针灸推拿结合黄芪桂枝五物汤治疗神经根型颈椎病的临床观察

目的:探讨针灸和疏经通督推拿结合黄芪桂枝五物汤对神经根型颈椎病患者颈椎功能、生命质量及炎性反应的影响。方法:选取2017年1月至2018年5月海南省人民医院收治的神经根型颈椎病患者104例作为研究对象,按照随机数字表法分为对照组与观察组,每组52例。对照组应用针灸结合普通推拿进行治疗,观察组应用针灸和疏经通督推拿结合黄芪桂枝五物汤治疗。比较2组患者临床疗效,治疗前、治疗40 d后中医证候积分、颈椎功能评分、视觉模拟评分(VAS)、健康调查简表(SF-36)生命质量量表评分及血清白细胞介素-8(IL-8)、超敏C反应蛋白(hs-CRP)和P物质水平。结果:观察组总有效率为94. 23%(49/52),对照组总有效率为76. 92%(40/52),观察组总有效率高于对照组(P 0. 05)。治疗40 d后2组患者中医证候积分、VAS较治疗前降低(P 0. 05),观察组患者中医证候积分、VAS低于对照组(P 0. 05)。治疗40 d后2组患者颈椎功能评分、SF-36生命质量量表各维度评分均较治疗前升高(P 0. 05),且观察组患者颈椎功能评分、SF-36生命质量量表各维度评分高于对照组(P 0. 05)。治疗40 d后2组患者血清IL-8、hs-CRP和P物质水平均较治疗前降低(P 0. 05),观察组患者IL-8、hs-CRP和P物质水平低于对照组(P 0. 05)。结论:针灸和疏经通督推拿结合黄芪桂枝五物汤可以有效改善神经根型颈椎病临床症状,提高患者颈椎功能和生命质量,降低炎性反应,治疗神经根型颈椎病效果较好。

Effects Observation on Acupuncture and Moxibustion Combined with Huangqi Guizhi Wuwu Decoction in the Treatment of Cervical Spondylotic Radiculopathy

To explore the effects of acupuncture and moxibustion combined with Shujing Tongdu Massage and Huangqi Guizhi Wuwu Decoction on cervical function, quality of life and inflammatory reaction in patients with cervical spondylotic radiculopathy.Methods:A total of 104 patients with cervical spondylotic radiculopathy who were admitted to Hainan provincial people''s hospital from January 2017 to May 2018 were selected.They were divided into an observation group(52 cases)and a control group(52 cases)according to random number table method.The control group was treated with acupuncture and moxibustion combined with general massage, and the observation group was treated with acupuncture and moxibustion combined with Shujing Tongdu Massage and Huangqi Guizhi Wuwu Decoction.The clinical effects of the 2 groups were compared, including TCM syndrome score, cervical vertebral function score, visual analogue score(VAS), SF-36 quality of life scale, serum interleukin-8(IL-8), hypersensitive C-reactive protein(hs-CRP)and substance P levels before and after treatment.Results:The total effective rate of the observation group was 94.23%(49/52), and that of the control group was 76.92%(40/52).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).40 d after treatment, the TCM syndrome score and VAS of the 2 groups were significantly lower than those before treatment(P<0.05).The TCM syndrome score and VAS of the observation group were significantly lower than those of the control group(P<0.05).40 d after treatment, the cervical function score and SF-36 quality of life scale of the 2 groups were significantly increased than before treatment(P<0.05).The cervical function score and SF-36 quality of life of the observation group were significantly higher than those of the control group(P<0.05).40 d after treatment, the serum levels of IL-8, hs-CRP and substance P in both groups were decreased than those before treatment(P<0.05).The levels of IL-8, hs-CRP and substance P in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Acupuncture and moxibustion combined with Shujing Tongdu Massage and Huangqi Guizhi Wuwu Decoction can effectively improve the clinical symptoms of cervical spondylotic radiculopathy, improve the function and quality of life of patients with cervical spondylotic radiculopathy, reduce inflammatory reaction, and they have a better effect in treating cervical spondylotic radiculopathy.