《内经》毛刺法治疗颈型颈椎病对照观察
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摘要
目的:观察《内经》毛刺法治疗颈型颈椎病的疗效。方法:将60例颈型颈椎病受试者随机分为《内经》毛刺法组(30例)与常规针刺组(30例)。《内经》毛刺法组浅刺颈项部,提捏针柄向外做小幅度的提拉,使皮肤随针尖提起,"如拔毛状";常规针刺组取颈夹脊、天柱等穴,得气后行泻法;两组每日治疗1次,一疗程5次,共2疗程。采用VAS、DNI进行评分,观察首次治疗后即时止痛效果及疗程结束后临床疗效。结果:首次治疗、治疗结束后两组VAS评分均明显降低(P <0. 01),但《内经》毛刺法组首次治疗后VAS评分降低更显著,且治疗后两组VAS改善相当;两组治疗前DNI评分无显著差异(P>0. 05),治疗后DNI评分与同组治疗前比较有显著差异(均P <0. 01),两组治疗后DNI评分比较,差异无统计学意义(P> 0. 05);《内经》毛刺法组总有效率96. 6%,常规针刺组总有效率90. 0%,《内经》毛刺法与常规针刺对颈型颈椎病的临床疗效相当(P> 0. 05)。结论:《内经》毛刺法与常规针刺对颈型颈椎病均有较好疗效,但《内经》毛刺法对颈型颈椎病的即时止痛效果优于常规针刺。
Objective: To study the clinical effect of cervical spondylosis treated by skin needling in Yellow Emperor's Inner Canon. Methods: 60 patients with cervical spondylosis were randomly divided into the skin needling group( n = 30) and the conventional acupuncture group( n = 30). In the skin needling group,shallow needling was applied to the neck,and the needle handle was lifted outwards to make the skin like pulling hair;in the conventional acupuncture group,the points such as the cervical Jiaji and Tianzhu( BL10) were selected,reducing method was applied after qi arrivial. The treatment was once per day for two courses( five times per course) in the two groups,VAS and DNI were used to evaluate the immediate analgesic effect after the first treatment and to evaluate the clinical efficacy at the end of the course. Results: After the first treatment and at the end of the treatment,the VAS scores were decreased significantly in the two groups( P < 0. 01); of which the skin needling group decreased more after the first treatment; but there was no statistical difference between the two groups in the VAS scores at the end of the treatment( P > 0. 05). There was no statistical difference in the DNI scores before the treatment between the two groups( P > 0. 05); after the treatment the DNI scores were improved considerably in the two groups( P < 0. 01),and there was no statistical difference between the groups( P > 0. 05). The total effective rate was 96. 6% in the skin needling group,and it was 90. 0% in the conventional acupuncture group; no significant difference was seen between the two groups( P > 0. 05). Conclusion:Both skin needling and conventional acupuncture have better curative effect on cervical spondylosis,but the former has better immediate analgesic effect.
Objective: To study the clinical effect of cervical spondylosis treated by skin needling in Yellow Emperor's Inner Canon. Methods: 60 patients with cervical spondylosis were randomly divided into the skin needling group( n = 30) and the conventional acupuncture group( n = 30). In the skin needling group,shallow needling was applied to the neck,and the needle handle was lifted outwards to make the skin like pulling hair;in the conventional acupuncture group,the points such as the cervical Jiaji and Tianzhu( BL10) were selected,reducing method was applied after qi arrivial. The treatment was once per day for two courses( five times per course) in the two groups,VAS and DNI were used to evaluate the immediate analgesic effect after the first treatment and to evaluate the clinical efficacy at the end of the course. Results: After the first treatment and at the end of the treatment,the VAS scores were decreased significantly in the two groups( P < 0. 01); of which the skin needling group decreased more after the first treatment; but there was no statistical difference between the two groups in the VAS scores at the end of the treatment( P > 0. 05). There was no statistical difference in the DNI scores before the treatment between the two groups( P > 0. 05); after the treatment the DNI scores were improved considerably in the two groups( P < 0. 01),and there was no statistical difference between the groups( P > 0. 05). The total effective rate was 96. 6% in the skin needling group,and it was 90. 0% in the conventional acupuncture group; no significant difference was seen between the two groups( P > 0. 05). Conclusion:Both skin needling and conventional acupuncture have better curative effect on cervical spondylosis,but the former has better immediate analgesic effect.
引文
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[13]陆永辉.《灵枢》恢刺法治疗颈型颈椎病疗效观察[J].中国针灸,2013,33(1):20-24.
[14]王翀敏,陈红薇,王延武,等.针刺肌筋膜触发点治疗椎动脉型颈椎病疗效观察[J].上海针灸杂志,2015,34(1):48-50.
[2]王冰,段义萍,张友常,等.颈椎病患病特征的流行病学研究[J].中南大学学报(医学版),2004,29(4):472-473.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:346-349.
[4]高树中,杨骏.针灸治疗学[M].北京:中国中医药出版社,2012:146-147.
[5]刘清国,胡玲.经络腧穴学[M].北京:中国中医药出版社,2012:8.
[6]Revill SI,Robinson JO,Rosen M,et al.The reliability of a liner analogue for evaluating pain[J].Anaesthesia,1976,31(9):1191-1198.
[7]Vernon H,Mior S.The Neck Disability Index:A study ofreliability and validity[J].J Manipulative Physiol Ther,1991,14(7):409-415.
[8]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.
[9]王姿雯,徐涛,张雨桐,等.针灸治疗颈型颈椎病临床研究进展[J].湖南中医杂志,2018,34(3):194-196.
[10]郑君,张昆.腧穴本真探究[J].江苏中医药杂志,2011,43(10):6-7.
[11]郑君,张昆.古时间针法的不足分析及其科学机制探骊[J].吉林中医药,2012,32(10):975-977.
[12]肖永俭,刘光亭.62种骨关节病的针灸治疗[M].北京:中国中医药出版社,1997:266-268.
[13]陆永辉.《灵枢》恢刺法治疗颈型颈椎病疗效观察[J].中国针灸,2013,33(1):20-24.
[14]王翀敏,陈红薇,王延武,等.针刺肌筋膜触发点治疗椎动脉型颈椎病疗效观察[J].上海针灸杂志,2015,34(1):48-50.