颈夹脊穴注射合颈神经根阻滞治疗神经根型颈椎病临床观察

目的观察颈夹脊穴注射复方当归注射液联合颈神经根阻滞治疗神经根型颈椎病的临床疗效。方法将96例神经根型颈椎病患者随机分为3组,A组(32例)行颈夹脊穴注射当归联合颈神经根阻滞治疗,B组(32例)单行颈神经根阻滞治疗,C组(32例)给予常规方法治疗,包括口服消炎镇痛药物、神经营养药物。治疗后1星期、3星期、3个月对3组疗效进行随访。结果 3组治疗后1星期、3星期、3个月VAS值较治疗前明显降低(P0.01);与C组比较,A组和B组各时间点的VAS评分明显降低(P0.05);但是治疗后3个月的VAS评分,A组明显低于B组(P0.05)。3组治疗后3个月改良Macnab疗效差异有统计学意义(P0.05),有效率分别为96.9%,87.5%,75.0%,根据卡方检验的结果,A组疗效优于B组和C组。3组之间治疗前后CGRP水平的差异有统计学意义(P0.01),认为A组、B组、C组在治疗后3个月外周血CGRP水平均有所下降,但A组下降较B组明显,B组下降较C组明显。结论治疗神经根型颈椎病,单用常规药物治疗虽然有效,但是起效慢,显效率不高,不是最优化的治疗方法;单行颈神经阻滞治疗神经根型颈椎病与颈夹脊穴注射当归联合颈神经根阻滞治疗神经根型颈椎病起效快,显效率高,但后者的远期疗效优于前者。

Clinical Observations on the Efficacy of Cervical Huatuo Jiaji Point Injection plus Cervical Nerve Root Blocks in Treating Cervical Spondylotic Radiculopathy

Objective To investigate the clinical efficacy of cervical Huatuo jiaji （Ex-B2） point injection of angelica plus cervical nerve root blocks in treating cervical spondylotic radiculopathy.Method Ninety-six patients with cervical spondylotic radiculopathy were randomly allocated to three groups.Group A （32 patients） received cervical Huatuo jiaji point injection of angelica plus cervical nerve root blocks; group B （32 patients）,cervical nerve root blocks alone; group C （32 patients）,routing treatment including oral administration of anti-inflammatory analgesics and neurotrophic drugs.The therapeutic effects were followed up in the three groups at one and three weeks,and three months after treatment.Result The VAS score was significantly lower in the three groups at one and three weeks,and three months after treatment than before （P＜0.01）.The VAS score was significantly lower at various time points in groups A and B than in group C （P＜0.05）.The VAS score was significantly lower at three months after treatment in group A than in group B （P＜0.05）.At three months after treatment,there was a statistically significant difference in modified Macnab criteria-determined therapeutic effect among the three groups （P＜0.05）.The efficacy rate was 96.9％,87.5％ and 75.0％ A Chi-square test showed that the therapeutic effect was better in group A than in groups B and C.There was a statistically significant posttreatment difference in CGRP levels among the three groups （P＜0.01）.Peripheral blood CGRP levels decreased in all groups A,B and C at three months after treatment,but it decreased more in group A than in group B and in group B than in group C.Conclusion Although routine medication alone is effective in treating cervical spondylotic radiculopathy,it produces an effect slowly,does not have a high marked efficacy rate and is not an optimal treatment.Cervical nerve root blocks alone or cervical Huatuo jiaji point injection of angelica plus cervical nerve root blocks produces a qui