.05),血清TNF-α、IL-8和IL-1β水平降低(P<0.05)。治疗后,研究组VAS和NDI评分低于对照组(P<0.05),颈椎前屈、后伸、左屈、右屈、左旋、右旋活动度大于对照组(P<0.05),正中神经和尺神经的F波传导速度以及F波出现率高于对照组(P<0.05),血清TNF-α、IL-8和IL-1β水平低于对照组(P<0.05)。结论在CT定位基础上行输刺治疗神经根型颈椎病上肢麻痛的临床疗效优于常规针刺,可缓解疼痛,改善颈椎活动度,减轻炎症反应,提高肌电图F波出现率和传导速度,有较好的神经修复作用。

Objective To observe the clinical efficacy of acupuncture on the basis of CT positioning in the treatment of upper limb numbness and pain in patients with cervical spondylotic radiculopathy and its influence on the F-wave conduction velocity of median nerve and ulnar nerve electromyography.Method A total of 98 cervical spondylotic radiculopathy patients with upper limb numbness and pain were selected as the research objects,and they were divided into a control group and a study group by the random number table method,with 49 cases in each group.The study group was treated with Shu-needling based on CT positioning,and the control group was treated with conventional acupuncture.The visual analog scale(VAS)score,neck disability index(NDI)score and range of motion of cervical spine,as well as serum levels of tumor necrosis factor-ɑ(TNF-ɑ),interleukin-8(IL-8)and interleukin-1β(IL-1β)before and after treatment were compared between the two groups.Electromyography was used to compare the conduction velocity of F-wave and occurrence rate of F-wave in median nerve and ulnar nerve before and after treatment.The clinical efficacy was compared between the two groups of.Result The total effective rate of the study group was higher than that of the control group(P<0.05).After treatment,the VAS and NDI scores were decreased(P<0.05),the range of motion of cervical flexion,extension,left and right flexion,left rotation and right rotation were increased(P<0.05),the conduction velocity and occurrence rate of F wave in median nerve and ulnar nerve were increased(P<0.05),and the serum levels of TNF-ɑ,IL-8 and IL-1βwere decreased(P<0.05)in the two groups.After treatment,the VAS and NDI scores in the study group were lower than those in the control group(P<0.05),the cervical flexion,extension,left flexion,right flexion,left rotation,and right rotation activities were higher than those in the control group(P<0.05),the conduction velocity of F wave and the occurrence rate of F-wave in the median nerve and ulnar nerve were higher than those in the control group(P<0.05),and the serum levels of TNF-ɑ,IL-8,and IL-1βwere higher was lower than those of the control group(P<0.05).Conclusion Shu-needling based on CT positioning is superior to conventional acupuncture in the treatment of upper limb numbness and pain in patients with cervical spondylotic radiculopathy,which can relieve pain,improve the range of motion of cervical spine,reduce inflammatory response,improve the occurrence rate and conduction velocity of F-wave in electromyography,and has a good nerve repair effect.