摘要
目的:观察神经肌肉电刺激(NMES)同步经皮神经电刺激(TENS)对神经根型颈椎病的疗效。方法:72例符合入组条件的神经根型颈椎病(CSR)患者,按Excel产生的随机数字随机分成3组:NMES组(n=24)、TENS组(n=24)、同步组(n=24)。NMES组予颈肩部NMES治疗同步麻木侧上肢安慰TENS治疗;TENS组予颈肩部安慰NMES治疗同步麻木侧上肢TENS治疗;同步组予颈肩部NMES治疗同步麻木侧上肢TENS治疗。每天1次,每次20min,连续治疗14天。分别在治疗前、治疗7次、14次及1个月后比较田中靖久颈椎病症状量表评分(TZCS)、颈椎功能障碍指数(NDI)评分及正中神经和尺神经F波传导速度、生活质量(SF-36),并观察14次治疗后的痊愈率和总有效率。结果:3组治疗前各项评分结果无显著性差异(P>0.05)。14次治疗后,同步组痊愈率69.57%,高于NMES组(40.91%)、TENS组(34.78%)(P<0.0167)。在TZCS、NDI、神经传导功能、生活质量(SF-36)评分方面,第14次治疗后即刻及治疗后1个月随访时同步组优于NMES组、TENS组(P<0.0167)。在TZCS评分方面,第7次治疗后即刻TENS组在颈肩疼痛、上肢麻木、手指麻木评分方面高于NMES组(P<0.0167);治疗后1个月随访时NMES组在颈肩疼痛、上肢麻木、手指麻木评分方面优于TENS组(P<0.0167)。在NDI方面,第14次治疗后即刻及治疗后1个月随访时NMES组优于TENS组(P<0.0167)。在神经传导方面,第14次治疗后即刻及治疗后1个月随访时NMES组评分高于TENS组(P<0.0167);第7次治疗后即刻,TENS组高于NMES组(P<0.0167)。在生活质量(SF-36)评分方面,治疗14次后及治疗后1个月随访时,同步组在躯体疼痛、情感职能、精神健康评分方面优于NMES组、TENS组(P<0.0167),其他方面无显著性差异。结论:NMES同步TENS可有效缓解CSR患者颈肩疼痛和麻木症状。
Objective:To observe the effect of NMES synchronized TENS on patients with cervical spondylotic radiculopathy.Method:According to the random number produced by Excel,72 patients with cervical spondylotic radiculopathy(CSR)were randomly divided into three groups:NMES group(n=24),TENS group(n=24)and synchronous group(n=24).Neck and shoulder NMES was used In the NMES group with the TENS comfort treatment on the side of upper limb numbness;TENS was used on the side of upper limb numbness in the TENS group with NMES comfort treatment on the neck and shoulder;and both NMES and TENS were used in the synchronous group.The treatment was performed every day for 14 days with a total of 20-minute session.The Tian Zhongjingjiu cervical spondylosis symptom scale(TZCS)score,neck disability index(NDI)score,median nerve and ulnar nerve F wave conduction velocity,and quality of life(SF-36)were compared before treatment,7,14 times and 1 month after treatment.After 14 treatment,the cure rate and total effective rate were observed.Result:There was no significant difference in the scores of the three groups before treatment.After 14 treatments,the synchronous group had a cure rate of 69.57%,which was higher than the NMES group(40.91%)and the TENS group(34.78%)(P<0.0167).The synchronous group outperformed the NMES group and the TENS group following the 14th treatment and 1 month follow-up after treatment in terms of TZCS,NDI,nerve conduction function,and SF-36 scores(P<0.0167).After 7th treatment,the TZCS score,the scores of neck shoulder pain,upper limb numbness and finger numbness in TENS group were higher than those in NMES group(P<0.0167).At 1 month follow-up,NMES group was superior to TENS group in neck and shoulder pain,upper limb numbness,finger numbness(P<0.0167).In terms of NDI,NMES group was superior to TENS group immediately after the 14th treatment and at the follow-up of 1 month after treatment(P<0.0167).In terms of nerve conduction,the scores of NMES group were higher than TENS group immediately after the 14th treatment and at the follow-up of 1 month after treatment(P<0.0167);Immediately after the seventh treatment,TENS group was higher than NMES group(P<0.0167).In terms of quality of life(SF-36)score,the synchronous group's physical pain,emotional function,and mental health score were better than those of the NMES and TENS groups after 14 treatments and a one-month follow-up(P<0.0167).There is no significant difference in other aspects.Conclusion:NMES synchronized TENS can effectively relieve neck shoulder pain and numbness in patients with CSR.
作者
李忠林
周晓卿
万军
张菶
陈桂凤
LI Zhonglin;ZHOU Xiaoqing;WAN Jun(Beijing University of Chinese Medicine Shenzhen Hospital(Longgang),Shenzhen,518172)
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2023年第6期780-786,792,共8页
Chinese Journal of Rehabilitation Medicine
基金
龙岗区经济与科技发展专项资金项目(LGKCYLWS2020073)。
关键词
神经根型颈椎病
神经肌肉电刺激
经皮神经电刺激
cervical spondylotic radiculopathy
neuromuscular electrical stimulation
transcutaneous electrical nerve stimulation
