筋骨通脉汤联合刺络放血治疗颈肩痛临床观察
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摘要
目的观察筋骨通脉汤联合刺络放血治疗颈肩痛的临床疗效。方法将120例颈肩痛患者随机分为2组。对照组60例予筋骨通脉汤治疗;治疗组60例在对照组治疗基础上加刺络放血治疗。2组均2周为1个疗程,2个疗程后统计临床疗效,并观察2组治疗前后疼痛视觉模拟评分法(VAS)评分、Barthel指数(BI)评分、Fugl-Meyer评分变化,以及血液流变学指标变化。结果治疗组总有效率93.3%,对照组总有效率83.3%,治疗组疗效优于对照组(P<0.05)。2组治疗后疼痛VAS评分均较本组治疗前降低(P<0.05),BI评分及Fugl-Meyer评分均较本组治疗前升高(P<0.05);治疗后治疗组VAS评分低于对照组(P<0.05),BI评分及Fugl-Meyer评分均高于对照组(P<0.05)。2组治疗后全血黏度(低切)、全血黏度(高切)、血浆黏度、红细胞比容及纤维蛋白原均较本组治疗前降低(P<0.05),治疗后治疗组全血黏度(低切)、全血黏度(高切)、血浆黏度、红细胞比容及纤维蛋白原均低于对照组(P<0.05)。结论筋骨通脉汤联合刺络放血治疗颈肩痛疗效优于单纯应用筋骨通脉汤治疗,并能进一步提高患者日常生活活动能力,改善血液流变学指标,安全可靠。
Objective To observe the clinical effects of Jin'gu Tongmai decoction combined with blood-letting therapy on neck and shoulder pain.Methods 120 cases with neck and shoulder pain were randomly divided into two groups.60 cases in control group were treated by Jin'gu Tongmai decoction,and 60 cases in treatment group were treated by blood-letting therapy on the basis of control group treatment,continuously treatment for four weeks.The changes of visual analogue scales(VAS) scores,Barthel index(BI),Fugl-Meyer scores,and changes of hemorheology index before and after treatment were observed in two groups,and the clinical effects were compared.Results The total effective rate in treatment group(93.3%) was superior to that in control group(83.3%,P <0.05).The VAS scores after treatment were decreased in two groups(P < 0.05),and BI index,Fugl-Meyer scores were higher than those before the treatment(P < 0.05).After treatment,the VAS scores in the treatment group was lower than that in the control group(P < 0.05),BI index and Fugl-Meyer scores were higher than those in the control group(P < 0.05).After treatment,whole blood viscosity(low cut),whole blood viscosity(high cut),plasma viscosity,hematocrit,and fibrinogen were lower than before treatment in the two groups(P < 0.05).The blood viscosity(low cut),whole blood viscosity(high cut),plasma viscosity,hematocrit,and fibrinogen after treatment in the treated group were lower than those in the control group(P< 0.05).Conclusion Jin'gu Tongmai decoction combined with blood-letting therapy in treating neck and shoulder pain is more effective than simple application of Jin'gu Tongmai decoction.It is safe and reliable,and it can further improve the ability of daily living activities of patients and improve the hemorheological indexes.
Objective To observe the clinical effects of Jin'gu Tongmai decoction combined with blood-letting therapy on neck and shoulder pain.Methods 120 cases with neck and shoulder pain were randomly divided into two groups.60 cases in control group were treated by Jin'gu Tongmai decoction,and 60 cases in treatment group were treated by blood-letting therapy on the basis of control group treatment,continuously treatment for four weeks.The changes of visual analogue scales(VAS) scores,Barthel index(BI),Fugl-Meyer scores,and changes of hemorheology index before and after treatment were observed in two groups,and the clinical effects were compared.Results The total effective rate in treatment group(93.3%) was superior to that in control group(83.3%,P <0.05).The VAS scores after treatment were decreased in two groups(P < 0.05),and BI index,Fugl-Meyer scores were higher than those before the treatment(P < 0.05).After treatment,the VAS scores in the treatment group was lower than that in the control group(P < 0.05),BI index and Fugl-Meyer scores were higher than those in the control group(P < 0.05).After treatment,whole blood viscosity(low cut),whole blood viscosity(high cut),plasma viscosity,hematocrit,and fibrinogen were lower than before treatment in the two groups(P < 0.05).The blood viscosity(low cut),whole blood viscosity(high cut),plasma viscosity,hematocrit,and fibrinogen after treatment in the treated group were lower than those in the control group(P< 0.05).Conclusion Jin'gu Tongmai decoction combined with blood-letting therapy in treating neck and shoulder pain is more effective than simple application of Jin'gu Tongmai decoction.It is safe and reliable,and it can further improve the ability of daily living activities of patients and improve the hemorheological indexes.
引文
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[14]罗永宝,何纯青.颈型颈椎病理论研究概述[J].辽宁中医药大学学报,2010,12(5):46-48.
[15]孙楠楠,杨传华,郭金昊,等.天麻及其有效成分治疗心血管疾病研究进展[J].山西中医,2017,33(5):57-58.
[16]崔明亮,孔祥玲,王景贵,等.中药脾肾并补方对交感型颈椎病临床疗效及心率变异性的影响[J].中国中西医结合杂志,2008,28(11):1034-1037.
[17]王本正.实用放血疗法[M].北京:中医古籍出版社,2009:47.
[18]陈小凯,吴虹,李旅萍,等.刺络放血法治疗颈椎病对ICAM-1影响的临床观察[J].亚太传统医药,2008,4(3):60-63.
[19]崔峻,章美琼,魏华娥,等.综合刺络疗法治疗急性期肩周炎临床及血液流变学的影响[J].江西中医药,2005,36(10):55-56.
[2]彭金凤,黄强民,朱传芳,等.慢性颈肩痛的发病机理及运动疗法研究现状[J].实用疼痛学杂志,2014,10(4):297-304.
[3]李树香.刺络放血疗法临床应用述评[J].中医学报,2012,27(6):778-780.
[4]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:186-187.
[5]Van Roo JD,Lazio MP,Pesce C,et al.Visual analog scale(VAS)for assessment of acute mountain sickness(AMS)on Aconcagua[J].Wilderness Environ Med,2011,22(1):7-14.
[6]朱镛连,张皓,何静杰.神经康复学[M].北京:人民军医出版社,2010:299.
[7]纪树荣.康复医学[M].北京:高等教育出版社,2004:70-73.
[8]孙钢.颈肩疼痛与颈椎动态影像学观察[J].中国医药导报,2010,7(19):232-233.
[9]杨进.五步手法联合中药热敷治疗颈肩疼痛60例[J].河南中医,2015,35(9):2117-2119.
[10]Sihawong R,Janwantanakul P,Jiamjarasrangsi W.Effects of an exercise programme on preventing neck pain among office workers:a 12-month clusterrandomised controlled trial[J].Occup Environ Med,2014,71(1):63-70.
[11]Pedersen MT,Andersen CH,Zebis MK,et al.Implementation of specific strength training among industrial laboratory technicians:long-term effects on back,neck and upper extremity pain[J].BMC Musculoskelet Disord,2013,14:287.
[12]潘福琼.颈椎病的病因、诊断及治疗进展[J].现代康复,2001,5(4B):86-87.
[13]马超,燕铁斌,Grace P Y Szeto.颈肩部疼痛及功能障碍与表面肌电图之间的关系[J].中华物理医学与康复杂志,2008,30(12):823-826.
[14]罗永宝,何纯青.颈型颈椎病理论研究概述[J].辽宁中医药大学学报,2010,12(5):46-48.
[15]孙楠楠,杨传华,郭金昊,等.天麻及其有效成分治疗心血管疾病研究进展[J].山西中医,2017,33(5):57-58.
[16]崔明亮,孔祥玲,王景贵,等.中药脾肾并补方对交感型颈椎病临床疗效及心率变异性的影响[J].中国中西医结合杂志,2008,28(11):1034-1037.
[17]王本正.实用放血疗法[M].北京:中医古籍出版社,2009:47.
[18]陈小凯,吴虹,李旅萍,等.刺络放血法治疗颈椎病对ICAM-1影响的临床观察[J].亚太传统医药,2008,4(3):60-63.
[19]崔峻,章美琼,魏华娥,等.综合刺络疗法治疗急性期肩周炎临床及血液流变学的影响[J].江西中医药,2005,36(10):55-56.