国医大师李士懋发汗法(寒痉汤)治疗寒凝证型颈椎病的多中心随机对照临床研究OA
A Multi-Center Randomized Controlled Clinical Study on the Treatment of Cervical Spondylopathy of Cold-Congealing Pattern with National Master of Traditional Chinese Medicine Li Shimao's Diaphoresis Method(HJD)
目的:观察国医大师李士懋应用发汗法(寒痉汤)治疗寒凝证型颈椎病的临床效果.方法:选取寒凝证型颈椎病患者480例,随机分为对照组(4个)和观察组,每组96例,4个对照组分别给予颈椎牵引、颈复康颗粒、颈椎针灸、颈椎推拿治疗,观察组给予寒痉汤治疗.观察五组患者治疗后的视觉模拟量表(VAS)评分、田中靖久颈椎病症状量表(20分法)评分、颈椎前凸角(CLA)、血浆黏度(PV)、红细胞压积(HCT)及临床疗效.结果:与4个对照组治疗前比较,五组患者治疗后 VAS评分、颈椎病症状、颈椎前凸角、血浆黏 度、红细胞压积等明显改善,差异均有统计学意义(P<0.05).观察组总有效率为94.79%,4个对照组总有效率分别为82.29%,79.17%,84.38%和85.42%,观察组总有效率明显高于4个对照组,与4个对照组比较总有效率差异有统计学意义(P<0.05).观察组颈椎前凸角改善幅度不及牵引组、推拿组,差异有统计学意义(P<0.05),但在疼痛缓解、血液流变学指标改善方面优势显著,差异有统计学意义(P<0.05).观察组不良反应发生率为6.25%(6/96),对照组总不良反应发生率为7.50%(29/384),组间差异无统计学意义(P>0.05),所有不良反应经对症处理后均缓解,未出现严重不良事件.结论:发汗法能够有效治疗寒凝证型颈椎病,缓解临床症状,减轻疼痛,改善颈椎前凸角及血液流变学指标,而且安全性高,值得临床推广应用.
Objective:To observe the clinical efficacy of the diaphoretic method developed by Li Shimao in treating cervical spondylosis with the cold-congealing pattern.Methods:A total of 480 patients with cervical spondylosis of cold-congealing pattern were randomly assigned to four control groups and one observation group,with 96 cases in each group.The four control groups received cervical traction,Jingfukang gran-ules,cervical acupuncture,and cervical tuina manipulation,respectively.The observation group was treated with Han-jing decoction(HJD)administered according to the diapho-retic method.Visual analogue scale(VAS)scores,Tanaka cervical spondylotic radiculopathy symptom score(20-point),cervical lordosis angle(CLA),plasma viscosity(PV),hematocrit(HCT),and clinical efficacy were evaluated before and after treatment in all five groups.Results:Com-pared with baseline,all five groups showed significant improvement after treatment in VAS scores,cervical spondylosis symptom scores,CLA,PV,and HCT(all P<0.05).The overall response rate was 94.79%in the observation group,and 82.29%,79.17%,84.38%,and 85.42%in the four control groups,respectively.The overall response rate in the observa-tion group was significantly higher than that in each control group(P<0.05).The observation group showed a smaller improvement in CLA than the traction and tuina manipulation groups(P<0.05),but demonstrated significant advantages in pain relief and hemorheological improvement.The incidence of adverse reactions in the observation group was 6.25%(6/96),while the total incidence of adverse reactions in the control groups was 7.50%(29/384).The difference between the groups was not statistically significant(P>0.05).All adverse reactions resolved spontaneously or were alleviated with symptomatic treatment,and no serious adverse events occurred.Conclusion:The diaphoretic method is effective for the treatment of cervical spondylosis of cold-congealing pattern.It alleviates clinical symptoms,reduces pain,improves cer-vical lordosis angle and hemorheological indices,and demonstrates good safety,suggesting that it warrants broader clinical application.
胡志勇;程文会;刘清磊;王文娟;周然然;王金榜;杨燕兵
河北省沧州中西医结合医院,河北省中西医结合骨关节病研究重点实验室(筹)(河北 沧州,061000)河北省沧州中西医结合医院,河北省中西医结合骨关节病研究重点实验室(筹)(河北 沧州,061000)河北省沧州中西医结合医院,河北省中西医结合骨关节病研究重点实验室(筹)(河北 沧州,061000)河北省沧州中西医结合医院,河北省中西医结合骨关节病研究重点实验室(筹)(河北 沧州,061000)河北省沧州中西医结合医院,河北省中西医结合骨关节病研究重点实验室(筹)(河北 沧州,061000)河北省中医院衡水市第二人民医院
医药卫生
发汗法寒痉汤颈椎病寒凝证颈椎前凸角血液流变学随机对照试验
diaphoretic methodHanjing decoctioncervical spondylosiscold-congealing patterncervical lordosis anglehemorheologyrandomized controlled trial
《中国中医骨伤科杂志》 2026 (5)
25-31,7
"十二五"国家科技支撑计划项目(2013BAI13B02)河北省中医药管理局项目(2022258)
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