摘要
目的
通过不同间隔时间针刺治疗颈椎病颈痛临床研究,找出较佳的治疗间隔时间。
方法
采用随机对照试验的临床研究方法。在广东省中医院针灸科选取符合纳入标准的颈椎病颈痛患者60例为研究对象,运用PEMS3.1软件包按1:1比例随机分为治疗1组(隔天一次,每周三次,周六、日休息)和治疗2组(每天一次,每周五次,周六、日休息),均针刺双侧百劳、大椎、双侧肩中俞、双侧中渚。患者取坐位,取以上俞穴,局部皮肤消毒后,用华佗牌管针1～1.5寸毫针,针身与皮肤呈90°,用管针进针法快速刺入穴位后施捻转提插手法,平补平泻。运针至得气后留针30分钟,每隔10分钟运针一次,每个穴位运针半分钟。共治疗10次。分别在治疗前与治疗结束,运用NorthwickPark颈痛量表(NPQ)与McGill疼痛量表评分来观察两组间的差别,在治疗1组治疗六次(相当于治疗2组完成疗程时,即第二周末)用NPQ及McGill疼痛量表评分观察相同治疗时间两组的差别,并随时记录研究过程中的不良反应及副作用。采用统计软件SPSS11.0对所收集的数据进行统计分析。计量资料使用t检验,计数资料使用x~2检验。
结果
1.治疗1组与治疗2组有效率分别为78.57%与74.07%,无显著差异(P＞0.05)。
2.治疗前,治疗1组与治疗2组NPQ及McGill量表评分无显著差异(P＞0.05)。
3.治疗1组治疗第六次后较治疗前NPQ及McGill评分均明显降低,差异均具显著性意义(P＜0.01);治疗1组治疗后较治疗第六次后NPQ及McGill评分均明显降低,差异均具显著性意义(P＜0.01)。治疗2组治疗后较治疗前NPQ及McGill评分明显降低,差异均具显著性意义(P＜0.01)。
4.治疗1组第六次治疗后与治疗2组治疗后NPQ及McGill评分无显著性差异(P＞0.05)。
5.治疗1组与治疗2组治疗后NPQ及McGill组间评分差异均无显著性意义(P＞0.05),但两组数据分别相差20%与30%。
6.两组治疗暂未发现有不良反应记录。
结论
针刺治疗颈椎病颈痛是一种安全有效的方法。治疗颈椎病颈痛中,隔天针刺一次与每天针刺一次都是有效果的,隔天针刺一次可能更有效率。但对两种间隔时间治疗颈椎病颈痛的远期疗效仍有待进一步深化研究。
Objective
Find out a better interval for treating the pain of cervical spondylosis through the clinical research on different interval in treating the pain of cervical spondylosis with acupuncture.
Method
This is a randomized,controlled trial.A total of 60 cases from acupuncture department in Guangdong Provincial Hospital of Traditional Chinese Medicine,according to the diagnosis criteria,were randomly divided into Group 1 and Group 2 by PEMS 3.1,treating them with acupuncture every other day and everyday respectively in weekdays,totally 10 times.Bailao (Ex-HN15),Dazhui(GV14),Jianzhongshu(SI1S),Zhongzhu(SJ3) were used.The patients sit on the chair when receiving the treatment.After sterilizing the local skin area,perpendicularly puncture the acupoints with 1.5～2 cun Huatuo tube needles.Lift,thrust and twist the needles with even reinforcing-reducing method until the qi arrives.Do the needle manipulation for half a minute every ten minutes.The curative effect was evaluated by the Northwick Park neckpain scale(NPQ) and McGill scale before the course,at the end of the second week during the course(i.e.when Group 1 finished the 6th time and Group 2 finished the whole course),and at the end of the course. Side effect and adverse reaction were ready to write down at any time.SPSS11.0 is used for data analysis.Measurement data is tested by t-test,and numeration data is tested byχ~2-test.
Result
1.The effective rate of Group 1 is 78.57%and Group 2 is 74.07%.There is no significant(P＞0.05) difference.
2.Before the course,there is no significant(P＞0.05) difference between Group 1 and Group 2 for the scores of NPQ and McGill.
3.In Group 1,the scores of NPQ and McGill significantly decrease(P＜0.01) form the beginning to the 6th time and from the 6th time to the end of the course.The scores of NPQ and McGill significantly decrease(P＜0.01) in Group 1 at the end of the course.
4.At the end of the 2nd week,there is no significant difference(P＞0.05) between Group 1 and Group 2 for the scores of NPQ and McGill.
5.At the end of the course,there is no significant difference(P＞0.05) between Group 1 and Group 2 for the scores of NPQ and McGill.However,the difference in score is 20%and 30%respectively.
6.No side effect and adverse reaction happened in both groups.
Conclusion
Treating the pain of cervical spondylosis with acupuncture is a safe and effective method.In addition,treating the pain of cervical spondylosis with acupuncture everyday or every other day for 10 times are both effective.The treatment of every other day is more effective.However,the long-term curative effect is suggested to the further research.
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