针刺联合运动疗法治疗神经根型颈椎病的疗效及安全性研究

Study on the Efficacy and Safety of Acupuncture Combined with Exercise Therapy in the Treatment of Cervical Spondylotic Radiculopathy

目的:研究针刺联合运动疗法治疗神经根型颈椎病的疗效及安全性。方法:选取2020年1月—2023年1月献县中医医院诊治的96例神经根型颈椎病为研究对象,采用随机数字表法分为针刺治疗组(对照组)和针刺联合运动疗法组(联合组)。比较两组患者疗效、并发症、疼痛评分、症状体征积分、中医证候积分、血液流变学指标、炎症因子、miR-146a及miR-204表达差异。结果:联合组患者治疗总有效率显著高于对照组(95.83%vs 79.17%,P<0.05)。联合组和对照组患者局部感染、颅脑症状、颈部疼痛、肢体麻木及局部损伤等并发症发生率差异无统计学意义(P>0.05)。联合组患者治疗后PRI评分、VAS评分、PPI评分、颈项不适积分、眩晕积分、上肢疼痛麻木积分、血浆黏度、全血高切黏度、全血低切黏度、IFN-γ、TNF-α、IL-1β、IL-6显著低于对照组(P<0.05,P<0.01),自觉症状积分、体格检查积分、日常活动积分、miR-146a、miR-204均显著高于对照组(P<0.05)。结论:针刺联合运动疗法可显著改善神经根型颈椎病症状体征、炎症反应、疼痛程度、血液黏度、炎症因子、miR-146a及miR-204水平,具有高效安全等优点,其疗效显著高于针刺疗法。

Objective:To investigate the efficacy and safety of acupuncture combined with exercise therapy in the treatment of cervical spondylotic radiculopathy.Methods:Ninety-six cases of cervical spondylotic radiculopathy treated from January 2020 to January 2023 were selected as the research objects.They were randomly divided into the acupuncture treatment group(control group)and the acupuncture combined with exercise therapy group(combined group).The efficacy,complications,pain scores,symptom and sign scores,traditional Chinese medicine syndrome scores,hemorheological parameters,inflammatory factors,and the expression of miR-146a and miR-204 were compared between the two groups.Results:The total effective rate in the combined group was significantly higher than that in the control group(95.83%vs 79.17%,P<0.05).There was no statistically significant difference in the incidence of local infection,cranial symptoms,neck pain,limb numbness,and local injury between the two groups(P>0.05).After treatment,the PRI score,VAS score,PPI score,neck discomfort score,dizziness score,upper limb pain and numbness score,plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,IFN-γ,TNF-α,IL-1β,and IL-6 in the combined group were significantly lower than those in the control group(P<0.05,P<0.01),while the self-reported symptom score,physical examination score,daily activity score,miR-146a,and miR-204 were significantly higher than those in the control group(P<0.05).Conclusion:Acupuncture combined with exercise therapy can significantly improve the symptoms,signs,inflammatory response,pain level,blood viscosity,inflammatory factors,miR-146a,and miR-204 in patients with cervical spondylotic radiculopathy.It has the advantages of high efficacy and safety,and its efficacy is significantly higher than that of acupuncture therapy alone.