摘要
目的观察刺络放血疗法联合加味身痛逐瘀汤治疗气滞血瘀型神经根型颈椎病(CSR)的疗效及对血清炎症因子和椎-基底动脉血流动力学的影响。方法将80例气滞血瘀型CSR患者按照随机数字表法分为2组,均予常规西药治疗,对照组40例加用刺络放血疗法,治疗组40例在对照组治疗基础上应用加味身痛逐瘀汤。2组均治疗2周。比较2组临床疗效;比较2组治疗前后中医证候评分变化;比较2组治疗前后血清炎症因子白细胞介素1β(IL-1β)、IL-6、IL-10、肿瘤坏死因子α(TNF-α)含量变化;比较2组治疗前后椎-基底动脉血流动力学指标变化。结果治疗组总有效率97.50%(39/40),对照组总有效率82.50%(33/40),治疗组疗效优于对照组(P<0.05)。2组治疗后肩颈臂疼痛、颈部压痛、颈项活动不利、肢体麻木、上肢活动不利、畏寒肢冷评分及总评分均较本组治疗前降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。2组治疗后血清IL-1β、IL-6、TNF-α含量均较本组治疗前降低(P<0.05),IL-10含量较本组治疗前升高(P<0.05),且治疗组治疗后血清IL-1β、IL-6、TNF-α含量均低于对照组(P<0.05),IL-10含量高于对照组(P<0.05)。2组治疗后左侧椎动脉、右侧椎动脉、基底动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)、平均血流速度(Vm)均较本组治疗前升高(P<0.05),血管搏动指数(PI)较本组治疗前降低(P<0.05),且治疗组治疗后左侧椎动脉、右侧椎动脉、基底动脉PSV、EDV、Vm均高于对照组(P<0.05),PI低于对照组(P<0.05)。结论刺络放血疗法联合加味身痛逐瘀汤治疗气滞血瘀型CSR,能改善患者临床症状及体征,提高疗效,可能与抑制炎性反应、调节椎-基底动脉血流动力学等因素有关。
Objective To observe the curative effect of blood-letting puncture therapy combined with modified Shentong Zhuyu Decoction in the treatment of cervical spondylotic radiculopathy(CSR)of qi stagnancy and blood stasis type and how to impact on serum inflammatory factors and hemodynamics.Methods Totally 80 CSR patients(qi stagnation and blood stasis type)were randomly divided into the treatment group and the control group,40 cases in each;in addition to conventional Western medicine,the control group was treated with blood-letting puncture therapy,and the treatment group was additionally treated with modified Shentong Zhuyu Decoction based on the control group.Both groups were treated for 2 weeks,aiming to compare the clinical efficacy,traditional Chinese medicine(TCM)syndrome scores,the serum inflammatory factors(interleukin-1β[IL-1β],IL-6,IL-10,tumor necrosis factorα[TNF-α]),hemodynamic indexes between the two groups.Results The overall effective rate in the treatment group was better than that in the control group(97.50%[39/40]vs 82.50%[33/40],[P<0.05],respectively).After treatment,the scores of TCM syndrome(shoulder and neck pain,neck tenderness,disadvantaged neck activities,numbness,disadvantaged upper limb movement,cold limbs)in the two groups were all decreased(P<0.05),and the reduction in the treatment group was more significant(P<0.05).The levels of serum IL-1β,IL-6 and TNF-αin groups were decreased compared with before treatment(P<0.05),which in the treatment group was common(P<0.05),while the levels of IL-10 in groups were increased than before treatment(P<0.05),the treatment group was more prevalent(P<0.05).After treatment,the left and right vertebral artery,and basilar artery peak systolic velocity(PSV),end-diastolic velocity(EDV)and mean blood velocity(Vm)in groups were all higher than those before treatment(P<0.05),the improvment in the treatment group was better than the control group(P<0.05);vascular pulsatility index(PI)was lower than that before treatment(P<0.05);which was lower in treatment group than the control group(P<0.05).Conclusion For CSR patients(qi stagnancy and blood stasis type),blood-letting puncture therapy combined with modified Shentong Zhuyu Decoction can improve clinical symptoms and physical signs,and curative effect by inhibiting inflammatory response and the regulating hemodynamics.
作者
苏代祥
彭一华
田永飞
汪玉瑶
SU Daixiang;PENG Yihua;TIAN Yongfei;WANG Yuyao(Department of Rehabilitation Medicine,Zhongxiang People's Hospital,Zhongxiang,Hubei 431900)
出处
《河北中医》
2022年第6期1002-1006,共5页
Hebei Journal of Traditional Chinese Medicine
关键词
脊柱骨赘病
颈椎
辨证分型
刺血疗法
中药疗法
Spinal osteophytes
Cervical vertebrae
Syndrome differentiation
Bloodletting therapy
Traditional Chinese medicine therapy
