Atypical cervical spondylotic radiculopathy resulting in a hypertensive emergency during cervical extension: A case report and review of literature

BACKGROUND Extensive research revealed the absence of reports documenting hypertensive emergencies precipitated by changes in the cervical spine posture.CASE SUMMARY We here present a 57-year-old woman diagnosed as having cervical spondylotic radiculopathy(CSR)who was scheduled for anterior cervical decompression and fusion.During post-anesthetic positioning,a sudden hypertensive surge was observed when the patient was in a supine position with the neck being slightly extended.This surge was promptly reversed through cervical flexion and head elevation.This event however required an alternate surgical approach for recovery—posterior laminoplasty and endoscopy-assisted nucleus pulposus removal.Following the 6-month outpatient follow-up period,cervical flexion and extension activities substantially improved in the patient without any episodes of increase in acute blood pressure.CONCLUSION Maintaining a safe hypotensive posture and performing rapid,thorough deco-mpression surgery may serve as effective interventions for patients presenting symptoms similar to those of CSR accompanied by hypertensive emergencies(HE).This would mitigate the underlying causes of these HEs.

Advances in modern Chinese medicine treatment of cervical spondylotic radiculopathy

Objective: On the basis of a brief description of the current research status of modern Chinese medicine on the name, etiology, pathogenesis and classification of cervical spondylotic radiculopathy, this paper summarizes the research progress of modern Chinese medicine treatment of cervical spondylotic radiculopathy from the perspective of modern Chinese medicine treatment. This article mainly summarizes the following aspects: modern Chinese medicine for internal and external use;Chinese medicine acupuncture with filiform needle, electro-acupuncture and warm moxibustion;Chinese medicine massage and acupoint therapy;moxibustion, cupping, scraping and other comprehensive treatment;and Chinese medicine comprehensive therapy. The purpose of this article is to provide references for modern Chinese medicine treatment of cervical spondylotic radiculopathy.

Keyhole Foraminotomy via a Percutaneous Posterior Full-endoscopic Approach for Cervical Radiculopathy:An Advanced Procedure and Clinical Study

Endoscopic cervical foraminotomy is increasingly used for cervical spondylotic radiculopathy(CSR),but there is great concern about radiation exposure because of the heavy dependence of this surgical method on fluoroscopy.The objective of this study was to introduce in detail an advanced surgical technique of keyhole foraminotomy via a percutaneous posterior full-endoscopic approach as a treatment for CSR and investigate its clinical outcomes.We retrospectively reviewed 33 consecutive patients with CSR who underwent keyhole foraminotomy via a percutaneous posterior full-endoscopic approach from October 2015 to April 2017.The patients’general characteristics,including operative time,blood loss,hospital stay,complications,and recurrence,were obtained.Clinical outcomes were evaluated using the visual analogue scale(VAS)for radicular pain,the neck disability index(NDI)for functional assessment,and the modified MacNab criteria for patient satisfaction.All operations were successfully performed(mean operation time,62 min),with no measurable blood loss or severe related complications.The mean follow-up was 25 months.The VAS and NDI scores were significantly improved as compared with those in the preoperative period(preoperative vs.final follow-up:7.6±1.6 vs.3.83±7.34 for VAS,P<0.01;69.5%±10.5%vs.17.54%±13.40%for NDI,P<0.01).Of the 33 patients,32(97.0%)had good-to-excellent global outcomes and all patients obtained symptomatic improvement.In conclusion,keyhole foraminotomy via a percutaneous posterior full-endoscopic approach is an efficient,safe,and feasible procedure for the treatment of CSR.Its simplified single-step blunt incision for localization appears to decrease radiation exposure risks.

Clinical practice guidelines of acupuncture-moxibustion for cervical spondylotic radiculopathy

On the basis of relevant literature and evidence, Clinical Practice Guidelines of Acupuncture-moxibust^on .for Cervical 5pondyloffc Radiculopathy has been formulated according to the quality of evidences and by adopting the method of Grades of Recommendations Assessment, Development and Evaluation （GRADE）, in which the objective of guidelines formulation, the scope of application of the guidelines, the principle of acupuncture-moxibustion treatment of cervical spondylotic radiculopathy, the time for intervention and different acupuncture-moxibustion regimens, etc. were specified.

Treatment of 30 patients with cervical spondylotic radiculopathy by acupuncture plus warming-needle moxibustion:a randomized controlled trial

Objective To observe the clinical efficacy of acupuncture plus warming-needle moxibustion for the treatment of cervical spondylotic radiculopathy.Methods Sixty patients with cervical spondylotic radiculopathy were randomly divided into a warming-needle moxibustion group（group A）and an acupuncture group（group B）according to random number table,with thirty cases in each group.For the patients in the group A,Fengchi（风池 GB 20）,Jingjiaji（Jiaji points on the neck）,Dazhui（大椎 GV 14）,Dazhu（大杼 BL 11）,Jugu（巨骨 LI 16）,Tianzong（天宗 SI 11）,Tianliao（天髎 TE 15）,Jianjing（肩井 GB 21） and Hegu（合谷 LI 4） were selected for warming-needle moxibustion.In the group B,Jianliao（肩髎 TE 14）,Jianyu（肩髃 LI 15）,Quchi（曲池 LI 11）,Tianjing（天井 TE 10）,Yangchi（阳池 TE 4）,and Waiguan（外关 TE 5） were selected for acupuncture.Both groups were treated once a day and ten times constituted a course of treatment.Results Compared with the group B,significant differences were observed in the group A after a course of treatment in terms of 20-score scoring for symptoms of cervical spondylotic radiculopathy,VAS scoring and clinical efficacy[16.63±2.31 vs 15.67±2.48,2.36±1.59 vs 3.98±2.32,100%（30/30） vs 86.7%,all P〈0.05].Conclusion Acupuncture plus warming-needle moxibustion can significantly reduce neck pain and improve neck function of patients with cervical spondylotic radiculopathy,which is worthy of clinical application due to its simple manipulation.

System evaluation and Meta analysis on clinical effi cacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy

Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy（CSR）. Methods Chinese National Knowledge Infrastructure（CNKI）, China Biology Medical（CBM） database, Chinese Science and Technology Periodical Database（VIP）, Wan Fang Data, Pubmed and Cochrane Library were retrieved to search the randomized controlled trials（RCT） on heat-sensitive moxibustion in treatment of CSR, and Meta analysis was conducted by applying Rev Man 5.3 software. Results Eventually, 10 papers were included in this study, including 1008 subjects. Meta analysis result showed： the total effective rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.13, 95%CI（1.06, 1.21）, Z=3.54, P=0.000 4]; the cure rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.80, 95%CI（1.52, 2.13）, Z=6.82, P〈0.000 01]; the improvement of short-form Mc Gill pain questionnaire（SF-MPQ） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–4.44, 95%CI（–6.38,-2.50）, Z=4.49, P〈0.000 01]; visual analogue scale（VAS） of treatment group was lower than that of control group, and the difference was statistically significant [MD=-0.36, 95%CI（-0.50, –0.23）, Z=5.42, P〈0.00001]; and the improvement of interleukin-6（IL-6） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–7.32, 95%CI（-11.49, –3.14）, Z=3.44, P=0.000 6]. Conclusion It is indicated from the Meta analysis result that the clinical efficacy of heat-sensitive moxibustion or acupuncture combined with heat-sensitive moxibustion in treatment of CSR is superior to that of simple acupuncture or traditional suspended moxibustion, providing a new therapeutic method for treatment of CSR. However, the abovementioned conclusion still needs to be confirmed through randomized blind controlled trials with high quality and large sample size since the sample size of included studies was small, and the quality was low.

Treatment of cervical spondylotic radiculopathy: acupuncture at neck Jiájǐ points and blood-letting puncture with the plum-blossom needle

Objective To observe the therapeutic effect of acupuncture at neck Jiájǐ （EX） points and blood-letting puncture with the plum-blossom needle on cervical spondylotic radiculopathy. Methods Sixty cases of cervical spondylotic radiculopathy were divided into a treatment group and a control group with 30 cases in each group. Acupuncture at neck Jiájǐ （EX） points （Extra） and blood-letting puncture with the plum-blossom needle were adopted for the treatment group. And acupuncture at neck Jiájǐ （EX） points was adopted for the control group. The therapeutic effect, visual analogue scale （VAS） and the numbness score were observed after 2 treatment courses. Results The total effective rate of the treatment group was 86.7% （26/30）, while the rate of the control group was 83.3% （25/30）. Comparison of the differences of the two groups was without statistic significance （P0.05）. The VAS scores of the two groups after treatment were both improved （both P0.01）, but without statistic significance between the two groups （P0.05）. The numbness scores of the two groups after treatment were both better than those before treatment （P0.01）. The therapeutic effect on numbness of the extremities of the treatment group was better than that of the control group （P0.05）. Conclusion Blood-letting puncture with the plum flower needle has a satisfactory effect on treatment of numbness of the extremities of patient with cervical spondylotic radiculopathy.

热敏灸联合耳穴贴压治疗CSR根性痛患者的临床研究

目的探讨神经根型颈椎病(cervical spondylotic radiculopathy,CSR)根性痛患者使用热敏灸联合耳穴贴压干预的效果。方法选取2022年9月至2023年9月江西中医药大学附属医院收治的CSR根性痛患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组实施常规干预联合耳穴贴压,观察组加用热敏灸干预,干预时间均为1个月。比较两组患者的疼痛程度、颈部活动度、生活质量及护理满意度。结果干预后两组患者的视觉模拟评分法评分均低于干预前,且观察组低于对照组(P<0.05);干预后两组患者的颈部活动度均提高,且观察组患者明显高于对照组(P<0.05);干预后,两组患者的健康状况调查简表评分均升高,且观察组患者高于对照组(P<0.05);与对照组比较,观察组患者高于护理满意度更高(P<0.05)。结论CSR根性痛患者使用热敏灸联合耳穴贴压可减轻疼痛,提高颈部活动度,改善生活质量,提高患者的护理满意度。

旋提手法治疗神经根型颈椎病的应力及椎间孔形态学特征:三维有限元分析

背景:颈椎旋提手法治疗神经根型颈椎病的临床疗效确切,安全性较好,已广泛应用于临床中,但其对各节段颈椎椎体、椎间盘的生物力学及椎间孔面积的影响尚未系统阐明。目的:基于三维有限元分析技术开展相关研究,为旋提手法治疗神经根型颈椎病的效应机制提供数字化证据。方法:选择1例颈背部无异常疾患的志愿者,将其颈椎旋转至生理极限体位状态下的CT影像资料作为有限元模型材料。分别通过Mimics19.0、Geomagic Studio 2013、Hypermash 14.0及ANSYS Workbench 2020 R2软件完成对有限元模型的初步构建,基于文献完成颈椎各组织结构的弹性模量、弹性系数赋值,基于团队前期工作基础在模型上加载旋提手法的力学工况,分析颈椎旋提手法对C3-T1节段各椎体、椎间盘的力学参数及其对颈椎旋颈对侧椎间孔面积的影响。结果与结论:(1)旋提手法实施时,骨性结构的应力明显高于椎间盘等软组织;(2)手法操作时各颈椎椎体顶部椎板处应力高,底部椎板处应力低,关节突关节处及横突处应力较低;而各椎间盘顶部髓核处应力较低,底部与椎板连接处应力较高,但椎间盘应力最高点在顶部外侧纤维环处;(3)另外,加载提扳力后较之加载前,C6/C7节段椎间孔投影面积明显增大;(4)提示旋提手法操作具有改变颈椎本身应力结构的力学特征,并能扩大患者旋颈对侧的C6/7椎间孔面积,实现治疗神经根型颈椎病的目的。

不同灸量麦粒灸对CSR模型大鼠相关炎性细胞因子IL-1β、IL-6影响

目的：通过观察不同灸量麦粒灸对CSR模型大鼠相关炎性细胞因子IL-1β、IL-6的影响,探讨麦粒灸干预CSR的量效机制。方法：（1）采用SPF级雌雄各半Wistar大鼠60只,随机平均分为：正常组、模型组、麦粒灸3壮组、麦粒灸6壮组、麦粒灸9壮组5组各12只;（2）造模成功后,选用直径约0.5 cm、高约0.5 cm的圆锥形艾炷分别对3、6、9壮组大鼠大椎穴进行施灸,每日1次,连续施灸7 d;（3）相应时间后处死取大鼠脊髓、神经根组织,采用ELISA法测定组织IL-1β、IL-6的浓度。结果：（1）模型组与正常组比较,大鼠压线处脊髓、神经根组织IL-1β、IL-6浓度比较具有显著性差异（P〈0.01）;（2）干预后,麦粒灸组大鼠压线处脊髓、神经根组织IL-1β、IL-6浓度与模型组比较均具有显著性差异（P〈0.01）;（3）麦粒灸6壮组对IL-1β、IL-6调节作用优于麦粒灸3壮组、9壮组（P〈0.01）。结论：不同灸量的麦粒灸均具有调节颈椎病神经根损伤后相关炎性细胞因子IL-1β、IL-6释放的作用,其中6壮组的调节作用优于3壮组与9壮组。

不同灸量麦粒灸对CSR大鼠PGE2、COX-2mRNA及其蛋白表达的影响

目的：通过观察不同灸量麦粒灸对CSR大鼠PGE2、COX-2mRNA及其蛋白表达的影响,探讨麦粒灸干预CSR的量效关系。方法：（1）采用SPF级雌雄各半Wistar大鼠60只,随机平均分为：正常组、模型组、麦粒灸3壮组、麦粒灸6壮组、麦粒灸9壮组5组各12只;（2）造模成功后,选用直径约0. 5 cm,高约0. 5 cm的圆锥形艾炷分别对3、6、9壮组大鼠大椎穴进行施灸,1次/d,连续施灸7 d后处死大鼠;（3）取大鼠颈动脉血、脊髓及神经根组织,采用放射性免疫分析血浆PGE2含量,并采用荧光定量PCR法及免疫组化法分别检测大鼠脊髓及神经根组织COX-2mRNA及COX-2蛋白表达情况。结果：（1）模型组与正常组比较,大鼠压线处脊髓、神经根组织COX-2、COX-2mRNA表达及血浆PGE2浓度比较具有显著性差异（P 〈0. 01）;（2）干预后,麦粒灸组大鼠血浆PGE2浓度、组织COX-2mRNA及其蛋白表达与模型组比较（均P 〈0. 01）;（3）麦粒灸6壮组PGE2浓度、COX-2mRNA及其蛋白表达与3、9壮组比较具有显著性差异（P〈0. 01）。结论：不同灸量的麦粒灸对颈椎病神经根损伤后PGE2含量、COX-2mRNA及其蛋白表达具有调节作用,其中6壮组的调节作用优于3、9壮组。

郑氏手法结合针刺治疗中老年神经根型颈椎病对其颈椎生理曲度影响的临床观察

目的观察郑氏手法结合针刺治疗中老年神经根型颈椎病的临床疗效及对其颈椎生理曲度的影响。方法将该院2021年6月—2022年5月收治的63例符合神经根型颈椎病急性期诊断标准的患者分为治疗组和对照组,其中治疗组在治疗中脱离2例,完成治疗30例,对照组在治疗中脱离1例,完成治疗30例。治疗组采用郑氏手法结合普通针刺治疗,对照组采用普通手法结合针刺治疗。1周治疗5次,两组均治疗2周。比较两组总体疗效,比较两组治疗前后视觉模拟评分法(visual analogue scale,VAS)、颈椎功能障碍指数(neck disability index,NDI)和颈椎病临床评价量表(clinical evaluation scale of cervical spondylosis,CASCS)评分变化;比较两组治疗前后颈椎生理曲度变化。结果治疗组治疗总有效率为86.67%(26/30),对照组治疗总有效率为63.33%(19/30)。治疗组总体疗效优于对照组(P<0.05);治疗组治疗后VAS评分、NDI评分低于对照组,CASCS评分高于对照组(P<0.05);治疗组治疗后颈椎生理弧度高于对照组(P<0.05)。结论郑氏手法结合针刺是治疗神经根型颈椎病的有效方案,值得临床进一步研究。

推拿结合针灸治疗神经根型颈椎病患者的疗效观察

目的探讨CSR的治疗方法。方法回顾性收集80例CSR患者的临床资料,根据治疗方法的不同将其分为两组,各40例。对照组予以中医针灸治疗,观察组加用中医推拿治疗。比较两组疗效以及主要症状积分、疼痛程度、颈椎功能的改善情况。结果观察组有效率为95%,高于对照组的77.5%(χ^(2)=5.17,P=0.023);观察组治疗后主要症状积分、疼痛程度、颈椎功能改善程度均优于对照组(t=8.45~18.55,P<0.05)。结论中医推拿结合针灸治疗CSR患者疗效更优。

归芪活血胶囊对神经根型颈椎病大鼠炎性损伤和微循环血流的影响

目的:探究归芪活血胶囊(GQ)对神经根型颈椎病(CSR)大鼠的治疗效应及机制。方法:观察CSR大鼠自发痛、热痛阈、步态评分、前肢和颈部体表微循环状态、脊髓病理结构及超微结构变化、脊髓p38磷酸化情况以及血清白细胞介素-1β(IL-1β)、IL-6以及肿瘤坏死因子-α(TNF-α)。结果:GQ高、中剂量在干预第14天时可显著升高CSR模型大鼠的热痛阈(P<0.05),降低其步态评分和自发痛评分(P<0.05,P<0.01);GQ各剂量均可改善CSR大鼠脊髓炎症水肿变化,显著增加尼氏(Nissl)染色阳性细胞数目(P<0.05),恢复髓鞘和线粒体正常形态,且GQ中剂量效果较明显;GQ高、中剂量可显著升高CSR大鼠颈部和前肢皮肤血流灌注量(P<0.05),对前肢远端血流灌注量的改善程度优于芬必得组(P<0.01);与模型组比较,GQ中剂量可降低CSR大鼠脊髓p38磷酸化比率。结论:GQ可以缓解CSR大鼠热痛觉过敏和步态不稳的程度,改善脊髓炎症病理变化,恢复前肢和颈部体表血流灌注量,且GQ中剂量在改善CSR大鼠炎症损伤方面更有优势。

臭氧联合低温等离子射频消融术对神经根型颈椎病的疗效

目的探讨臭氧联合低温等离子射频消融术对神经根型颈椎病的疗效及炎性反应的影响。方法对2022年5月至2023年5月在首都医科大学附属北京安贞医院疼痛科治疗的75例神经根型颈椎病患者行臭氧联合低温等离子射频消融术。采用视觉模拟评分(VAS)和颈椎功能障碍指数(NDI)评估治疗前及治疗后2周的疼痛程度。酶联免疫吸附试验(ELISA)分析治疗前及治疗2周后肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和干扰素-γ(IFN-γ)的水平。结果臭氧联合低温等离子射频术后VAS及NDI评分较术前显著降低[VAS:5.36(4,7)vs.1.32(1,2),P<0.0001;NDI:32.72(24,70)vs.7.62(3.55,8.9),P<0.0001]。手术治疗两周后可有效降低炎性细胞因子IL-6、TNF-α和IFN-γ的水平,减轻炎性反应[IL-6:4.33(2.51,5.04)vs.3.49(2.08,4.43),P<0.05;TNF-α:1.95(1.41,2.21)vs.1.61(1.02,2.03),P<0.05;IFN-γ:1.84(1.18,2.47)vs.1.55(0.76,2.09),P<0.05]。结论臭氧联合低温等离子射频术是治疗神经根型颈椎病的一种有效的方法。

循经按摩治疗神经根型颈椎病

目的:观察循经按摩治疗神经根型颈椎病的临床疗效。方法:选择2020年3月至2023年6月就诊的神经根型颈椎病患者64例,分为观察组和治疗组各32例。观察组采用常规治疗,男14例,女18例,年龄32~55(41.34±7.23)岁;病程9~17(14.23±3.56)个月;C5、C6神经根受压12例,C7神经根受压17例,C8神经根受压3例。治疗组在常规治疗的基础上加以循经按摩治疗,男17例,女15例,年龄30~54(40.86±6.97)岁;病程8~18(15.43±3.48)个月;C5、C6神经根受压14例,C7神经根受压16例,C8神经根受压2例。分别在治疗前和治疗2周后采用疼痛视觉模拟评分(visual analogue scale,VAS)、颈椎功能障碍指数评分(neck disability index,NDI)、颈椎病临床评价量表(clinical assessment scale for cervical spondylosis,CASCS)评价临床疗效,并比较治疗前后颈椎功能活动度。结果:治疗2周后,治疗组和观察组的VAS、NDI评分均降低,CASCS评分均升高(P<0.001)。治疗2周后,治疗组VAS、NDI评分低于观察组,CASCS评分高与观察组(P<0.001)。与治疗前相比,两组治疗2周后前屈、后伸、左侧屈、右侧屈、左旋转、右旋转活动度均增加(P<0.05)。与观察组相比,治疗组前屈、后伸、左侧屈、右侧屈、左旋转、右旋转活动度增加更明显(P<0.05)。结论:循经按摩治疗神经根型颈椎病疗效显著,能有效缓解颈项部疼痛,改善临床症状,患者满意度更高。

小针刀配合针灸推拿牵引治疗神经根型颈椎病的效果

目的探讨小针刀配合针灸推拿牵引治疗神经根型颈椎病的效果。方法选取2022年10月至2023年10月潜江市中心医院康复医学科收治的50例神经根型颈椎病患者作为研究对象,采用计算机随机数法将其分为观察组(n=25)和对照组(n=25)。观察组患者采用小针刀配合针灸推拿牵引治疗,对照组患者采用小针刀治疗。比较两组患者的神经根型颈椎病症状及体征、疼痛感、生活质量评分,并比较两组的治疗效果与不良事件发生率。结果治疗后,观察组的神经根型颈椎病症状及体征评分低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组的疼痛感评分低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组的生活质量评分高于对照组,差异有统计学意义(P<0.05)。观察组患者的总有效率高于对照组,差异有统计学意义(P<0.05)。观察组的不良事件总发生率低于对照组,差异有统计学意义(P<0.05)。结论为神经根型颈椎病患者提供小针刀配合针灸推拿牵引治疗,有助于改善患者的神经根型颈椎病症状及体征,减轻患者的疼痛感,提升患者的生活质量,控制不良事件发生率,提高治疗效果。

针刺颈痛穴联合推拿治疗神经根型颈椎病临床研究

目的观察针刺颈痛穴联合推拿治疗神经根型颈椎病(cervical spondylotic radiculopathy,CSR)的临床疗效。方法将66例CSR患者随机分为对照组和观察组,每组33例,观察组予以针刺颈痛穴联合推拿治疗,对照组予以常规针刺治疗。治疗前后分别观察两组患者颈部疼痛、肢体麻木、颈部活动受限评分,颈部功能残障指数(neck disability index,NDI)评分,简化McGill疼痛问卷(short-form Mcgill pain questionaire,SF-MPQ)评分及颈椎前屈、后伸、旋转、侧屈的活动度,并比较两组临床疗效。结果治疗后两组患者颈部疼痛、肢体麻木、颈部活动受限评分,SF-MPQ的视觉模拟量表、现时疼痛强度、疼痛等级指数评分,NDI评分均显著降低(P<0.05),颈椎前屈、后伸、旋转、侧屈的活动度显著升高(P<0.05);观察组在降低上述评分和提高颈椎前屈、后伸、旋转、侧屈活动度方面均显著优于对照组(P<0.05)。观察组临床疗效显著优于对照组(P<0.05)。结论针刺颈痛穴联合推拿治疗CSR的效果显著,有利于提高颈椎活动度和减轻临床症状。

基于“筋、节、骨、髓”分型探讨神经根型颈椎病的手法治疗

神经根型颈椎病(CSR)是一种由于颈椎间盘和椎间关节退变引起的疾病,主要表现为颈部、肩部及上肢神经支配区域的疼痛、感觉异常和运动障碍。传统中医的筋骨辨证在治疗该病时存在概念不清、辨证分型不一等问题。岐黄学者林定坤教授在筋骨辨证的基础上,结合现代解剖学提出了颈椎“筋”“节”“骨”“髓”4大分型。该文通过总结林定坤教授对CSR筋骨辨证学术思想,总结手法治疗该病的作用靶点,提出基于筋劳、节错、骨变和髓损等4种病损分型,采用理筋、调节、护髓和治骨4种手法治疗,以期完善骨伤科手法治疗CSR的辨证施治体系,为临床提供参考。

阿是穴四花刺法治疗神经根型颈椎病颈肩肢痛症的随机对照研究

目的:探究阿是穴四花刺法治疗神经根型颈椎病颈肩肢痛症的临床疗效。方法:本研究纳入2021年6月至2023年12月于四川省中西医结合医院、四川省第二中医医院门诊就诊且符合纳入标准的神经根型颈椎病患者,共计370例。采用随机对照研究方法,将患者随机分为对照组和治疗组,每组185例。治疗组接受阿是穴四花刺法治疗,对照组接受常规针刺法治疗,分别在治疗前、治疗后第1、2、3、7、14天进行评定,并观察其疼痛强度、疼痛频度、疼痛持续时间、压痛、生活质量评分的变化,以判断疗效。结果:治疗后,两组患者在VAS评分、SF-MPQ评分、疼痛频度评分、疼痛持续时间评分、压痛评分、生活质量评分方面都有显著改善。与对照组相比,治疗组的疼痛频度更早得到改善,其余各项指标在相同时间节点改善程度更高(P<0.05)。结论:阿是穴四花刺法治疗神经根型颈椎病颈肩肢痛症具有肯定疗效,相比常规针刺法治疗其起效更快,疗效更好,在提高患者生活质量方面也表现出优势,是治疗神经根型颈椎病颈肩肢痛症的理想方法。