F波检测在电针治疗神经根型颈椎病疗效评价中的应用

目的观察采用F波（F-wave）技术对电针治疗神经根型颈椎病疗效进行判定的可行性。方法200例神经根型颈椎病患者予以“4＋5”穴位优化组合方案（4个基本穴，5个辨证配穴）治疗，并分别在治疗前、治疗结束后以及随访6个月后进行疗效评定和F波检测。结果治疗后显效率为62．5％，总有效率为87．5％：随访6个月显效率为53．5％，总有效率为80．5％，治疗结束和随访6个月在显效率及总有效率方面无统计学差异（P〉0．05）。治疗前227侧上肢F波检查均有不同程度的异常，205侧上肢F波传导速度减慢的患者经治疗后和随访6个月后，正中神经及尺神经腕至C7、肘至C7的F波传导速度增快，与治疗前比较差异均有统计学意义（P〈0．001），治疗后与随访6个月后比较差异无统计学意义（P〉0．05）。158侧F波潜伏期延长患者经治疗后和随访6个月后，正中神经和尺神经平均F波潜伏期与治疗前比较差异均有统计学意义（P〈0．001），治疗后与随访6个月后比较差异无统计学意义（P〉0．05）。结论F波传导速度和潜伏期的变化与患者病情的变化呈正相关，可用作神经根型颈椎病临床疗效评定的客观指标之一，具有较好的临床应用价值。

Application of F Wave Detection to Evaluating the Therapeutic Effect of Electroacupuncture on Cervical Spondylotic Radiculopathy

Objective To investigate the feasibility of using F wave detection techniques to evaluate the therapeutic effect of electroacupuncture on cervical spondylotic radiculopathy. Method Two hundred patients with cervical spondylotic radiculopathy were treated using an optimized ＂4＋5＂ point combination protocol （four basic acupoints and five adjunct acupoints selected according to syndrome differentiation）. The therapeutic effect was evaluated and F wave was detected before treatment, at the end of treatment and at the 6-month follow-up. Result The marked efficacy rate and the total efficacy rate were 62.5% and 87.5%, respectively, at the end of treatment and 53.5% and 80.5%, respectively, at the 6-month follow-up. There were no statistically significant differences in the marked efficacy rate and the total efficacy rate between at the end of treatment and at the 6-month follow-up （P〉0.05）. The pretreatment examination showed different degrees of F wave abnormality in 227 upper limbs. Wrist-C7 and elbow-C7 median nerve and ulnar nerve F wave conduction velocities increased in the patients with pretreatment low F wave conduction velocity in 205 upper limbs after treatment and at the 6-month follow-up. After treatment, there were statistically significant differences in all the velocities as compared with before treatment （P〈0.001） and not as compared with at the 6-month follow-up （P〉0.05）. In the patients with pretreatment prolonged F wave latency on 158 sides, there were statistically significant differences in average median nerve and ulnar nerve F wave latencies between after treatment or at the 6-month follow-up and before treatment （P〈0.001） and not between after treatment and at the 6-month follow-up （P〉0.05）. Conclusion The changes in F wave conduction velocity and latency are directly proportional to the change in the patient＇s condition. They can be used as two of objective evaluation indices of the clinical therapeutic effect on cervical spondylotic radiculopathy and have high value to clinical application.