针刀配合美式整脊对神经根型颈椎病患者疼痛程度、颈椎功能的影响OA
Effect of acupotomy combined with Chiropractic manipulative therapy on the pain level and cervical function of patients with cervical spondylotic radiculopathy
目的 探讨针刀配合美式整脊在神经根型颈椎病患者中的应用效果.方法 选取2021年11月至2023年10月收治的神经根型颈椎病患者80例,随机数字表法分为观察组和常规组,各40例.常规组接受美式整脊治疗,观察组接受针刀配合美式整脊治疗.观察两组临床疗效,比较两组治疗前后疼痛视觉模拟评分法(VAS)评分、颈椎功能障碍指数(NDI)评分、血液流变学[血浆黏度、全血黏度(低切、中切、高切)]、正中神经及尺神经F波传导速度、疼痛介质[血清P物质、β-内啡肽(β-EP)、前列腺素E2(PGE2)、5-羟色胺(5-HT)]水平及安全性.结果 观察组治疗总有效率[95.00％(38/40)]高于常规组[77.50％(31/40)](P＜0.05);治疗后观察组疼痛VAS、NDI评分较常规组低(P＜0.01);观察组治疗后全血低切、中切、高切黏度及血浆黏度均低于常规组,正中神经、尺神经F波传导速度高于常规组(P＜0.01);与常规组比较,观察组治疗后血清PGE2、P物质、5-HT较低,β-EP较高(P＜0.01);两组不良反应发生率比较差异无统计学意义(P＜0.05).结论 针刀配合美式整脊治疗神经根型颈椎病效果可靠且安全,可促进神经传导,调节血液流变,加速疼痛介质代谢,从而减轻患者疼痛程度,改善颈椎功能.
Objective To investigate the application effect of acupotomy combined with Chiropractic manipulative therapy in patients with cervical spondylotic radiculopathy(CSR).Methods A total of 80 patients with CSR admitted from November 2021 to October 2023 were selected.The patients were divided into observation group and conventional group by random number table method,with 40 patients in each group.The conventional group received Chiropractic manipulative therapy,and the observation group received acupotomy combined with Chiropractic manipulative therapy.The clinical efficacy of the two groups was observed,and the visual analogue scale(VAS)pain score,neck disability index(NDI)score,hemorheological indicators[plasma viscosity,whole blood viscosity(at low,medium,and high shear rate)],F-wave conduction velocities of the median and ulnar nerves,pain mediators[serum substance P,β-endorphin(β-EP),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)]levels before and after treatment and safety were compared between the two groups.Results The total effective rate of treatment in the observation group[95.00％(38/40)]was higher than that in the conventional group[77.50％(31/40)](P＜0.05),and after treatment,the VAS pain scores and NDI scores of the observation group were lower than those of the conventional group(P＜0.01).After treatment,the whole blood viscosity at low,medium and high shear rate and plasma viscosity in the observation group were lower than those in the conventional group,and the F-wave conduction velocities of the median and ulnar nerves was higher than that in the conventional group(P＜0.01).After treatment,compared with the conventional group,the serum PGE2,substance P,5-HT in the observation group were lower,while β-EP was higher(P＜0.01),and there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Acupotomy combined with Chiropractic manipulative therapy is effective and safe in the treatment of patients with CSR.It can promote nerve conduction,regulate hemorheological parameters,and accelerate the metabolism of pain mediators,thereby reducing the degree of pain and improving cervical spine function.
刘淳;陈朝晖
首都医科大学附属北京康复医院中医推拿科,北京 100144北京中医药大学针推学院康复系,北京 100020
神经根型颈椎病针刀美式整脊颈椎功能β-内啡肽前列腺素E2血液流变学肌电图
cervical spondylotic radiculopathyacupotomyChiropractic manipulative therapycervical functionβ-endorphinprostaglandin E2hemorheologyelectromyography
《临床误诊误治》 2026 (2)
99-105,7
首都医科大学附属北京康复医院2021-2023年科研发展专项-康复临床研究培育专项青年项目(2021-048)
评论