防风汤加减结合项三针治疗神经根型颈椎病的临床研究

Clinical Study of Modified Fangfeng Decoction and Nape Tri-Acupuncture Combined Therapy in the Treatment of Cervical Spondylotic Radiculopathy

  • 摘要: 目的 观察防风汤加减结合项三针(针刺颈夹脊、颈百劳和阿是穴)治疗神经根型颈椎病(CSR)风寒痹阻证的疗效及安全性。方法 将140例患者随机分为对照组和治疗组,各70例,对照组给予甲钴胺+复方硫酸软骨素,治疗组给予防风汤加减+项三针,疗程均为4周。比较2组患者治疗前后颈痛量表(NPQ)、颈椎病临床评价量表(CASCS)、颈椎关节活动度量表(CROM)和CSR风寒痹阻证中医证候评分;检测左侧椎动脉的平均流速(LBVA-Vm)、基底动脉平均流速(VA-Vm)、右侧椎动脉的平均流速(RBVA-Vm)、椎动脉阻力指数(VA-RI)和椎基底动脉内径(VAD);检测血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)和神经肽Y(NPY)和核因子-κB(NF-κB)的含量;观察2组有效率和不良反应发生率。结果 研究期间脱落6例。治疗后治疗组总有效率94.2%,高于对照组的84.8%(P<0.05);治疗组NPQ和中医证候评分低于对照组(P<0.05),CASCS和CROM评分高于对照组(P<0.05);治疗组BVA-Vm、VA-Vm、BVA-Vm和VAD水平高于对照组(P<0.05),VA-RI水平低于对照组(P<0.05);治疗组IL-1β、TNF-α、NPY和NF-κB含量低于对照组(P<0.05);治疗组不良反应发生率2.9%,低于对照组(22.7%,P<0.05)。结论 防风汤加减结合项三针可明显改善CSR风寒痹阻证患者的临床症状,不良反应发生率低,值得临床推广应用。

     

    Abstract: OBJECTIVE To observe the efficacy and safety of Fangfeng decoction and nape tri-acupuncture-jia ji (EX-B2), bai lao (EX-HN14) and ashi point combined therapy in treating cervical spondylotic radiculopathy (CSR) with wind-cold obstruction syndrome. METHODS 140 patients were randomly divided into the control group and the treatment group with 70 cases in each. The control group was given mecobalamin + compound chondroitin sulfate, and the treatment group was given modified Fangfeng decoction + tri-acupuncture. The course of treatment were both 4 weeks. The Northwick Park Neck Pain Questionnaire (NPQ), clinical assessment scale for cervical spondylosis (CASCS), cervical range of motion (CROM) and TCM syndrome scores of CSR wind-cold obstruction syndrome were compared between the two groups both before and after treatment. The left bilateral vertebral artery velocity mean (LBVA-Vm), vertebral artery velocity mean (VA-Vm), right bilateral vertebral artery velocity mean (RBVA-Vm), vertebral artery resistance index (VA-RI) and Vertebrobasilar artery velocity mean (VAD) were detected. The content of serum interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), neuropeptide Y (NPY) and nuclear factor κB (NF-κB) were measured. The effective rate and the incidence of adverse reactions in the two groups were observed. RESULTS 6 cases were abscission during the research. After treatment, the total effective rate of the treatment group was 94.2%, which was significantly higher than that of the control group (84.8%, P<0.05). The scores of NPQ and TCM syndrome in the treatment group were significantly lower than those in the control group (P<0.05), and the scores of CASCS and CROM were significantly higher than those in the control group (P<0.05). The levels of BVA-Ym, VA-Vm, BVA-Vm and VAD in the treatment group were higher than those in the control group (P<0.05), and the levels of VA-RI were lower than those in the control group (P<0.05). The contents of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), neuropeptide Y (NPY) and nuclear factor κB (NF-κB) in the treatment group were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions in the treatment group was 2.9%, significantly lower than that in the control group (22.7%, P<0.05). CONCLUSION Modified Fangfeng decoction and tri-acupuncture combined therapy can significantly improve the clinical symptoms of CSRS patients with wind-cold obstruction syndrome, with a low incidence of adverse reactions, which is worthy of clinical application.

     

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