巨刺法配合电针治疗神经根型颈椎病的临床疗效观察

发布时间：2018-01-09 10:05

本文关键词：巨刺法配合电针治疗神经根型颈椎病的临床疗效观察　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察巨刺法配合电针治疗神经根型颈椎病的临床疗效,探讨该疗法治疗神经根型颈椎病的临床应用价值。方法:在广州中医药大学第一附属医院针灸科门诊及病房和广州医科大学附属第三医院中医科门诊,选择符合诊断及纳入标准的60例神经根型颈椎病患者,采用简单随机分组的方法分为治疗组和对照组,每组各30例。治疗组采用巨刺法配合电针疗法,主穴选取颈夹脊穴、大椎、风池、完骨、天柱、大抒,配穴选肩井、肩毭、曲池、手三里、外关、合谷、后溪、阿是穴。主穴选双侧穴位加大椎穴,配穴选健侧,针刺得气后连接鑫升牌G6805-I型电针治疗仪,用疏密波,电针频率4/20Hz,强度以患者能耐受为度,留针30分钟后出针;对照组采取常规针法配合电针疗法,选穴方面主穴同治疗组,配穴选患侧。两组患者均隔日治疗1次,每周3次,2周为一个疗程,共治疗4周2个疗程。采用视觉疼痛模拟评分表(Visual Analog Scales,VAS)、田中靖久颈椎病症状量表20分法及颈椎功能障碍指数(the Neck Disability Index,NDI)调查问卷分别在治疗前、治疗1个疗程即2周、治疗2个疗程即4周后对纳入病例进行评分,记录得分,评价患者症状改善程度及两种疗法的临床疗效等。成果:1.治疗组和对照组在性别构成、年龄大小和治疗前各个量表评分差异均无统计学意义(P0.05),说明两组患者基线一致,有可比性。2.两组患者治疗1个疗程(2周)、2个疗程(4周)后视觉疼痛模拟评分表、田中靖久颈椎病症状量表20分法及颈椎功能障碍指数的得分均有不等程度的改善,同治疗前比较各量表在治疗1个疗程(2周)、2个疗程(4周)后得分差异具有统计学意义(P0.05),说明两组治疗方案均可有效缓解神经根型颈椎病的临床症状。3.两组患者治疗前在视觉疼痛模拟评分量表评分、田中靖久颈椎病症状体征量化积分及功能障碍指数问卷积分差异无统计学意义(P0.05);治疗1个疗程(2周)、2个疗程(4周)后田中靖久症状体征量表积分及功能障碍指数问卷积分比较差异无统计学意义(P0.05)且两量表在治疗2个疗程(4周)后前后差值比较无统计学意义(P0.05),说明治疗组在改善神经根型颈椎病患者总体症状、体征以及日常生活质量等方面与对照组疗效相当;治疗1个疗程(2周)、2个疗程(4周)后视觉疼痛模拟评分量表评分比较差异有统计学意义(P0.05)且在2个疗程(4周)后该量表治疗前后评分差值比较有统计学意义(P0.05),说明在缓解患者自觉疼痛程度方面,治疗组优于对照组。结论:巨刺法配合电针治疗神经根型颈椎病疗效理想,在改善患者疼痛方面,临床疗效优于常规针刺加电针组,且安全性高,可考虑在临床进一步推广应用。
[Abstract]:Objective: To observe the effect of opposing needling with electroacupuncture in treating cervical spondylotic radiculopathy, explore the therapeutic value of clinical application of the treatment of nerve root type of cervical spondylosis. Methods: in the third hospital outpatient and ward of acupuncture and moxibustion Department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine and Guangzhou Medical University affiliated outpatient department of traditional Chinese medicine, the choice conforms to the diagnosis and the inclusion criteria of 60 cases of nerve the root type of cervical spondylosis, the method is simple and randomly divided into treatment group and control group, 30 cases in each group. The treatment group with needling method combined with electro acupuncture therapy, the main acupoints selected Jiaji, Dazhui and Fengchi, Wanggu, Tianzhu, Dazhu, acupoints selected shoulder, shoulder Dou, Quchi three, hand, Waiguan, Hegu, Hou Xi, Ashi points. Main points bilateral acupoints and acupoints selected Tachui, contralateral, acupunctureat connection Xin Sheng brand G6805-I type electro acupuncture, electroacupuncture with dilatational wave, frequency of 4/20Hz, strength in patients with Neng Nai By degrees, the needle for 30 minutes after the needle; the control group adopted conventional acupuncture and electro acupuncture therapy, acupoint selection on the main points of the same treatment group. The acupoints selected affected side. Two groups of patients were treated 1 times every other day, 3 times a week, 2 weeks for a course of treatment, a total of 2 treatment course. By 4 weeks visual analogue score table (Visual Analog Scales, VAS), Tanaka Yasushi long cervical spondylosis symptoms scale 20 score and neck disability index (the Neck Disability Index, NDI) questionnaire respectively before treatment, 1 course of treatment is 2 weeks, 2 course of treatment is 4 weeks after the inclusion of score, score, symptom improvement and evaluation of patients with clinical curative effect of two kinds of therapy. Results: 1. treatment group and control group in gender, age and the size of each scale score before treatment showed no significant difference (P0.05), two groups of patients at baseline, can be compared with.2. in the two groups treatment of 1 patients A course of treatment (2 weeks), 2 courses (4 weeks) after the visual analogue scale, Tanaka Yasushi long cervical spondylosis symptoms scale 20 score and neck disability index scores ranging from improved compared with before treatment, the scale in the 1 course of treatment (2 weeks), 2 courses (4 weeks) were statistically significant differences in scores (P0.05), showed that treatment two groups can effectively alleviate the nerve root type cervical spondylosis clinical symptoms of.3. patients in the two groups before treatment in the visual analogue scale score, no significant Tanaka Yasushi long cervical spondylosis symptoms index and function disorder questionnaire quantitative integral integral difference (P0.05); 1 courses of treatment (2 weeks), 2 courses (4 weeks) after Tanaka Yasushi long symptoms scale scores and disability index questionnaire score no significant difference (P0.05) and the two scale in the 2 course of treatment (4 weeks) before and after no statistical difference Significance (P0.05), indicating that the treatment group in improving the nerve root type of cervical spondylosis patients overall symptoms, signs and the quality of daily life and other aspects of the same effect as the control group; 1 courses of treatment (2 weeks), 2 courses (4 weeks) after the visual analogue scale score difference was statistically significant (P0.05) and in 2 courses (4 weeks) after the scale before and after treatment score difference was statistically significant (P0.05), that in alleviating the pain degree of patients in the treatment group than the control group. Conclusion: needling method with ideal curative effect on cervical spondylosis of nerve root type in Electroacupuncture treatment, improve pain, the clinical efficacy is superior to conventional acupuncture and electro acupuncture group, and high safety, can consider further clinical application.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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