电针联合穴位注射血塞通治疗神经根型颈椎病的临床观察

目的  探讨电针联合穴位注射血塞通治疗神经根型颈椎病的临床疗效。方法  选取2013年1月-2015年1月在济南市第三人民医院就诊的90例神经根型颈椎病的患者作为研究对象，随机将其分为电针组、穴位注射组及电针联合穴位注射组，每组30例。电针组选择风池、大椎、肩井、外关及病变部位的夹脊穴进行电针治疗，穴位注射组将血塞通注射液注射于病变部位的夹脊穴，电针联合穴位注射组在电针治疗后进行穴位注射。采用田中靖久颈椎病量表、疼痛视觉评分（VAS）对患者治疗前、治疗结束后进行评分；同时采用放射免疫测定法测定各组治疗前后血浆中血栓素B2的表达水平。结果  在疗效评价方面，电针联合穴位注射组治疗有效率高于电针组及穴位注射组，差异有统计学意义（P =0.003和0.008），穴位注射组治疗有效率高于电针组（P =0.012）。在症状体征改善方面，3组治疗后评分均比治疗前高，进一步比较治疗后3组评分发现，电针联合穴位注射组评分明显高于电针组及穴位注射组（P =0.008和0.009），穴位注射组评分也高于电针组（P=0.037）。在疼痛缓解方面，3组患者治疗后评分均比治疗前低，进一步比较治疗后3组评分发现，电针联合穴位注射组评分低于电针组及穴位注射组（P =0.002和0.012），穴位注射组评分也低于电针组（P =0.017）。3种方法治疗后血浆中的血栓素B2（TXB2）的含量均比治疗前要低，电针联合穴位注射组治疗后血栓素B2的含量明显低于电针组及穴位注射组（P =0.018和0.023），穴位注射组治疗后的血栓素B2的含量也低于电针组（P =0.042）。 结论  电针联合穴位注射治疗疗效评价、症状体征改善、疼痛改善等方面优于电针及穴位注射治疗，穴位注射治疗优于单针治疗，且3种方法的治疗作用可能与影响了血浆中TXB2的含量有关。

Clinical observation on effect of electroacupuncture combined xuesaitong acupoint injection for treatment of cervical spondylotic radiculopathy

Objective To explore the clinical effect of electroacupuncture combined xuesaitong acupoint injection for treatment of cervical spondylotic radiculopathy. Methods Ninty patients with the diagnosis of cervical spondylotic radiculopathy between Jan 2013 and Jan 2015, were randomly divided into electroacupuncture group, acupoint injection group and combined treatment group. The electroacupuncture group received electroacupuncture treatment at fengchi, dazhui, jianjing, waiguan and coresponding jiaji points. The acupoint injection group adopted xuesaitong acupoint injection into coresponding jiaji points. The combined treatment group received acupoint injection after electroacupuncture treatment. Quantitative score of signs and symptoms and visual analogue scales (VAS) were applied to evaluate the curative effect. Serum levels of TXB2 was detected by radioimmunoassay. Results The effective rate of combined treatment group was higher than the other two groups (P = 0.003 and 0.008), whilst the acupoint injection group was higher than the electroacupuncture group (P = 0.012). After treatment, the scores of signs and symptoms of three groups were elevated, and the combined treatment group was higher than the other two groups (P = 0.008 and 0.009), while the acupoint injection group was higher than the electroacupuncture group (P = 0.037). The VAS scores of three groups were declined after respective treatment. The combined treatment group showed lower score than the other two groups (P = 0.002 and 0.012), and the acupoint injection group was lower than the electroacupuncture group (P = 0.017). The serum levels of TXB2 of the three groups were similar with the results on the VAS score. Conclusions Electroacupuncture combined acupoint injection therapy showes superiority to electroacupuncture and acupoint injection therapy, acupoint injection therapy is superior to the electroacupuncture therapy. Moreover, the treatment effects of the three methods may be associated with serum levels of TXB2.