推拿治疗颈型颈椎病60例疗效观察

颈椎病是一种常见的中老年疾病。但随着生活节奏的加快，工作、学习的压力加大，经常长时间使用电脑等因素，使得患颈椎病的人越来越年轻。其病因病机是颈项部肌肉的劳损、椎间盘退变、骨质增生等通过直接刺激压迫或炎症刺激或影响血液运行。使颈部脊神经根、脊髓、椎动脉、及交感神经发生功能或结构上的损害．所以临床上颈椎病分为五型：颈型、神经根型、脊髓型、椎动脉型和交感型。

Influence of different acupoint combinations on immediate effect of surface electromyography of patients with cervical spondylosis

Objective To observe the influence of different acupoint combinations on immediate effect of surface electromyography of patients with cervical spondylosis, and to explore the interactions and laws among different acupoint combinations. Methods Acupuncture in three kinds of different acupoint combinations was conducted on 90 patients with cervical spondylosis（three groups）： group A [distal point selection group： Kūnlún（昆仑 BL 60） and Hòuxī（后溪 SI 3）]; group B [local point selection group： Fēngchí（风池 GB 20） and Tiānzhù（天柱 BL 10）]; group C（distal and local point selection group： BL 60, SI 3, GB 20 and BL 10）. Self control before and after treatment was adopted to observe the mean value of surface electromyography（SEMG） amplitude, to measure the mean values of integrated electromyography（IEMG） and electromyography root mean square（RMS）, and to calculate the variation rate of electromyography amplitude of trapezius on the affected side of patients before and after acupuncture. The differences of influences of different acupoint combinations on immediate effect of surface electromyography were compared intra-group, and the differences among the three groups after acupuncture were also compared. Results According to the intragroup comparison before and after acupuncture, the differences of mean value of electromyography amplitude, variation rate of electromyography amplitude, IEMG and RMS were both statistically significant（all P〈0.05）. According to the inter-group comparison after acupuncture, the mean value of electromyography amplitude, variation rate of electromyography amplitude, IEMG and RMS varied in different degrees, however, the differences were not significant（all P〉0.05）; there was no significant difference in the total effective rate among the three groups（P〉0.05）. Conclusion Acupuncture treatment in different acupoint combinations can increase IEMG and RMS and reduce mean value of electromyography amplitude and variation rate of electromyography amplitude, enhance cervical vertebral stability and active contractility of muscle fiber, and improve the fatigue resistance of neck flexion; while, the therapeutic effect of acupuncture on cervical spondylosis has nothing to do with the distance or the number of selected acupoint.

Transverse striation needling for 30 cases of cervical spondylosis

Objective To observe the clinical efficacy of transverse striation needling in treatment of cervical spondylosis.Method Thirty patients were diagnosed with cervical spondylosis in Guoyitang Clinic,Yanwu Branch of Zhongshan Hospital,Xiamen University from July,2013 to March,2015,and were included into this study.Transverse striation needling,i.e.transverse insertion into the transverse striation of the cervical vertebra,was adopted for the 30 patients,and conventional acupuncture at Fēngchí（风池 GB 20,bilateral）,Jiānj？ng（肩井 GB 21,bilateral） and Jiānzhōngshù（肩中俞 SI 15,bilateral） was combined.The treatment was conducted for once a day,twice a week,and 6 times were needed in total.Follow-up visit was performed two months after the treatment.Result Among the 30 patients,the markedly effective rate was 70.0%（21/30）,effective rate was 30.0%（9/30）,and the total effective rate was 100.0%.There was no relapse during two months after the treatment.Conclusion The therapeutic effect of transverse striation needling in treatment of cervical spondylosis was good.

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.

Blood-letting puncture and cupping at Dong's unique extra points for 65 cases of neck type of cervical spondylosis

Objective To observe the clinical effect of blood-letting puncture and cupping at Chōngxiāo（冲霄 Extra） point of Dong＇s unique Extra-ordinary points in the treatment of neck type of cervical spondylosis.Methods Sixty-five patients of neck type of cervical spondylosis were selected and treated with blood-letting puncture and cupping at Chōngxiāo（冲霄 Extra） point once every two or three days,three times constituted one course and two successive courses were given,then the clinical effect was evaluated.Results The curative rate was 69.2%（45/65）,and the total effective rate was 92.3%（60/65）.Conclusion Blood-letting puncture and cupping at Dong＇s Chōngxiāo（冲霄 Extra） point can be used to treat neck type of cervical spondylosis with simple manipulation and obvious efficacy.

Acupuncture at the superficial fascia for 48 cases of cervical type of cervical spondylosis

Objective To observe the clinical efficacy of acupuncture at the superficial fascia for cervical type of cervical spondylosis. Methods Acupuncture at the superficial fascia was carried out for 48 patients with cervical type of cervical spondylosis by selecting the tender points on both sides of the cervical vertebral body and on the neck and shoulders. The treatment was conducted for once a day and treatment for 5 times was considered as 1 course of treatment. Two days were free from treatment between courses, and 3 courses were needed in total. The scores of McGill pain questionnaire [MPQ, including three indexes： Pain rating index （PRI）, Visual analogue scale （VAS） and Present pain intensity （PPI） ] of patients before and after treatment were compared, therapeutic effct of cervical type of cervical spondylosis was evaluated. Results According to the comparison before and after treatment, the scores of PRI （29.44±9.26 vs13.15±7.04）, VAS （5.63±2.73 vs 1.23±1.15）, and PPI （3.00±1.24 vs 0.38±0.49） of patients with cervical type of cervical spondylosis reduced significantly （all P〈0.05）, indicating that the differences were statistically significant. Among 48 cases, cured 40 cases （83.33%）, markedly effective 4 cases （8.34%）, effective 3 cases （6.25%）, ineffective i case （2.08%）. The total effective rate was 97.92% （47/48）. Conclusion The curative effect of acupuncture at the superficial fascia for cervical type of cervical spondylosis was satisfactory.