颈后特定点注射治疗交感型颈椎病153例
摘要
目的:观察颈后特定点(竺氏点)注射治疗交感型颈椎病的临床有效性、安全性。方法:回顾性分析2016年1月至2018年12月采用颈后"竺氏点"注射治疗交感型颈椎病患者153例,其中男67例,女86例;年龄为41～87岁,平均(57.40±10.53)岁。术前所有患者均摄取颈椎X线片及MRI,均提示存在颈椎不稳、退变等。所有患者均采用5 mL注射器抽取2 mL 0.9%氯化钠生理盐水+2 mL鹿瓜多肽提取物+1 mL曲安奈德针剂进行颈后"竺氏点"注射,左右两边各注射2.5 mL.治疗前后采用20分评分法及患者主观满意度对该治疗方式进行评价,其中主观满意度分为优、良、可、差4个等级。结果:153例患者均获得3～12个月随访,平均(5.65±2.11)个月。所有患者在治疗前交感症状评分为8～19分,平均(14.52±2.75)分,治疗后1,3及6个月平均评分分别为(1.99±0.93)分、(2.62±1.19)分及(3.59±1.46)分,治疗后各随访时间点与治疗前比较差异均有统计学意义(P<0.05),各随访点之间差异无统计学意义(P>0.05)。注射治疗后患者主观满意度评价:优114例,良39例,优良率为100%.结论:颈椎不稳与退变是引起交感型颈椎病的主要原因,运用颈后"竺氏点"注射治疗具有较好的临床疗效,值得临床推广应用。
引文
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[12] KALLAKURI S,GAVANAUGH J M,BLAGOEV D C.An immunohistochemical study of innervation of lumbar spinal dura and longitudinal ligaments[J].Spine(Phila Pa 1976),1998,23(4):403-411.
[13] 韩涛,谢雁鸣,黎元元,等.应用鹿瓜多肽注射液治疗的颈椎病患者的临床特征与联合应用研究[J].中国全科医学,2018,21(4):480-485.
[2] 刘洪,越雷,陈顺伦,等.前路椎间盘切除椎间融合术治疗伴交感症状的颈椎病[J].北京大学学报:医学版,2018,50(2):347-351.
[3] 孙宇,陈琪福.第二届颈椎病专题座谈会纪要[J].中华外科杂志,1993,31(8):472-476.
[4] 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.
[5] 欧国峰,董博,刘继华,等.神经根型颈椎病的中西医治疗进展[J].现代中西医结合杂志,2017,26(7):791-793.
[6] RYAN G M,COPE S.Cervical vertigo[J].Lancet,1955,269(6905):1355-1358.
[7] HULSE M.Disequelibrium caused by a functional disturbance of the upper cervical spine,clinical aspects and differential diagnosis[J].Manual Med,1983,1:18-23.
[8] MUHEREMU A,SUN Y.A typical symptoms in patients with cervical spondylosis might be the result of stimulation on the dura mater and spinal cord[J].Med Hypotheses,2016,91(1):44-46.
[9] CLELLAND S,MARASCALCHI B J,PASSIAS P G,et al.Impact of race and insurance status on surgical approach for cervical spondylotic myelopathy in the united States:a population-nased analysis[J].Spine(Phila Pa 1976),2017,42(3):186-194.
[10] 彭宝淦,侯树勋,吴仕良.颈椎病突出间盘组织炎性及应特性的研究[J].中国脊髓脊柱杂志,2002,12(1):38-40.
[11] AHMED M,BJURHOLM A,KREICBERGS A,et al.Neuropeptide Y,tyrosine hydroxylase and vasoactive intestinal polypeptide-immu-noreactive nerve fibers in the vertral bodies,dics,dura mater,and spinal ligaments of the rat lumbar spine[J].Spine(Phila Pa 1976),1993,18(15):2252-2256.
[12] KALLAKURI S,GAVANAUGH J M,BLAGOEV D C.An immunohistochemical study of innervation of lumbar spinal dura and longitudinal ligaments[J].Spine(Phila Pa 1976),1998,23(4):403-411.
[13] 韩涛,谢雁鸣,黎元元,等.应用鹿瓜多肽注射液治疗的颈椎病患者的临床特征与联合应用研究[J].中国全科医学,2018,21(4):480-485.