杵针“大椎八阵”穴治疗神经根型颈椎病的临床研究
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摘要
目的：本课题旨在研究杵针疗法治疗神经根型颈椎病的疗效和安全性,为神经根型颈椎病的治疗提供更安全有效的治疗方法。
方法：采用随机、对照、单盲的研究方法,60例纳入研究的病例被随机分为对照组和治疗组,每组各30例。对照组采用常规针刺法治疗,治疗组在对照组的基础上加上杵针治疗。治疗时间,每日治疗1次,每周治疗5次,周六,日休息,连续治疗四周,共20次。治疗前后分别采用Huskission“视觉模拟评分法(VAS)”和“疼痛分级指数(pain rating index, PRI)”,并结合患者的主观征候,颈部活动度、体征、心理及社会适应、生活质量综合表现评分,进行疗效评价。
结果：60例病人中,57例完成整个研究过程,脱失病例3例。治疗组29例中临床痊愈12例(41.3%),显效10例(34.5%),有效6例(20.7%),无效1例(3.5%),愈显率75.9%,总有效率96.6%,对照组临床痊愈率4例(14.3%),显效4例(14.3%),有效18例(64.3%),无效2例(7.1%),愈显率28.6%,总有效率92.9%。两组愈显率及两组疗效构成比较有明显差异(P<0.05)。治疗后两组患者疼痛评分,主观征候,颈部活动度和体征检查,心理及社会适应能力,生活质量皆有明显改善。治疗组优于对照组(P<0.05)。
结论：杵针疗法对神经根型颈椎病的功能、心理及社会适应能力、生活质量有明显改善作用,并能迅速缓解根性疼痛。
Objective:This paper aims at studying the curative effect and security of cervical spondylotic radiculopathy with LI Zhongyu's Pestle needling.and applies a safer and more effective method for the cervical spondylotic radiculopathy than before.
Methods:To adopt the research method of random contrast single blind, there are 60 cases divided into the treatment group randomly, each group is 30 cases. The contrast group was used the acupuncture only; whereas the treatment group was used both the acupuncture and LI Zhongyu's Pestle needling. The therapeutic period is that one time for a day and five times for a week.For Saturday and Sunday, the patients would have a rest.The treatment would continued for four weeks and general twenty times. From beginning to end, the research chooses the scores of Huskission "VAS", "PRI" combined with the score of symptom, the sign of neck, psychology, the social adaptation and the life quality to evaluate the effectiveness.
Results:Among 60 cases,57patients finished the study whereas 3 lost. With the 29 cases in the treatment group,12 cases were clinical cure.The cure rate is 41.3%,10 cases were markedly better.Which is 34.5%.6 cases were effective. The effective rate is 20.7%; 1 cases were invalid and accounting for 3.5%.The markedly effective rate is 75.9%.The total effective rate is 96.6%.In the contrast group which used the acupuncture only,4 cases were clinical cure.The cure rate is 14.3%,4 cases were markedly better.Which is 14.3%.18 cases were effective. The effective rate is 64.3%; 2 cases were invalid and accounting for 7.1%.The markedly effective rate is 28.6%.The total effective rate is 92.9%. Comparing the two groups, there are more significant differences between the markedly effective rate and the effective constitute(P＞0.05).After the treatment, the pain evaluation, subjective symptom and the physical check, psycology and social adaptation, and life quality evaluation are markedly improvement, the compare of the two groups is markedly different(P＞0.05).
Conclusion:LI Zhongyu's Pestle needling can positively improve the functions of cervical vertebrae in the radicular spondylosis, psycology and social adaptation, and life quality and relieve spinal root pain promptly.
方法：采用随机、对照、单盲的研究方法,60例纳入研究的病例被随机分为对照组和治疗组,每组各30例。对照组采用常规针刺法治疗,治疗组在对照组的基础上加上杵针治疗。治疗时间,每日治疗1次,每周治疗5次,周六,日休息,连续治疗四周,共20次。治疗前后分别采用Huskission“视觉模拟评分法(VAS)”和“疼痛分级指数(pain rating index, PRI)”,并结合患者的主观征候,颈部活动度、体征、心理及社会适应、生活质量综合表现评分,进行疗效评价。
结果：60例病人中,57例完成整个研究过程,脱失病例3例。治疗组29例中临床痊愈12例(41.3%),显效10例(34.5%),有效6例(20.7%),无效1例(3.5%),愈显率75.9%,总有效率96.6%,对照组临床痊愈率4例(14.3%),显效4例(14.3%),有效18例(64.3%),无效2例(7.1%),愈显率28.6%,总有效率92.9%。两组愈显率及两组疗效构成比较有明显差异(P<0.05)。治疗后两组患者疼痛评分,主观征候,颈部活动度和体征检查,心理及社会适应能力,生活质量皆有明显改善。治疗组优于对照组(P<0.05)。
结论：杵针疗法对神经根型颈椎病的功能、心理及社会适应能力、生活质量有明显改善作用,并能迅速缓解根性疼痛。
Objective:This paper aims at studying the curative effect and security of cervical spondylotic radiculopathy with LI Zhongyu's Pestle needling.and applies a safer and more effective method for the cervical spondylotic radiculopathy than before.
Methods:To adopt the research method of random contrast single blind, there are 60 cases divided into the treatment group randomly, each group is 30 cases. The contrast group was used the acupuncture only; whereas the treatment group was used both the acupuncture and LI Zhongyu's Pestle needling. The therapeutic period is that one time for a day and five times for a week.For Saturday and Sunday, the patients would have a rest.The treatment would continued for four weeks and general twenty times. From beginning to end, the research chooses the scores of Huskission "VAS", "PRI" combined with the score of symptom, the sign of neck, psychology, the social adaptation and the life quality to evaluate the effectiveness.
Results:Among 60 cases,57patients finished the study whereas 3 lost. With the 29 cases in the treatment group,12 cases were clinical cure.The cure rate is 41.3%,10 cases were markedly better.Which is 34.5%.6 cases were effective. The effective rate is 20.7%; 1 cases were invalid and accounting for 3.5%.The markedly effective rate is 75.9%.The total effective rate is 96.6%.In the contrast group which used the acupuncture only,4 cases were clinical cure.The cure rate is 14.3%,4 cases were markedly better.Which is 14.3%.18 cases were effective. The effective rate is 64.3%; 2 cases were invalid and accounting for 7.1%.The markedly effective rate is 28.6%.The total effective rate is 92.9%. Comparing the two groups, there are more significant differences between the markedly effective rate and the effective constitute(P＞0.05).After the treatment, the pain evaluation, subjective symptom and the physical check, psycology and social adaptation, and life quality evaluation are markedly improvement, the compare of the two groups is markedly different(P＞0.05).
Conclusion:LI Zhongyu's Pestle needling can positively improve the functions of cervical vertebrae in the radicular spondylosis, psycology and social adaptation, and life quality and relieve spinal root pain promptly.
引文
1郑莜萸中药新药临床研究指导原则(试行)[M].北京：中国科技医药出版社,2002.
2国家中医药管理局.中医病证诊断疗效标准[S].南京：南京大学出版社,1994：33-34.
3李仲愚.杵针治疗学「M]成都：四川科学技术出版社,1990.5.
4周建伟.蒋振亚,叶锐彬.针灸推拿为主治疗神经根型颈椎病：多中心随机对照研究[J].中国针灸.2006：26(8)：537-543.
5胥少汀.脊髓损伤治疗进展[J].当代医学,2000,(01).
6刘彩云.针刺泊疗神经根型颈椎病60例疗效分析.内蒙古医学杂志.2004：10(39)：652-654.
7郭奋进.针刺治疗神经根型颈椎病疗效观察.针灸临床杂志2004：20(4)：6-8.
8董洪英,王秀云,孟向文.针刺四天穴治疗神经根型颈椎病46例临床观察[J],中医杂志,2003,44(9)：659.
9成都中医药大学硕士学位论文李雪青“天宗穴苍龟探穴法针刺”治疗神经根型颈椎病的临床研究[C]2005,04-01.
10蔡玉梅,何静芳,黄文燕等.不同方法治疗颈椎病的临床疗效观察[J].针灸临床杂志,2003,19(7)：62-63.
11杜宇征,李大军.不同刺法针刺颈夹脊穴治疗颈椎病疗效观察[J].中医杂志,2001,42(9)：534-535
12汪文清,章红.针刺颈夹脊穴138例[J].湖北中医杂志,2002,24(10)：48-49.
13周奇志,宋开源,刘一曼.李仲愚杵针刺激大鼠“足三里”穴区对中枢单胺类神经递质量的影响.成都中医药大学学报[J]1999：22(3)：28-29.
14燕铁斌.现代康复治疗学[M].广州：广东科技出版社,2004.493-495.
1刘美荣.扬刺、排刺为主治疗神经根型颈椎病[J].针灸临床杂志,2002,18(1)：41.
2鄢卫平.针灸治疗颈椎病100例小结[J].甘肃中医,2003,16(11)：33-34.
3王丽娟.针刺扶突穴为主治疗神经根型颈椎病47例[J].河北中医,2005,27(12)：908.
3许晓明,戴晓红,邹伟.针灸治疗颈椎病60例疗效观察[J].中医药信息,2003,20(3)：36.
4王萍.夹脊穴针灸治疗颈椎病50例疗效观察.针灸临床杂志,2000,16(11)：35.
5刘美荣.扬刺、排刺为主治疗神经根型颈椎病.针灸临床杂志,2002,18(1)：41.
6李惠源.针刺、牵引加运动综合治疗神经根型颈椎病94例.针灸临床杂志,2002,18(11)：23.
7吴扬扬,鲍安珍.腹针治疗神经根型颈椎病120例[J].上海针灸杂志,2005,24(1)：7.
8闫海国.动态针刺法治疗神经根型颈椎病疗效观察[J].辽宁中医杂志,2003,307：573.
9邵萍,裘敏蕾,忻志平,等.电针夹脊穴治疗神经根型颈椎病疗效观察[J].中国临床康复,2002,618：2767.
10王丽.电针夹脊配后溪穴治疗神经根型颈椎病[J].云南中医中药,2001,22(6)：36.
11张洪来,靳瑞.电针与牵引治疗神经根型颈椎病的随机对照研究[[J].中国针灸,2003,23(11)：637.
12李蔚.温针灸颈夹脊穴治疗神经根型颈椎病32例[J].福建中医药,2002,33(3)：20.
13王成银,王文英.针灸加穴位注射颈夹脊穴为主治疗颈椎病63例[J].针灸临床杂志,2002,18(5)：7-8.
14罗道珊,陈丹云.穴位注射为主治疗神经根型颈椎病疗效观察[J].中国针灸,2001,21(3)153.
15张丽民,郝蕾,王月梅.穴位注射为主治疗颈椎病124例[J].上海针灸杂志,199716 (1)：17.
16丁文涛,张涛.水针手法综合治疗神经根型颈椎病78例[J].陕西中医,2001 22(8)：491.
17王世广.磁极针与普通毫针治疗神经根型颈椎病疗效对照观察[J].中国针灸,2000,20(7)：407-408.
18任志远,高骥,刘玉英等.针灸刀治疗神经根型颈椎病附697例报告[J].颈腰痛杂志,1998,19(3)：200.
19林木南,刘献祥,刘建华,等.针刀治疗神经根型颈椎病50例临床研究[J].中国中医骨伤科杂志,2003,11(1)：42-43.
20王岩松.针灸加中药离子导入治疗神经根型颈椎病100例临床观察[J].江苏中医药,2003,24(12)：42.
21石瑜,吴志明.针刺与中药离子导入治疗颈椎病42例[J].中国针灸,1998,(4)：221.
22彭建民,曾少平.电针夹脊穴结合牵引治疗神经根型颈椎病的临床观察[J].海南医学,2002,13(8)：77.
23薛平武.针刺为主治疗神经根型颈椎病的临床分析[J].颈腰痛杂志,2003,24(1)：54-55.
24王仙梅,周子信.电针围刺加刺络拔罐治疗神经根型颈椎病66例[J].陕西中医,2004,25(1)：60.
25仁义钟.针灸刮痧治疗神经根型颈椎病[J].中国针灸,1995,15(1)：4.
26孙利军,周永田.针刺加手法治疗神经根型颈椎病远期疗效观察[J].针灸临床杂志,2002,18(1)：6.
27肖华强.推拿针灸治疗神经根型颈椎病300例[J].中国中医药科技,2003,10(3)：189.
28胡从富.针灸与中药熏蒸疗法治疗神经根型颈椎病70例[J].针灸临床杂志,2003,19(10)：21.
29蒋振亚,李常度.杵针大椎八阵穴为主治疗颈椎病的临床观察[J].中国针灸,2001,21(2)：94.
2国家中医药管理局.中医病证诊断疗效标准[S].南京：南京大学出版社,1994：33-34.
3李仲愚.杵针治疗学「M]成都：四川科学技术出版社,1990.5.
4周建伟.蒋振亚,叶锐彬.针灸推拿为主治疗神经根型颈椎病：多中心随机对照研究[J].中国针灸.2006：26(8)：537-543.
5胥少汀.脊髓损伤治疗进展[J].当代医学,2000,(01).
6刘彩云.针刺泊疗神经根型颈椎病60例疗效分析.内蒙古医学杂志.2004：10(39)：652-654.
7郭奋进.针刺治疗神经根型颈椎病疗效观察.针灸临床杂志2004：20(4)：6-8.
8董洪英,王秀云,孟向文.针刺四天穴治疗神经根型颈椎病46例临床观察[J],中医杂志,2003,44(9)：659.
9成都中医药大学硕士学位论文李雪青“天宗穴苍龟探穴法针刺”治疗神经根型颈椎病的临床研究[C]2005,04-01.
10蔡玉梅,何静芳,黄文燕等.不同方法治疗颈椎病的临床疗效观察[J].针灸临床杂志,2003,19(7)：62-63.
11杜宇征,李大军.不同刺法针刺颈夹脊穴治疗颈椎病疗效观察[J].中医杂志,2001,42(9)：534-535
12汪文清,章红.针刺颈夹脊穴138例[J].湖北中医杂志,2002,24(10)：48-49.
13周奇志,宋开源,刘一曼.李仲愚杵针刺激大鼠“足三里”穴区对中枢单胺类神经递质量的影响.成都中医药大学学报[J]1999：22(3)：28-29.
14燕铁斌.现代康复治疗学[M].广州：广东科技出版社,2004.493-495.
1刘美荣.扬刺、排刺为主治疗神经根型颈椎病[J].针灸临床杂志,2002,18(1)：41.
2鄢卫平.针灸治疗颈椎病100例小结[J].甘肃中医,2003,16(11)：33-34.
3王丽娟.针刺扶突穴为主治疗神经根型颈椎病47例[J].河北中医,2005,27(12)：908.
3许晓明,戴晓红,邹伟.针灸治疗颈椎病60例疗效观察[J].中医药信息,2003,20(3)：36.
4王萍.夹脊穴针灸治疗颈椎病50例疗效观察.针灸临床杂志,2000,16(11)：35.
5刘美荣.扬刺、排刺为主治疗神经根型颈椎病.针灸临床杂志,2002,18(1)：41.
6李惠源.针刺、牵引加运动综合治疗神经根型颈椎病94例.针灸临床杂志,2002,18(11)：23.
7吴扬扬,鲍安珍.腹针治疗神经根型颈椎病120例[J].上海针灸杂志,2005,24(1)：7.
8闫海国.动态针刺法治疗神经根型颈椎病疗效观察[J].辽宁中医杂志,2003,307：573.
9邵萍,裘敏蕾,忻志平,等.电针夹脊穴治疗神经根型颈椎病疗效观察[J].中国临床康复,2002,618：2767.
10王丽.电针夹脊配后溪穴治疗神经根型颈椎病[J].云南中医中药,2001,22(6)：36.
11张洪来,靳瑞.电针与牵引治疗神经根型颈椎病的随机对照研究[[J].中国针灸,2003,23(11)：637.
12李蔚.温针灸颈夹脊穴治疗神经根型颈椎病32例[J].福建中医药,2002,33(3)：20.
13王成银,王文英.针灸加穴位注射颈夹脊穴为主治疗颈椎病63例[J].针灸临床杂志,2002,18(5)：7-8.
14罗道珊,陈丹云.穴位注射为主治疗神经根型颈椎病疗效观察[J].中国针灸,2001,21(3)153.
15张丽民,郝蕾,王月梅.穴位注射为主治疗颈椎病124例[J].上海针灸杂志,199716 (1)：17.
16丁文涛,张涛.水针手法综合治疗神经根型颈椎病78例[J].陕西中医,2001 22(8)：491.
17王世广.磁极针与普通毫针治疗神经根型颈椎病疗效对照观察[J].中国针灸,2000,20(7)：407-408.
18任志远,高骥,刘玉英等.针灸刀治疗神经根型颈椎病附697例报告[J].颈腰痛杂志,1998,19(3)：200.
19林木南,刘献祥,刘建华,等.针刀治疗神经根型颈椎病50例临床研究[J].中国中医骨伤科杂志,2003,11(1)：42-43.
20王岩松.针灸加中药离子导入治疗神经根型颈椎病100例临床观察[J].江苏中医药,2003,24(12)：42.
21石瑜,吴志明.针刺与中药离子导入治疗颈椎病42例[J].中国针灸,1998,(4)：221.
22彭建民,曾少平.电针夹脊穴结合牵引治疗神经根型颈椎病的临床观察[J].海南医学,2002,13(8)：77.
23薛平武.针刺为主治疗神经根型颈椎病的临床分析[J].颈腰痛杂志,2003,24(1)：54-55.
24王仙梅,周子信.电针围刺加刺络拔罐治疗神经根型颈椎病66例[J].陕西中医,2004,25(1)：60.
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