经筋辨证配合运动针法治疗神经根型颈椎病的疗效及作用机制研究

Efficacy and Mechanism of Meridian Sinew Syndrome Differentiation Combined with Movement Acupuncture in the Treatment of Cervical Spondylotic Radiculopathy

目的:研究经筋辨证配合运动针法治疗神经根型颈椎病(CSR)的疗效及其作用机制。方法:随机数表法将2021年1月—2023年1月献县中医医院收治的120例CSR患者分为观察组(经筋辨证配合运动针法治疗)与对照组(传统针刺治疗),每组60例。对比两组临床疗效、治疗前后疼痛程度[Northwick Park颈痛量表(NPQ)、视觉模拟评分法(VAS)]、角度肌张力、症状功能评分、颈部肌肉表面肌电信号、血清中相关因子[Ras同源基因家族成员(RhoA)mRNA表达水平、Rho激酶1(ROCK1)mRNA表达水平、白细胞介素-1β(IL-1β)含量]。结果:治疗3个月后,观察组总有效率明显高于对照组(P<0.01);治疗3个月后,观察组NPQ、VAS评分、RhoA及ROCK1 mRNA相对表达水平、IL-1β含量低于治疗前及同期对照组(P<0.05),静息状态下的AUC、最大自主收缩状态下的曲线下面积(AUC)、症状功能评分、胸锁乳突肌中位频率,颈伸肌中位频率明显高于治疗前及同期对照组(P<0.05)。结论:经筋辨证配合运动针法可有效治疗CSR,改善患者疼痛等症状,并且改善患者肌张力、降低肌肉痉挛,作用机制可能与调节RhoA/ROCK信号通路进而减轻机体炎症有关。

Objective:To study the efficacy and mechanism of meridian sinew syndrome differentiation combined with movement acupuncture in treating cervical spondylotic radiculopathy(CSR).Methods:A total of 120 CSR patients admitted to Xianxian Hospital of Traditional Chinese Medicine from January 2021 to January 2023 were randomly divided into an observation group(treated with meridian sinew syndrome differentiation combined with movement acupuncture)and a control group(treated with traditional acupuncture),with 60 cases in each group.Clinical efficacy,pain levels before and after treatment[Northwick Park Neck Pain Questionnaire(NPQ),Visual Analog Scale(VAS)],muscle tone,symptom functional scores,surface electromyographic signals of neck muscles,and serum levels of related factors[Ras homolog gene family member A(RhoA)mRNA expression level,Rho kinase 1(ROCK1)mRNA expression level,interleukin-1β(IL-1β)content]were compared between the two groups.Results:After 3 months of treatment,the total effective rate in the observation group was significantly higher than that in the control group(P<0.01).After 3 months of treatment,the NPQ and VAS scores,relative expression levels of RhoA mRNA and ROCK1 mRNA,and IL-1βcontent in the observation group were lower than those before treatment and those in the control group at the same time(P<0.05).The area under the curve(AUC)in the resting state,AUC in the maximum voluntary contraction state,symptom functional scores,median frequency of the sternocleidomastoid muscle,and median frequency of the cervical extensor muscle were significantly higher than those before treatment and those in the control group at the same time(P<0.05).Conclusion:Meridian sinew syndrome differentiation combined with movement acupuncture can effectively treat CSR,improve symptoms such as pain,and enhance muscle tone while reducing muscle spasms.The mechanism may be related to the regulation of the RhoA/ROCK signaling pathway,thereby alleviating inflammation in the body.