摘要
目的基于“肌筋膜链”理论指导下,观察铁闩散热奄包热熨治疗风寒湿型神经根型颈椎病患者的临床疗效。方法选取2022年7月至2023年12月收治的风寒湿型神经根型颈椎病患者114例作为研究对象,按照信封法随机分为铁闩散组、坎离砂组和粗盐组,每组38例。铁闩散组采用铁闩散+粗盐包进行颈部疼痛区域热熨治疗,粗盐组采用粗盐热奄包,坎离砂组采用坎离砂热奄包。受试者,结局评估员和统计学家在各组分配方面被盲法。比较患者治疗前1 d(T0)及治疗后1、7、14 d(T1、T2、T3)不同时间点的视觉模拟疼痛量表(VAS)评分、颈椎功能障碍指数量表(NDI)评分、记录中医症候积分、治疗前后炎症因子水平,并且在治疗前后及治疗过程中进行安全性观察。结果96例患者顺利进行试验,以及完成2周内的各项指标评分测定,无严重不良事件发生。T0~T3,各组VAS评分均有所下降,但铁闩散组在T2和T3时VAS评分显著低于砍离砂组和粗盐组(P<0.001);各组NDI评分从T0到T3均有所下降,但铁闩散组在T3时的NDI评分显著低于砍离砂组和粗盐组(P=0.012);T0~T3,各组的肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平均有所下降,但铁闩散组的下降幅度更大,且在多个时间点显著低于其他两组(P<0.05);各组基质金属蛋白酶-13(MMP-13)水平在T0~T3期间均有所上升,但粗盐组和铁闩散组在T3时的MMP-13水平显著高于砍离砂组(P<0.05)。结论铁闩散热奄包热熨治疗风寒湿型神经根型颈椎病疗效明显,安全性高,使用方便,值得临床推广。
Objective e To evaluate the clinical efficacy of the Menghe Tieshuan Powder-based hot compress treatment for cold-damp type cervical spondylotic radiculopathy,guided by the myofascial chain theory.Methods A total of 114 patients diagnosed with cold-damp type cervical spondylotic radiculopathy between July 2022 and December 2023 were randomly assigned using envelope method into three groups(n=38 each):the Tieshuan Powder group,the Kanli Sand group,and the Coarse Salt group.The Tieshuan group received hot compress therapy using Tieshuan Powder combined with coarse salt applied to the painful cervical area.The control groups received either Kanli Sand or coarse salt hot compresses.Participants,outcome assessors,and statisticians were blinded to group allocations.Outcome measures included Visual Analog Scale(VAS)for pain,Neck Disability Index(NDI),traditional Chinese medicine(TCM)syndrome scores,and serum inflammatory markers,evaluated at baseline(T0)and on days 1(T1),7(T2),and 14(T3)after treatment.Safety monitoring was conducted throughout the treatment period.Results Ninety-six patients completed the study without severe adverse events.VAS scores declined in all groups over time;however,the Tieshuan group showed significantly lower VAS scores at T2 and T3 compared with the other two groups(P<0.001).NDI scores also im-proved in all groups,with the Tieshuan group showing a significantly lower score at T3(P=0.012).Tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels decreased in all groups,with the Tieshuan group showing greater and statistically significant reductions at multiple time points(P<0.05).Matrix metalloproteinase-13(MMP-13)levels increased across all groups from T0 to T3,but were significantly higher in the Tieshuan and coarse salt groups compared to the Kanli Sand group at T3(P<0.05).Conclusion The Tieshuan Powder-based hot compress,derived from the Menghe Medical School,demonstrates significant efficacy and high safety in treating cold-damp type cervical spondylotic radiculopathy.Its simplicity and clinical feasibility make it worthy of broader application.
作者
曹娜
柏亚妹
陈莹
武文婷
吴园
张曦
高俊
孙晗
CAO Na;BAl Ya-mei;CHEN Ying;WU Wen-ting;WU Yuan;ZHANG Xi;GAO Jun;SUN Han(School of Nursing,Nanjing Uninversity of Chinese Medicine,Nanjing 210046,Jiangsu,China;不详)
出处
《广东医学》
2025年第5期725-731,共7页
Guangdong Medical Journal
基金
江苏省中医药科技发展计划项目(MS2022074)
常州市孟河医派传承创新发展项目(MH202424)。
关键词
肌筋膜链
孟河医派
颈椎病
风寒湿型
热熨治疗
myofascial chain
Menghe
cervical spondylosis
Cold-Damp syndrome
hot compress therapy
