摘要
目的探讨分型针刺治疗颈椎病的必要性和有效性。方法选择临床常见的颈型、神经根型、椎动脉型颈椎病患者,每型80例共240例。各型患者采用随机数字表法分入观察组和常规组。观察组(120例)采用分型治疗,颈型采用辨经论治,神经根型采用从脾胃论治,椎动脉型采用项五针;常规组(120例)各型均采用相同的治疗方法(常规取穴)。在治疗前、治疗5次、治疗10次后颈型和神经根型选用颈椎病治疗成绩评分表(CSAS)和目测类比疼痛分度量表(VAPS),椎动脉型选用颈性眩晕症状与功能评估量表(ESCV)评分表进行评估。治疗10次后评估整体疗效。结果颈型患者中,两组治疗后CSAS和VAPS评分与同组治疗前比较差异均有统计学意义(P<0.05,P<0.01),组间比较差异无统计学意义(P>0.05)。神经根型患者中,两组治疗5次后CSAS和VAPS评分与治疗前比较差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05);两组治疗10次后CSAS和VAPS评分与治疗前比较差异有统计学意义(P<0.01),组间比较差异有统计学意义(P<0.05)。椎动脉型患者中,观察组治疗5次后ESCV评分与治疗前比较差异有统计学意义(P<0.01),常规组亦有降低(P<0.05),组间比较差异有统计学意义(P<0.05);10次后两组ESCV评分与治疗前比较差异均有统计学意义(P<0.01),组间比较差异有统计学意义(P<0.05)。治疗10次后观察组愈显率和总有效率分别为76.6%和92.8%,对照组分别为54.2%和86.0%,两组愈显率比较差异有统计学意义(P<0.01)。结论分型针刺治疗颈椎病可明显提高临床疗效。
Objective To explore the necessity and effectiveness of type-based acupuncture treatment for cervical spondylosis.Method Two hundred and forty patients with clinically common cervical spondylosis,cervical spondylotic radiculopathy or cervical spondylotic vertebral arteriopathy,80 cases each type,were enrolled.Every type of patients was randomly allocated to observation and conventional groups.The observation group（120 patients） received type-based acupuncture treatment.Cervical spondylosis was treated by syndrome differentiation;cervical spondylotic radiculopathy,from the spleen and stomach;cervical spondylotic vertebral arteriopathy,with nape five-needle acupuncture.Every type of the conventional group（120 patients） received the same therapeutic method（conventional selection of acupoints）.Before and after five and ten sessions of treatment,cervical spondylosis and cervical spondylotic radiculopathy were scored using the CSAS and the VAPS and cervical spondylotic vertebral arteriopathy was scored using the ESCV.The overall therapeutic effects were evaluated after ten treatments.Result Of the patients with cervical spondylosis,there were statistically significant pre-/post-treatment differences in the CSAS and VAPS scores in the two groups（P〈0.05,P〈0.01） but no statistically significant differences in the scores between the groups（P〈0.05）.Of the patients with cervical spondylotic radiculopathy,there were statistically significant differences in the CSAS and VAPS scores in the two groups after five treatments compared with before（P〈0.05） but no statistically significant differences in the scores between the groups（P〈0.05）;after ten treatments there were statistically significant differences in the scores in the two groups compared with before（P〈0.01） and also between the groups（P〉0.05）.Of the patients with cervical spondylotic vertebral arteriopathy,there was a statistically significant difference in the ESCV score in the observation group after five treatments compared with before（P〈0.01）;the score also decreased in the conventional group（P〈0.05）;there was a statistically significant difference between the groups（P〈0.05）;after ten treatments there was a statistically significant difference in the ESCV score in the two groups compared with before（P〈0.01） and also between the groups（P〈0.05）.After ten treatments,the cure and marked efficacy rate and the total efficacy rate were 76.6% and 92.8%,respectively,in the observation group and 54.2% and 86.0%,respectively,in the conventional group.There was a statistically significant difference in the cure and marked efficacy rate between the two groups（P〈0.01）.Conclusion Type-based acupuncture can markedly improve the clinical therapeutic effect on cervical spondylosis.
作者
蔡玉梅
郑继范
王灿
姚秋雯
CAI Yu-mei ZHENG Ji-fan WANG Can YAO Qiu-wen(Shanghai Yangpu District Kongjiang Hospital, Shanghai200093,Chin)
出处
《上海针灸杂志》
2016年第10期1233-1237,共5页
Shanghai Journal of Acupuncture and Moxibustion
基金
上海市"杨浦区中医三年行动计划"科研课题(ZY201402002)
关键词
颈椎病
针刺
辨证分型
Cervical spondylosis
Acupuncture
Symptom differentiation-based acupuncture
