摘要
目的 探讨刃针结合腹针治疗神经根型颈椎病的疗效及其对患者椎动脉和基底动脉血液流变学的影响。方法 选择2019年9月至2021年6月在广西壮族自治区中医药研究院针灸推拿科治疗的76例神经根型颈椎病患者为研究对象,按照计算机生成的随机数字分为对照组和观察组各38例,对照组患者行局部穴位针刺配合腹针治疗,观察组患者行局部刃针操作配合腹针治疗,以10次腹针为一个疗程进行观察记录。分别采用Borden氏法、颈椎疼痛量表(NPQ)、《神经根型颈椎病疗效判定方法》评价两组患者治疗前后的颈椎生理曲度、颈椎疼痛度和中医症候积分,使用美国3F公司的彩色诊断仪(TDS-9900型)评价两组患者两侧椎动脉和基底动脉的收缩峰值血液流速(Vp)、平均血液流速(Vm)、舒张末期血液流速(Vd)。结果 两组患者治疗后颈椎生理曲度经X光线检查均较治疗前明显改善,治疗后观察组和对照组患者的颈椎生理曲度分别为(3.64±0.89) mm、(4.43±1.03) mm,相对治疗前[观察组(2.38±0.21) mm、对照组(2.49±0.25) mm]明显增大,且观察组改变大于对照组,差异均有统计学意义(P<0.05);治疗后,观察组和对照组患者的NPQ评分分别为(15.33±3.14)分、(17.38±3.28)分,相对治疗前[观察组(30.25±5.32)分、对照组(28.53±5.08)分]均降低,差异均有统计学意义(P<0.05);治疗后,两组患者的中医症候量表积分较治疗前均降低,且观察组的中医症候量表积分明显低于对照组,差异均有统计学意义(P<0.05);治疗后,对照组患者右椎动脉的Vp、Vd较治疗前增快,差异有统计学意义(P<0.05),观察组治疗后右椎动脉Vp、Vm以及左椎动脉、基底动脉Vp、Vm、Vd比治疗前明显增快,且观察组患者治疗后双侧椎动脉的Vd,基底动脉的Vp、Vm和Vd与对照组治疗后比较差异均有统计学意义(P<0.05)。结论 刃针配合腹针治疗神经根型颈椎病既可以改善患者椎动脉血流循环,又可以改善颈部血液流变学状态,临床应用效果显著,值得临床上进一步深入研究。
Objective To explore the effect of blade acupuncture combined with abdominal acupuncture in the treatment of cervical spondylotic radiculopathy and its effect on hemorheology of vertebral artery and basilar artery.Methods From September 2019 to June 2021, 76 patients with cervical spondylotic radiculopathy treated in the Department of Acupuncture and Massage, Guangxi Academy of Traditional Chinese Medicine were selected as the research objects. According to the random number generated by computer, they were divided into the control group and the observation group, with 38 cases in each group. Patients in the control group were treated with local acupuncture combined with abdominal acupuncture, while those in the observation group were treated with blade acupuncture combined with abdominal acupuncture. Ten times of abdominal acupuncture were taken as a course of treatment. Borden’s method, Cervical Pain Scale(NPQ), and Evaluation Method for Efficacy of Cervical Spondylosis of Nerve Root Type were used to evaluate the physiological curvature of cervical vertebra, pain degree of cervical vertebra, and TCM symptom score in the two groups before and after treatment. Color diagnostic apparatus TDS-9900(3F Company, United States) were used to detect the systolic peak blood flow(Vp), mean blood flow(Vm), and end diastolic blood flow(Vd) of bilateral vertebral arteries and basilar arteries of the two groups. Results The physiological curvature of cervical spine in the two groups after treatment was significantly improved compared with that before treatment. After treatment, the curvature was(3.64±0.89) mm in the observation group and(4.43±1.03) mm in the control group, which were significantly increased compared with(2.38 ±0.21) mm and(2.49 ±0.25) mm before treatment;the improvement in the observation group were greater than those in the control group;the differences were statistically significant(P<0.05). After treatment, the NPQ score was(15.33±3.14) points in the observation group and(17.38±3.28) points in the control group,which were significantly decreased compared with(30.25±5.32) points,(28.53±5.08) points before treatment(P<0.05).The TCM syndrome scale scores of the two groups after treatment were significantly lower than those before treatment,and the score of the observation group was significantly lower than that of the control group, and the difference between the two groups was statistically significant(P<0.05). After treatment, the right vertebral artery Vp, Vd in the control group was significantly increased compared with that before treatment(P<0.05);the Vp and Vm of right vertebral artery and the Vp, Vm, Vd of basilar artery of left vertedral artery in the observation group after treatment were significantly increased compared with those before treatment;after treatment, Vd of bilateral vertebral artery, Vp, Vm, and Vd of basilar artery in the observation group were significantly different from those in the control group;the differences were statistically significant(P<0.05). Conclusion Blade acupuncture combined with abdominal acupuncture is effective in the treatment of cervical spondylotic radiculopathy. It can not only improve the blood circulation of the vertebral artery, but also improve the hemorheology of the neck, which is worthy of further clinical research.
作者
吕春燕
曾诗睿
LV Chun-yan;ZENG Shi-rui(Department of Acupuncture and Massage,Guangxi Academy of Traditional Chinese Medicine,Nanning 530021,Guangxi,CHINA)
出处
《海南医学》
CAS
2022年第24期3207-3210,共4页
Hainan Medical Journal
基金
广西中医药适宜技术开发与推广项目(编号:GZSY20—05)。
关键词
神经根型颈椎病
刃针
腹针
血液流速
中医症候积分
疗效
Cervical spondylotic radiculopathy
Blade acupuncture
Abdominal acupuncture
Blood flow rate
TCM syndrome score
Curative effect
