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三维正骨推拿手法治疗神经根型颈椎病的临床研究 被引量:21

Clinical Study on Three-dimensional Orthopedic Tuina Approach in the Treatment of Cervical Spondylotic Radiculopathy
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摘要 目的观察三维正骨推拿手法对神经根型颈椎病患者的临床疗效。方法选取2018年12月至2019年8月岳阳市中医医院收治的神经根型颈椎病患者60例,按随机数字表法分为观察组和对照组,每组30例。观察组采用三维正骨推拿手法,对照组采用电针颈夹脊穴法,观察各组的临床疗效,并对比各组治疗前后疼痛视觉模拟评分(visual analogue scale,VAS)、颈痛量表(neck pain questionnaire,NPQ)评分及超声影像下C5~C7神经根横切面内径。结果观察组总有效率(96.7%)与对照组(93.3%)比较差异无统计学意义(P>0.05)。两组患者治疗后VAS、NPQ评分、C5~C7神经根横切面内径均较治疗前降低(P<0.05),且观察组治疗后的VAS、NPQ评分、C7神经根横切面内径低于对照组(P<0.01),但治疗后观察组与对照组C5~C6神经根横切面内径比较差异无统计学意义(P>0.05)。在起效时间节点上,观察组在治疗1 d、5 d的起效率优于对照组(P<0.05)。结论三维正骨推拿手法治疗神经根型颈椎病疗效确切且优于电针颈夹脊穴法,能有效改善患者颈部疼痛症状和神经根受压情况,起效时间更快,值得临床上推广应用。 Objective To observe the clinical efficacy of three-dimensional orthopedic Tuina approach in the treatment of patients with cervical spondylotic radiculopathy(CSR).Methods A total of 60 patients with CSR admitted into Yueyang City Hospital of Traditional Chinese Medicine from December 2018 to August 2019 were selected and randomly assigned into an observation group and a control group,with 30 cases in each group.The observation group was given three-dimensional orthopedic Tuina approach,and the control group was given electroacupuncture neck Jiaji acupoint.The clinical efficacy of each group was observed.The visual analogue scale(VAS),neck pain questionnaire(NPQ)scores,and the C5~C7 inner diameter of nerve root under ultrasonography of each group before and after treatment were compared.Results There was no significant difference in the total effective rate between the observation group(96.7%)and the control group(93.3%)(P>0.05).The VAS,NPQ scores,and the C5~C7 inner diameter of nerve root of the two groups were decreased than before treatment(P<0.05),and the VAS,NPQ scores,and the C7 inner diameter of the observation group was lower than the control group(P<0.01).After treatment,there was no significant difference in C5~C6 inner diameter of nerve root between the observation group and the control group(P>0.05).At the onset time point,the onset efficiency of the observation group on the 1st and 5th days of treatment was better than that of the control group(P<0.05).Conclusion Three-dimensional orthopedic Tuina approach shows certain clinical benefits for patients with CSR,and it was better than electroacupuncture neck Jiaji acupoint method.It effectively alleviates the symptoms of cervical pain and reduces nerve root compression of patients,with fast onset time,which is worthy of clinical promotion and application.
作者 蒋学余 张婷 任祥 王宗迪 吕洁 徐元培 林伟弟 常小荣 JIANG Xueyu;ZHANG Ting;REN Xiang;WANG Zongdi;LYU Jie;XU Yuanpei;LIN Weidi;CHANG Xiaorong(Yueyang Hospital Affiliated to Hunan University of Chinese Medicine,Yueyang,Hunan 414000,China;School of Acupuncture-Moxibustion and Tuina,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;Hunan Provincial Key Laboratory of Traditional Chinese Medicine Diagnostics,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China)
出处 《湖南中医药大学学报》 CAS 2020年第3期337-341,共5页 Journal of Hunan University of Chinese Medicine
基金 国家科技部中医药现代化专项(2018YFC1707806) 湖南省自然科学基金面上项目(2019JJ40217) 湖南省中医药管理局科研计划项目(2019114)。
关键词 神经根型颈椎病 三维正骨推拿手法 电针 颈夹脊穴 VAS NPQ评分 cervical spondylotic radiculopathy three-dimensional orthopedic Tuina approach electroacupuncture at neck Jiaji acupoints visual analogue scale neck pain questionnaire scores
作者简介 蒋学余,男,主任医师,硕士研究生导师,研究方向:针灸推拿治病机理研究;通讯作者:常小荣,女,二级教授,博士研究生导师,E-mail:xrchang1956@163.com。
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