不同治法对神经根型颈椎病临床疗效的比较研究

发布时间：2018-06-10 20:28

  本文选题：颈椎病 + 神经根型　； 参考：《福建中医药大学》2016年博士论文

【摘要】：目的：采用三组不同的方法对神经根型颈椎病进行治疗,通过其疗效的比较与分析研究,为该病的临床治疗提供一种更合理有效的治疗方案。方法：本研究采用随机数字表法,先将90位患者按照中医辨证分型分为风寒湿痹型、气血不足型、气滞血瘀型和肝肾亏虚型。然后再随机将90人分成A、B、C3组,每组30人。A组采用针刺配合手法治疗,B组采用手法配合理疗治疗,C组采用针刺配合理疗法治疗,疗程为三个月。以SF-36健康调查量表及颈椎病治疗成绩评分表CASCS,辅以X-线检查,观察3组不同治疗方法的临床疗效。采用统计软件SPSS-21.0对所收集数据进行统计分析,得出结论。结果：(1)年龄分组与中医辨证分型：从三组的年龄分布来看,患者以35-49岁年龄段占最多；三组中医辨证分型中以肝肾亏虚型患者占最多病例,由此可见神经根型颈椎病常见于中年及中老年,且多以肝肾亏虚为其主要病机。(2)三组在性别、年龄分布、中医辨证分型、治疗效果及痛阈(VAS)综合积分、治疗前后症状体征比较,经统计学分析均无明显差异(P0.05),说明三组间具有可比性。(3)通过临床评价量表评价三组治疗神经根型颈椎病的效果,A组治疗后有效率为72.%,C组有效率为71.4%,B组的为50.7%。(4)三组间的SF-36健康调查简表显示：A组治疗后34.57%的有效率,优于C组的27.15%及B组的25.71%。(5)三组治疗前后的痛阈(VAS)综合积分结果相当,但均显示疼痛程度上有3度的减轻；A组治疗前均数-治疗后均数为5.87-2.87=3,B组为5.90-3.20=3.7,C组为5.37-2.77=2.6。结论：针刺配合手法治疗比手法配合理疗和针刺配合理疗的效果更佳,更能有效地缓解神经根型颈椎病所引起的疼痛、麻木等临床症状。
[Abstract]:Objective: three groups of different methods were used to treat cervical spondylopathy of nerve root type, and to provide a more reasonable and effective treatment scheme for the treatment of cervical spondylopathy by comparison and analysis of its curative effect. Methods: 90 patients were divided into wind-cold and dampness type, Qi and blood deficiency type, Qi stagnation and blood stasis type and liver and kidney deficiency type according to TCM syndrome differentiation. Then 90 patients were randomly divided into three groups: group A (n = 30) were treated with acupuncture plus manipulation, group B (n = 30) were treated with acupuncture and physiotherapy, group C (n = 30) were treated with acupuncture and therapy for three months. The clinical effects of different treatment methods were observed with SF-36 health survey scale and score scale of treatment score of cervical spondylosis (CASCS), supplemented by X- ray examination. The statistical software SPSS-21.0 was used to analyze the collected data, and the conclusion was drawn. Results (1) Age group and TCM syndrome differentiation: according to the age distribution of the three groups, the majority of the patients were aged 35-49, and the most of the three groups were the patients with deficiency of liver and kidney. It can be seen that cervical spondylosis of nerve root type is common in middle and middle age, and the main pathogenesis of cervical spondylosis is deficiency of liver and kidney as its main pathogenesis. (2) in sex, age distribution, TCM syndrome differentiation, treatment effect and pain threshold VAS-integrated integral, the symptoms and signs before and after treatment are compared. Statistical analysis showed that there was no significant difference between the three groups (P 0.05), indicating that the effectiveness of the three groups in the treatment of cervical spondylosis of nerve root type was evaluated by clinical evaluation scale. The effective rate of group A was 72.30%. The effective rate of group C was 71.4%. The effective rate of group B was 50.7%. A summary of the SF-36 health survey showed that the effective rate was 34.57% in group A after treatment. Compared with group C (27.15%) and group B (25.71%), the scores of VASs before and after treatment were similar, but they showed that there were 3 degrees of pain relief in group A before and after treatment. The mean of group B was 5.90-3.203.73.7C was 5.37-2.772.6. Conclusion: acupuncture combined with manipulation is more effective than manipulation combined with physical therapy and acupuncture combined with physiotherapy, and can effectively relieve the clinical symptoms such as pain and numbness caused by cervical spondylosis of nerve root type.
【学位授予单位】：福建中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R274.9
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本文编号：2004497