中医三联法联合“四方抗阻”训练治疗神经根型颈椎病临床研究

Clinical Study on Triple Therapy of TCM Combined with"Four-way Resistance"Training in the Treatment of Cervical Spondylotic Radiculopathy

目的:探讨中医三联法联合“四方抗阻”训练治疗神经根型颈椎病(cervical spondylotic radiculopathy,CSR)的有效性、安全性及复发率。方法:将50例CSR患者随机分为观察组和对照组,各25例。对照组给予中医三联法(推拿+牵引+电针)治疗,观察组在对照组基础上予“四方抗阻”训练治疗,均以连续治疗5天为1个疗程,疗程间休息2天,共治疗4个疗程。治疗结束后比较两组总有效率、颈椎功能障碍量表(neck disability index,DNI)评分、视觉模拟量表(visual analogue score,VAS)评分、现有疼痛强度(present pain intensity,PPI)评分,并观察两组不良反应发生情况及复发率。结果:观察组总有效率[92.0%(23/25)]高于对照组[80.0%(20/25)](P<0.05);治疗后两组DNI、VAS及PPI评分均降低(P<0.05),且观察组降低程度大于对照组(P<0.05);观察组复发率[8.0%(2/25)]低于对照组[20.0%(5/25)](P<0.05)。结论:中医三联法联合“四方抗阻”训练能够有效地提高颈椎稳定性,缓解颈肩部疼痛,改善颈功能障碍,降低复发率。

Objective:To survey the effectiveness,safety and recurrence rate of TCM triple therapy and"four-way resistance"training in the treatment of cervical spondylotic radiculopathy(CSR).Methods:All 50 CSR patients were randomized into the observation group and the control group with 25 cases in each group.The control group was treated with TCM triple therapy(massage+traction+acusector),and the observation group with"four-way resistance"training based on the therapy the control group accepted,five days were one course of the treatment,and the interval was two days,and both groups were treated for four courses.By the end of the treatment,to compare total effective rate,the scores of DNI,VAS and PPI between both groups,and to observe the incidences of adverse reaction and the recurrence rate between both groups.Results:Total effective rate of the observation group was[92.0%(23/25)],higher than[80.0%(20/25)]of the control group(P<0.05);after the treat-ment,the scores of DNI,VAS and PPI reduced in the two groups(P<0.05),and the decrease of the observation group was greater than that of the control group(P<0.05);the recurrence rate of the observation group was[8.0%(2/25)],lower than[20.0%(5/25)]of the control group(P<0.05).Conclusion:TCM triple therapy and"four-way resis-tance"training could effectively enhance cervical stability,relieve neck and shoulder pain,improve cervical dysfunction with low recurrence rate.