综合疗法治疗神经根型颈椎病80例

近年来 ,我们采用综合疗法治疗神经根型颈椎病患者 80例 ,疗效满意 ,现报告如下。临床资料 :本组男 4 5例 ,女 35例 ,年龄 30～ 70岁 ,病程 3天至 2年 ,多无明显外伤史 ,均有反复落枕史。以颈肩及颈背疼痛不适、颈项部活动受限 ,疼痛向一侧上肢放射至 2个或 3个手指为主征。神经牵拉试验及压头试验阳性。X线片侧位片示颈椎生理前凸减小、变直或反弓 ,椎间隙改变 ,椎体前缘有骨刺形成 ;正位片示椎间隙改变 ,钩椎关节不同程度增生 ,部分病侧过伸过屈 ,动力位颈椎侧位片有不稳倾向。治疗方法 :1牵引 :颌枕布带行坐位牵引 ,开始用小重量(1.5 kg…     

神经根型颈椎病的治疗

神经根型颈椎病是一种颈椎退行性疾病,引发该病的主要原因是由于增生产生直接压迫或者是增生物对其周围的软组织产生过度刺激引起的局部损伤性炎症和粘连对神经进行压迫产生的。因此该病的主要病症表现为疼痛和麻木,给患者带来了极大的痛苦。目前临床上对于该病的治疗也取得了一定的效果,临床上对于神经根型颈椎病的治疗方式较为多样化,主要包括保守性的药物治疗、手术治疗以及其他治疗方式。临床上对于神经根型颈椎病的治疗常采取以上治疗方法中的一种或者是几种综合进行治疗,均取得了不同程度的良好疗效。本文主要就目前临床上常用的药物疗法、手术疗法和其他疗法的应用情况进行综述。     

温针灸治疗神经根型颈椎病的疗效

颈椎病是临床常见病和多发病,其发病率逐年上升,发病年龄也趋于年轻化.有统计表明,50岁左右的人群中大约有25％的人患过或正患此病,60岁左右患此病者竟达50％,70岁左右几乎达100％[1].神经根型是颈椎病的最常见类型,以男性居多,多为慢性.症状可为一侧性或两侧性,通常为单神经根受累[2].发病主要见于颈4一颈5以下,以颈5、颈6、颈7神经根受累为多见[3].职业分布集中在制造业工人、财务人员、教师、办公室文员、司机等长期低头颈部负荷过度的职业.本文采用温针灸治疗该病,采用普通针刺作为对照,对其临床疗效进行观察分析.     

手法治疗神经根型颈椎病的体感诱发电位的观察研究

目的 观察手法治疗神经根型颈椎病的体感诱发电位(somatosensory evoked potentials,SEP)变化.方法 40例神经根型颈椎病患者分为手法组及常规组各20例,治疗前及治疗2周后检查SEP.结果 治疗后总有效率手法组95%,常规组85%;临床治愈率手法组为60%,常规组40%.两组间疗效及平均治疗时间差异无统计学意义.治疗前SEP异常率为55%(22/40例),主要表现为N9、N11及N13潜伏期延长;治疗后2组各潜伏期均有改善,手法组N11潜伏期改善较常规组更显著(P<0.05).结论 手法治疗可改善神经根型颈椎病的临床症状.     

牵引联合Mulligan技术治疗神经根型颈椎病43例疗效观察

目的探讨牵引联合Mulligan技术在神经根型颈椎病中的应用效果。方法前瞻性将86例神经根型颈椎病患者进行随机配对设计。对照组采用颈椎牵引;观察组采用颈椎牵引＋Mulligan技术。采用目测类比法（VAS）及颈椎病临床评价量表（CASCS）评定疗效。结果观察组治疗后VAS评分明显低于对照组,CASCS评分明显高于对照组,P均〈0．01。结论牵引联合Mulligan技术治疗神经根型颈椎病效果较好。     

超声引导下经颈侧方入路行颈神经根阻滞治疗神经根型颈椎病疗效分析

目的 探讨超声引导下经颈侧方入路行颈神经根阻滞治疗神经根型颈椎病的临床疗效。方法选择2016-02～2019-06该院收治的108例神经根型颈椎病患者作为研究对象,按照治疗方法的不同将其分为观察组(55例)和对照组(53例)。对照组采用根据体表解剖定位经颈前方入路行颈神经根阻滞治疗,观察组应用超声引导下经颈侧方入路行颈神经根阻滞治疗,比较两组穿刺时间及穿刺成功率,以及两组治疗后疼痛视觉模拟评分量表(VAS)评分、颈椎功能障碍指数(NDI)评分、健康状况评分、治疗有效率及并发症发生率。结果 观察组穿刺成功率高于对照组,穿刺所用时间短于对照组,差异有统计学意义(P 0. 05)。治疗前,两组VAS评分、NDI评分、生理健康(PH)评分和精神健康(MH)评分比较差异均无统计学意义(P 0. 05)。在治疗后第1、3、6个月,两组的VAS评分均显著低于治疗前(P 0. 05),且观察组VAS评分显著低于对照组(P 0. 05);治疗后第1、3、6个月,两组的NDI评分低于治疗前,PH评分和MH评分高于治疗前,差异有统计学意义(P 0. 05),且在治疗后第3、6个月,观察组NDI评分低于对照组,PH评分和MH评分高于对照组,差异有统计学意义(P 0. 05)。观察组治疗有效率为94. 55%,对照组治疗有效率为79. 25%,差异有统计学意义(P 0. 05)。结论 超声引导下经颈侧方入路行颈神经根阻滞治疗神经根型颈椎病效果理想,穿刺成功率高,具有广阔的临床应用前景。     

推拿配合电针疗法治疗神经根型颈椎病疗效观察

神经根型颈椎病是颈椎病中发病率最高的一型,以老年人居多,占60％-70％,近年来发病有年轻化趋势。2007年6月～2009年12月,我院采用推拿配合电针疗法治疗神经根型颈椎病患者48例,效果满意。现报告如下。临床资料：同期收治的神经根型颈椎病患者96例,男54例,女42例;年龄24-67岁,平均51岁;病程1周～15a。     

华伤特色熨疗治疗老年神经根型颈椎病临床效果观察

目的 观察华伤Ⅰ号熨疗方在治疗老年神经根型颈椎病方面的临床疗效。方法 应用随机对照试验设计,以2∶1的比例分配试验组与对照组病例,于2019年4月至2021年8月期间,共纳入154例符合标准的老年神经根型颈椎病受试者,其中试验组102例,对照组52例。试验组采用华伤Ⅰ号熨疗方治疗,对照组采用双氯芬酸二乙胺乳胶剂(扶他林)治疗,疗程2周。分别于治疗前和治疗后1, 2周和1月末随访时,观察2组神经根型颈椎病疗效评价体系症状体征积分变化情况。试验全程记录不良事件。结果 与治疗前基线比较,在治疗2周末,2组均可有效改善老年神经根型颈椎病患者的颈肩疼痛症状、颈椎活动度和症状体征总积分(P<0.05);同时,试验组在缓解颈肩疼痛症状和降低症状体征总积分方面优于对照组(P<0.05);进一步比较2组临床有效率,试验组有效率74%,高于对照组67.35%(P>0.05)。1个月末随访时,试验组临床复发率(36.49%)低于对照组(60.61%)(P<0.05)。试验过程中未收集到不良事件。结论 华伤Ⅰ号熨疗方治疗老年神经根型颈椎病临床疗效明显,复发率低,安全性好。     

Clinical control study of traditional Chinese medicine hot compress combined with traction in the treatment of cervical spondylotic radiculopathy: Study protocol

Cervical spondylotic radiculopathy (CSR) is the most common type of cervical spondylosis, accounting for about 60% of the incidence of cervical spondylosis. Both cervical traction and traditional Chinese medicine hot compress are common and effective treatment for CSR. This study will be performed to investigate the effect of a combination of cervical traction and traditional Chinese medicine hot compress on CSR. In this non-blinded, randomized controlled trial, 100 eligible patients will be randomly divided into a treatment group (intermittent cervical traction combines with traditional Chinese medicine hot compress) and a control group (intermittent cervical traction combined with hot compresses). Before and after the intervention, the Visual Analog Scale score, Neck Disability Index score, and 20-score scale of symptoms will be evaluated at baseline and at 7, 14, 21, and 28 days. During the treatment period, any signs of acute adverse events, such as paralysis of aggravated pain, nausea, dizzy, and even syncope, will be recorded at each visit. Although intermittent cervical traction and traditional Chinese medicine hot compress have been used in the treatment of CSR in China for many years, there is no consensus on its effectiveness of combination therapy. This experiment will provide convincing evidence of the efficacy of intermittent cervical traction combined with traditional Chinese medicine hot compress in the treatment of CSR.     

"痉"证方治疗脊髓型颈椎病的临床研究

目的观察“痉”证方治疗“痉证型”脊髓型颈椎病的疗效。方法以“痉”证方治疗“痉证型”脊髓型颈椎病，并以西药为对照组，以脊髓型颈椎病功能状态评定为标准，比较两组治疗前后改善率，进行临床疗效评定。结果“痉”证方组总有效率为80．0％．对照组总有效率为57、14％。“痉”证方组疗效优于对照组（P〈0．05）。结论“痉”证方治疗“痉证型”脊髓型颈椎病疗效显著。     

Yunmen (LU 2) combined with neck-seven-acupoint acupuncture for arm numbness caused by cervical spondylotic radiculopathy: A case report

Rationale:Cervical spondylotic radiculopathy (CSR) is a common sensory, motor, and reflex disorder. Numbness, a common subjective symptom of CSR, lacks objective quantitative indicators and recognized effective treatments, but is also difficult to recover from. We present a case report describing a traditional acupuncture treatment for CSR, utilizing a special acupuncture method and point, namely the Yunmen point.Patient concerns:A 40-year-old woman presented with unilateral arm numbness caused by CSR.Diagnoses:A diagnosis of CSR was made in the orthopedic department of a local hospital.Interventions:We attempted acupuncture at the Yunmen (LU 2) acupoint combined with neck-seven-acupoint under computed tomographic guidance.Outcomes:After 10 times treatment sessions, the patient no longer experienced weakness, coldness, or numbness in the affected upper limb. In addition, the stiffness in the neck and shoulders was reduced. On physical examination, the patient''s left brachial plexus traction test was negative; reassessment of the CSR-20-point score scale showed a perfect score, and the visual analog scale score was 0.Lessons:Our report indicates that acupuncture at the LU 2 acupoint combined with neck-seven-acupoint is effective in treating numbness and coldness of the arm, and other neurological symptoms caused by cervical spondylosis. Moreover, with the appropriate acupuncture technique, the risk of acupuncture at the LU 2 acupoint can be minimized.     

The efficacy and safety of fire needle for cervical spondylotic radiculopathy: A protocol for systematic review and meta-analysis

Background:Cervical spondylotic radiculopathy (CSR) is one of the most common types of cervical spondylosis, and its treatments are mainly for relieving radicular pain and improving dysfunction. The existing randomized controlled trials (RCTs) suggest that fire needle may be a potential therapy in the treatment of CSR, but there is no evidence-based medical evidence to date. Therefore, this study will systematically evaluate the efficacy and safety of fire needle in the treatment of CSR.Methods:We will search for 7 electronic databases (PubMed, EMBASE, Cochrane library, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Sinomed, and Wanfang Database) and 2 trial registration platforms (ClinicalTrials.gov and Chinese Clinic Trials.gov) to collect eligible studies. The RCTs related to fire needle for CSR and published up to June 30, 2021 will be included, regardless of language. We will consider the visual analogue scale as the primary outcome and the secondary outcome will include cervical range of motion, assessment of muscle strength, neck disability index, the MOS item short from health survey, activities of daily living, total efficiency, and adverse reactions. We will use the standard proposed in Cochrane Handbook 5.1.0 to assess the quality and bias risk of every RCT, and all analyses will be conducted through RevMan software V5.3 (Copenhagen: Nordic Cochrane Center, Cochrane, Collaborative Organization, 2014).Results:This systematic review and meta-analysis will provide a convincing synthesis of existing evidences on the efficacy and safety of fire needle for CSR, and the results will be submitted to a peer-reviewed journal for publication.Conclusion:The results of this study will provide high-quality evidence of fire needle in the treatment of CSR for clinical decision-making.INPLASY registration number:INPLASY202170041.     

Comparison of the efficacy and safety of acupuncture and acupotomy for patients with cervical spondylotic radiculopathy: A protocol for systematic review and meta-analysis

Background:There is no systematic review to compare the efficacy of acupuncture and acupotomy in patients with cervical spondylotic radiculopathy. It is worthy to critically review the evidence of the comparison of these 2 therapies to inform clinical practice. Therefore, the purpose of this study was to compare the efficacy and safety of acupuncture and acupotomy in the treatment of cervical spondylotic radiculopathy and to provide evidence for clinical practice.Methods:Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library were searched in March 2021 by 2 independent reviewers. Data extraction was performed independently, and any conflict was resolved before final analysis. Only randomized clinical trials were included in this study. Outcomes included pain intensity, symptom score, neck disability index, total effective rate, and curative rate. The Cochrane risk of bias tool is used to evaluate the risk of bias of included randomized controlled trials by 2 independent reviewers.Results:We hypothesized that these 2 methods would provide similar therapeutic benefits. The results of this research will be delivered in a peer-reviewed journal.Conclusion:This study expects to provide credible and scientific clinical evidence for the efficacy and safety of acupuncture and acupotomy in the treatment of cervical spondylotic radiculopathy.OSF registration number:10.17605/OSF.IO/U7T6A.     

Efficacy and safety of electroacupuncture in treatment of cervical spondylosis: A protocol of randomized controlled trial

Background:Cervical Spondylotic radiculopathy (CSR) is the most common spinal degenerative disease. Its clinical manifestations are pain and numbness in the neck and arm and limitation of neck movement, which greatly affects the life and work of patients. Acupuncture and electroacupuncture are commonly used in China, the efficacy of acupuncture has been confirmed. Existing evidence shows that electroacupuncture seems to be better than acupuncture, but there is a lack of clinical research to directly compare the two.Methods:This is a prospective randomized controlled trial to compare the efficacy of electroacupuncture and acupuncture in the treatment of CSR and to explore the safety and potential mechanism of electroacupuncture in the treatment of CSR. Approved by the Clinical Research Ethics Committee of our hospital, the patients are randomly divided into an experimental group (electroacupuncture group) or control group (acupuncture group). The patients are followed up for 30 days after 4 weeks of treatment. Observation indexes included VAS score, Neck Disability Index, Yasuhisa Tanaka 20 Score Scale, adverse reactions and so on. Finally, the data will be analyzed by SPSS 18.0 software.Discussion:This study will directly compare the advantages and disadvantages of electroacupuncture and acupuncture in the treatment of CSR. The results of this study will help to guide patients with CSR to choose appropriate treatment.Trial registration:OSF Registration number: DOI 10.17605/OSF.IO/9MKPN     

前路和后路手术方式治疗老年脊髓型颈椎病的疗效比较

目的探讨老年脊髓型颈椎病（cervical spondylotic myelopathy,CSM）不同入路手术的疗效,以期提高老年CSM的临床效果。方法选择接受手术治疗的160例老年CSM患者,根据手术入路的方式分为前路组（n=80）与后路组（n=80）。前路组患者接受颈椎前路减压植骨融合术;后路组患者接受颈椎后路单开门椎管成形术。观察并比较2组患者的手术时间、术中及术后并发症、脊髓神经功能优良率及手术前后日本骨科学会评分（JOA）的变化。结果前路组平均手术时间比后路组明显缩短（P〈0.05）;前路组平均术中出血量显著少于后路组（P〈0.01）。2组脊髓神经功能优良率差异无统计学意义（P〉0.05）;2组术后JOA评分均较术前明显改善,差异有统计学意义（P〈0.05）,术后前路组JOA评分改善优于后路组（P〈0.05）。结论颈椎前路减压植骨融合术和颈椎后路单开门椎管成形术治疗CSM均具有较好的疗效;合理选择好手术适应证可提高老年CSM患者的临床疗效及减少并发症的发生。     

脊髓型颈椎病的平衡功能定量检测

目的 研究脊髓型颈椎病（ cervical spondylotic myelopathy, CSM ）患者的静态平衡功能。方法 平衡检测仪对脊髓型颈椎病和正常人平衡进行检测，通过测定动摇径总长（LNG）、重心轨迹的包络面积（ENV．AREA）、摆动角度（DEG）、Romherg率和单位面积轨迹长（LNG／A）分析CSM平衡功能，比较CSM平衡功能与颈椎体位和Nurick分型的相关性。结果 CSM患者动摇径总长、重心轨迹的包络面积、摆动角度、Romberg率、单位面积轨迹长与正常人比较显著增加，平衡减退与Nurick分型呈正相关。结论 脊髓型颈椎病患者静态平衡功能比正常人明显减退．静态平衡检测可以客观反应患者的平衡功能。