毫针深刺、浅刺颈夹脊穴治疗神经根型颈椎病疗效对比研究

Comparative study on the therapeutic effect of deep needling and shallow needling at cervical Jiaji point in the treatment of cervical spondylotic radiculopathy

目的 观察并比较毫针深刺与常规浅刺颈夹脊穴治疗神经根型颈椎病的疗效。方法 将62例神经根型颈椎病患者采用随机数字表法分为深刺组和浅刺组,各31例。深刺组选取C_(1~7)双侧夹脊穴为主穴,行毫针深刺,深度35~40 mm,得气后行捻转、提插补法操作;选取双侧肝俞、肾俞、风池,患侧肩井、曲垣、曲池、外关、合谷、后溪等穴为配穴,施以常规浅刺,深度20~30 mm。浅刺组取穴同深刺组,均行常规浅刺,深度20~30 mm。2组均每日针刺1次,每次留针30 min,治疗10次为1个疗程,疗程之间间隔1 d。治疗2个疗程后,比较2组的临床疗效及治疗前后的视觉模拟评分法(VAS)评分、田中靖久颈椎病症状评分。结果 治疗后2组VAS评分明显降低,田中靖久颈椎病症状评分明显升高,与同组治疗前比较差异均有统计学意义(P<0.05),且深刺组作用更明显,与浅刺组治疗后比较差异均有统计学意义(P<0.05);深刺组总有效率为93.55%(29/31),浅刺组为83.87%(26/31),2组比较差异有统计学意义(P<0.05)。结论 毫针深刺颈夹脊穴治疗神经根型颈椎病疗效确切,可明显减轻患者的疼痛、麻木等不适症状,改善患者的颈椎功能,提高其生活、工作能力,且对深层组织基本无损伤,疗效优于常规浅刺治疗,值得临床借鉴应用。

Objective To observe and compare the therapeutic effects of deep needling with filiform needles and conventional shallow needling on cervical Jiaji point(EX-B2)in treating cervical spondylotic radiculopathy.Methods 62 patients with cervical spondylotic radiculopathy were divided into a deep-needling group and a shallow-needling group by random number table method,with 31 cases in each group.In the deep-needling group,C1~7 bilateral Jiaji points were selected as the main points,and deep-needling was performed with filiform needles at a depth of 35~40 mm,followed by twisting,lifting,and insertion invigoration method after obtaining qi.The matching points included Ganshu(BL18),Shenshu(BL23),Fengchi(GB20)on both sides,and Jianjing(GB21),Quyuan(SI13),Quchi(LI11),Waiguan(TE5),Hegu(LI4)and Houxi(SI3)on the affected side for conventional shallow acupuncture at a depth of 20~30 mm;the acupoints in the shallow-needling group were identical to those in the deep-needling group but received conventional superficial insertion at a depth of 20~30 mm.Both groups received daily acupuncture treatment for 30 minutes per session over a course of ten treatments with one day intervals between courses.After two courses of treatment,the clinical efficacy,visual analogue scale(VAS)score,and symptom score according to Yasuhisa Tanaka’s cervical spondylosis scores were compared between the two groups.Results After treatment,the VAS scores significantly decreased in both groups while symptom scores according to Yasuhisa Tanaka’s cervical spondylosis scores significantly increased compared to before treatment(P<0.05).The effect was more pronounced in the deep-needling group than in the shallow-needling group after treatment(P<0.05).The total effective rate was 93.55%(29/31)in the deep-needling group and 83.87%(26/31)in the shallow-needling group with a statistically significant difference between both groups(P<0.05).Conclusions Deep-needling of the cervical Jiaji point with filiform needles is effective in treating cervical spondylotic radiculopathy,resulting in significant reduction in pain,numbness,and other discomfort symptoms while improving cervical spine function,living and working ability without causing damage to deep tissue.The curative effect is superior to conventional shallow-needling treatment,warranting clinical reference and application.