摘要
目的探讨针灸联合推拿分期施治对颈椎病患者中医证候、疼痛、颈椎曲度及炎性反应因子的影响。方法选取诊治的颈椎病患者140例,随机分为对照组与观察组,每组70例,对照组采用推拿治疗,观察组采用针灸联合推拿分期施治,观察治疗前后患者中医证候积分变化,采用疼痛分级指数(PRI)和疼痛视觉模拟评分法(VAS)对疼痛程度进行评价,观察颈椎生理曲度变化,采用颈椎活动度评分对患者颈椎活动度进行评分,检测患者治疗前后血清白细胞介素-8(IL-8)、IL-4、肿瘤坏死因子α(TNF-α)、P物质水平变化。结果两组患者治疗前中医证候积分比较差异无统计学意义(P>0.05),治疗后颈肩部疼痛、颈部压痛、颈部活动受限、上肢麻木疼痛证候积分较治疗前下降(P<0.05),且观察组下降程度大于对照组(P<0.05);两组患者治疗前PRI及VAS评分比较差异无统计学意义(P>0.05),治疗后PRI及VAS评分较治疗前下降(P<0.05),且观察组下降程度大于对照组(P<0.05);两组患者治疗前颈椎生理曲度C值及颈椎活动度评分比较差异无统计学意义(P>0.05),治疗后C值及颈椎活动度评分较治疗前升高(P<0.05),且观察组升高程度大于对照组(P<0.05);两组患者治疗前血清IL-8、IL-4、TNF-α、P物质水平比较差异无统计学意义(P>0.05),治疗后以上指标水平均低于治疗前(P<0.05),且观察组下降程度大于对照组(P<0.05)。结论颈椎病患者采用针灸联合推拿分期施治能明显有助于缓解各种症状,减轻疼痛及炎症反应,促进颈椎生理曲度的恢复,其作用可能与抑制炎症反应有关。
Objective To investigate the effect of acupuncture combined with Tuina in different stages on TCM symptoms,pain,cervical curvature and inflammatory factors of patients with cervical spondylosis.Methods We collected 140 cases with cervical spondylosis and they were randomly divided into the control group and the observation group and 70 cases in each group.The control group was treated with Tuina and the observation group was treated by acupuncture combined with Tuina in different sta-ges.The changes of TCM syndrome scores before and after treatment,the pain grade index(PRI)and visual analogue scale(VAS)were used to evaluate the pain.The changes of the physiological curvature of the patients'cervical spine were observed,the range of motion of the patients'cervical spine was scored by using the cervical range of motion score and the serum levels of interleukin-8(IL-8),IL-4,tumor necrosis factorα(TNF-α)and substance P were detected before and after treatment.Results There was no significant difference in TCM syndrome scores between the two groups before treatment(P>0.05).The scores of neck and shoulder pain,neck tenderness,neck movement limitation,upper limb numbness and pain symptoms were de-creased after treatment(P<0.05),and the decrease degree of the observation group was greater than that of the control group(P<0.05).There were no significant differences in PRI or VAS scores between the two groups before treatment(P>0.05).The PRI and VAS scores were decreased after treatment compared with those before treatment(P<0.05),and the decrease de-gree in the observation group was greater than that in the control group(P<0.05).There were no significant differences in C value of cervical physiological curvature or the range of motion of the patients'cervical spine scores between the two groups before treatment(P>0.05).The C value of cervical physiological curvature and the range of motion of the patients'cervical spine scores were increased after treatment compared with those before treatment(P<0.05),and the increase degree in the observation group was greater than that in the control group(P<0.05).There were no significant differences in IL-8,IL-4,TNF-αand P substances between the two groups before treatment(P>0.05).The levels of IL-8,IL-4,TNF-αand P substances were decreased after treatment compared with those before treatment(P<0.05),and the decrease degree in the observation group was greater than that in the control group(P<0.05).Conclusion The acupuncture combined with Tuina in different stages of patients with cervical spondylosis can significantly help to alleviate symptoms,pain and inflammation.The effect of promoting the recovery of cervical physiological curvature may be related to the inhibition of inflammatory response.
作者
钱雪旗
牟恒
戎军
龚伟
QIAN Xueqi;MOU Heng;RONG Jun;GONG Wei(Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine,Hangzhou 310009,Zhejiang,China)
出处
《中华中医药学刊》
CAS
北大核心
2022年第6期90-93,共4页
Chinese Archives of Traditional Chinese Medicine
基金
中华医学会临床医学科研专项基金(19010182385)。
关键词
针灸
推拿
颈椎病
中医证候
疼痛
颈椎曲度
炎症因子
acupuncture
Tuina
cervical spondylosis
TCM symptoms
pain
cervical curvature
inflammatory cytokines
