分经辨治针刺结合中药热敷治疗神经根型颈椎病的疗效观察

目的观察通过分经辨治针刺结合中药热敷治疗神经根型颈椎病的疗效。 方法选取2016年1月至2017年12月安徽省淮北市濉溪县中医院针灸科神经根型颈椎病患者90例，将患者按就诊时间先后随机分为3组，针刺组、热敷组和观察组，每组30例。针刺组采用单纯针刺，热敷组采用单纯中药热敷，观察组采用分经辨治针刺结合中药热敷治疗。针刺组和中药热敷组均为每日1次，6次为1个疗程，休息3 d，继续治疗1个疗程，2个疗程后评价疗效。采用Fisher Exact检验比较3组神经根型颈椎病患者总有效率和愈显率，采用方差分析比较3组神经根型颈椎病视觉模拟量表评分(VAS)。 结果观察组中治愈23例，显效5例，有效2例，无效0例，总有效率为100%(30/30)；针刺组中治愈15例，显效8例，有效3例，无效4例，总有效率为86.7%(26/30)；热敷组中治愈4例，显效5例，有效8例，无效13例，总有效率为56.7%(17/30)；3组疗效的总有效率和愈显率比较，差异均具有统计学意义(χ²＝29.205、19.290，P均<0.01)。观察组治疗前后VAS评分差值(4.47±1.35)比针刺组(2.88±2.02)和热敷组(1.31±1.29)分别高1.83(95%CI：1.02～2.66)和3.40(95%CI：2.58～4.22)，且差异均具有统计学意义(t＝2.70、5.74，P<0.01)，针刺组平均VAS评分比热敷组高1.57(95%CI：0.75～2.38)，差异有统计学意义(t＝3.04，P<0.01)。 结论分经辨治针刺结合中药热敷治疗神经根型颈椎病疗效优于单纯针刺、单纯中药热敷。

Observation on curative effect of acupuncture by syndrome differentiation of channels combined with hot compress with traditional Chinese medicine on cervical spondylotic radiculopathy

ObjectiveTo observe the curative effect of acupuncture by syndrome differentiation of channels combined with hot compress with traditional Chinese medicine on cervical spondylotic radiculopathy. MethodsNinety patients with cervical spondylotic radiculopathy from January 2016 to December 2017 were randomly divided into three groups: acupuncture group, hot compress group and observation group, 30 cases in each group. Acupuncture group was treated with simple acupuncture, hot compress group was treated with simple traditional Chinese medicine hot compress, and observation group was treated with the combination of acupuncture by syndrome differentiation of channels and hot compress with traditional Chinese medicine. Acupuncture and hot compress of traditional Chinese medicine were applied once a day, with 6 times as a course of treatment, and rest for 3 days. Then the other course of treatment was followed, and the efficacy was evaluated after 2 courses. Fisher Exact test was used to compare the total effective rate and healing rate of three groups. Variance analysis was used to compare the visual analogue scale score (VAS) of three groups. ResultsThe results showed that 23 cases in the observation group were cured, 5 cases were markedly effective, 2 cases were effective and 0 cases were ineffective. The total effective rate was 100% (30/30). In the acupuncture group, 15 cases were cured, 8 cases were markedly effective, 3 cases were effective and 4 cases were ineffective. The total effective rate was 86.7% (26/30). In the hot compress group, 4 cases were cured, 5 cases were markedly effective, 8 cases were effective and 13 cases were ineffective. The total effective rate was 56.7% (17/30). The total effective rate and the marked recovery rate of the three groups were significantly different (χ²=29.205, 19.290, all P<0.01). The difference of VAS before and after treatment in the observation group was higher by 1.83 (95% CI: 1.02~2.66) and 3.40 (95% CI: 2.58~4.22) than that in the acupuncture group (2.88±2.02) and the hot compress group (1.31±1.29), respectively, and the difference was statistically significant (t=2.70, 5.74, all P<0.01). The average VAS in the acupuncture group was higher by 1.57 (95% CI: 0.75~2.38) than that in the hot compress group, and the difference had statistical significance (t=3.04, P<0.01). ConclusionThe curative effect of acupuncture by syndrome differentiation of channels combined with hot compress with traditional Chinese medicine on cervical spondylotic radiculopathy is obviously better than that of simple acupuncture group and traditional Chinese medicine hot compress group.