
浏览全部资源
扫码关注微信
河南省中医院/河南中医药大学 第二附属医院,郑州 450002
张攀,硕士,主治医师,从事颈肩腰腿痛疾病的中医药干预与治疗,E-mail:panzhang_1987@126.com
王勤俭,硕士,副主任医师,从事中医药治疗颈肩腰腿痛,E-mail:wqjzyy@sina.com
收稿日期:2022-05-07,
网络出版日期:2022-07-21,
纸质出版日期:2023-01-05
移动端阅览
张攀,王勤俭,徐冬康等.羌活胜湿汤加减联合臭氧注射、射频热凝靶点穿刺术治疗神经根型颈椎病风寒痹阻型临床观察[J].中国实验方剂学杂志,2023,29(01):91-96.
ZHANG Pan,WANG Qinjian,XU Dongkang,et al.Modified Qianghuo Shengshitang Combined with Ozone Injection and Radiofrequency Thermocoagulation Target Puncture in Treatment of Cervical Spondylotic Radiculopathy with Wind-cold Blockage Type[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(01):91-96.
张攀,王勤俭,徐冬康等.羌活胜湿汤加减联合臭氧注射、射频热凝靶点穿刺术治疗神经根型颈椎病风寒痹阻型临床观察[J].中国实验方剂学杂志,2023,29(01):91-96. DOI: 10.13422/j.cnki.syfjx.202201729.
ZHANG Pan,WANG Qinjian,XU Dongkang,et al.Modified Qianghuo Shengshitang Combined with Ozone Injection and Radiofrequency Thermocoagulation Target Puncture in Treatment of Cervical Spondylotic Radiculopathy with Wind-cold Blockage Type[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(01):91-96. DOI: 10.13422/j.cnki.syfjx.202201729.
目的
2
观察羌活胜湿汤加减联合臭氧注射、射频热凝靶点穿刺术治疗神经根型颈椎病(风寒痹阻型)的临床疗效。
方法
2
选择2020年8月至2021年5月于河南省中医院治疗的68例神经根型颈椎病患者,以随机数字表法分组,34例患者为观察组,患者为对照组,对照组给予羌活胜湿汤安慰剂颗粒,同时予臭氧注射、射频热凝靶点穿刺术治疗,观察组给予羌活胜湿汤加减联合臭氧注射、射频热凝靶点穿刺术治疗,治疗前后检测两组患者肿瘤坏死因子-
α
(TNF-
α
)、降钙素原(PCT)、白细胞介素-2(IL-2)、白细胞介素-1
β
(IL-1
β
)、6-酮前列腺素E1
α
(6-keto-PGE1
α
)、血浆P物质(SP)、
β
内啡肽(
β
-EP)、脂质过氧化物(LPO)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平,给予患者疼痛视觉量表(VAS)、颈椎功能障碍指数量表(NDI)、颈椎病临床评价量表(CASCS)评价,观察临床疗效。
结果
2
与本组治疗前比较,治疗后两组患者IL-1
β
、PCT、TNF-
α
水平降低,IL-2水平升高(
P
<
0.05);治疗后与对照组比较,观察组IL-1
β
、PCT、TNF-
α
、IL-2改善更明显(
P
<
0.05)。与本组治疗前比较,治疗后两组患者SOD水平升高,LPO、MDA水平降低(
P
<
0.05);治疗后与对照组比较,观察组SOD、LPO、MDA改善更明显(
P
<
0.05)。与本组治疗前比较,治疗后两组患者SP、6-keto-PGE1
α
水平降低,
β
-EP水平升高(
P
<
0.05);治疗后与对照组比较,观察组SP、6-keto-PGE1
α
、
β
-EP改善更明显(
P
<
0.05)。与本组治疗前比较,治疗后观察组VAS、NDI评分降低,CASCS评分升高(
P
<
0.05);治疗后与对照组比较,观察组VAS、NDI、CASCS评分改善更明显(
P
<
0.05)。治疗后,观察组患者总有效率高于对照组(
Z
=2.018,
P
<
0.05)。
结论
2
羌活胜湿汤加减联合臭氧注射、射频热凝靶点穿刺术治疗神经根型颈椎病(风寒痹阻型)患者,可抑制患者炎症,清除氧自由基,改善疼痛介质水平,缓解患者疼痛,提升颈椎功能及临床疗效。
Objective
2
To observe the clinical efficacy of Qianghuo Shengshitang combined with ozone injection and radiofrequency thermocoagulation target puncture in the treatment of cervical spondylotic radiculopathy (wind-cold blockage type).
Method
2
Sixty-eight patients with cervical spondylotic radiculopathy who were treated in Henan Province Hospital of Traditional Chinese Medicine from August 2020 to May 2021 were included and grouped into a control group and a research group by random number table, with 34 patients in each group. The control group was administrated with placebo granules of Qianghuo Shengshitang, and treated with ozone injection and radiofrequency thermocoagulation target puncture at the same time. The research group was given modified Qianghuo Shengshitang combined with ozone injection and radiofrequency thermocoagulation target puncture. Before and after treatment, patients in two groups were tested for the levels of tumor necrosis factor-
α
(TNF-
α
), procalcitonin (PCT), interleukin-2 (IL-2), interleukin-1
β
(IL-1
β
), 6-ketoprostaglandin E1
α
(6-keto-PGE1
α
), plasma substance P (SP),
β
-endorphin (
β
-EP), lipid peroxide (LPO), malondialdehyde (MDA), and superoxide dismutase (SOD). The pain visual scale (VAS), cervical dysfunction index (NDI), and clinical evaluation scale for cervical spondylosis (CASCS) were given to patients to evaluate the clinical efficacy.
Result
2
Compared with those before treatment, the levels of IL-1
β
, PCT, and TNF-
α
in two groups were decreased, and the level of IL-2 was increased (
P
<
0.05). The improvement of IL-1
β
, PCT, TNF-
α
, and IL-2 was more obvious in the research group as compared with the control group (
P
<
0.05). After treatment, the levels of SOD in two groups were increased, while the levels of LPO and MDA were decreased (
P
<
0.05). After treatment, the improvement of SOD, LPO, and MDA was more obvious in the research group as compared with the control group (
P
<
0.05). Compared with those before treatment, the levels of SP and 6-keto-PGE1
α
in two groups were decreased after treatment, and the level of
β
-EP was increased (
P
<
0.05). The improvement of -keto-PGE1
α
and
β
-EP was more obvious in the research group as compared with the control group after treatment (
P
<
0.05). Compared with those before treatment, the VAS and NDI scores of the research group were decreased, and the CASCS scores were increased (
P
<
0.05). After treatment, the improvement of VAS, NDI, and CASCS of the research group was more obvious as compared with the control group (
P
<
0.05). After treatment, the total effective rate of patients in the research group was higher than that in the control group (
Z
=2.018,
P
<
0.05).
Conclusion
2
Modified Qianghuo Shengshitang combined with ozone injection and radiofrequency thermocoagulation target puncture in the treatment of patients with cervical spondylotic radiculopathy (wind-cold blockage type) can inhibit inflammation, remove oxygen free radicals, improve the level of pain mediators, relieve pain, and improve cervical spine function and clinical efficacy.
李远峰 , 王震 , 张茜 , 等 . 针刀松解颈肩部MTrPs联合“三期”辨证牵引法治疗神经根型颈椎病临床症状及对患者血清炎性因子的影响 [J]. 海南医学院学报 , 2021 , 27 ( 13 ): 983 - 987 .
LIANG K , FENG P , FENG X , et al . Diffusion tensor imaging and fiber tractography reveal significant microstructural changes of cervical nerve roots in patients with cervical spondylotic radicu-lopathy [J]. World Neurosurg , 2019 , 126 ( 6 ): 57 - 64 .
魏戌 , 方圣杰 , 孙凯 , 等 . 神经根型颈椎病中医证候研究进展 [J]. 南京中医药大学学报 , 2021 , 37 ( 4 ): 632 - 636 .
雷秋慧 . 郑氏温通针法治疗风寒阻络证神经根型颈椎病35例 [J]. 中医研究 , 2020 , 33 ( 1 ): 46 - 49 .
周兰洁 , 郑英杰 , 沈春冬 . 电针配合羌活胜湿汤加减治疗神经根型颈椎病(寒湿阻络证)的疗效观察 [J]. 颈腰痛杂志 , 2021 , 42 ( 2 ): 219 - 221 .
董燕 , 侯酉娟 , 李莎莎 , 等 . 经典名方羌活胜湿汤的古代文献分析 [J]. 中国实验方剂学杂志 , 2018 , 24 ( 17 ): 1 - 5 .
神经根型颈椎病诊疗规范化研究专家组 . 神经根型颈椎病诊疗规范化的专家共识 [J]. 中华外科杂志 , 2015 , 53 ( 11 ): 812 - 814 ..
中华外科杂志编辑部 . 颈椎病的分型、诊断及非手术治疗专家共识(2018) [J]. 中华外科杂志 , 2018 , 56 ( 6 ): 401 - 402 .
HELLER G Z , MANUGUERRA M , CHOW R . How to analyze the visual analogue scale:Myths,truths and clinical relevance [J]. Scand J Pain , 2016 , 13 : 67 - 75
CARREON L , GLASSMAN S D , CAMPBELL M J , et al . Neck disability index, short form-36 physical component summary, and pain scales for neck and arm pain. The minimum clinically important difference and substantial clinical benefit after cervical spine fusion [J]. Spine J , 2010 , 10 ( 6 ): 469 - 474 .
张鸣生 , 许伟成 , 林仲民 , 等 . 颈椎病临床评价量表的信度与效度研究 [J]. 中华物理医学与康复杂志 , 2003 , 25 ( 3 ): 25 - 28 .
国家中医药管理局 . 中医病证诊断疗效标准 [M]. 北京 : 中国医药科技出版社 , 2012 .
赵定麟 , 侯铁胜 , 陈德玉 , 等 . 现代脊柱外科学 [M]. 上海 : 世界图书出版公司 , 2006 : 420 - 424 .
吕更宽 . 艾灸治疗神经根型颈椎病的疗效观察及红外温度变化 [D]. 福州 : 福建中医药大学 , 2017 .
REN J , LI R , ZHU K , et al . Biomechanical comparison of percuta-neous posterior endoscopic cervical discectomy and anterior cervi-cal decompression and fusion on the treatment of cervical spondy-lotic radiculopathy [J]. J Orthop Surg Res , 2019 , 14 ( 1 ): 71 .
莫日养 . 射频热凝靶点穿刺术联合臭氧治疗神经根型颈椎病症状复发的临床研究 [D]. 南宁 : 广西中医药大学 , 2018 .
GABRIEL A B , SILVIA T E , SANDRA M M S , et al . In vitro e-valuation of wound healing and antimicrobial potential of ozone therapy [J]. J Craniomaxillofac Surg , 2017 , 45 ( 3 ): 364 - 370 .
齐文斌 . 不同浓度臭氧联合射频消融术治疗神经根型颈椎病的疗效分析 [J]. 淮海医药 , 2021 , 39 ( 1 ): 17 - 20 .
杨广营 , 杨柯 , 娄本海 . 温经通痹汤联合穴位贴敷治疗神经根型颈椎病对疼痛及炎症的影响 [J]. 实用中医药杂志 , 2021 ( 7 ): 1112 - 1114 .
包英华 , 陆彩霞 , 张玉柱 . 张氏一号方火龙灸治疗风寒痹阻型神经根型颈椎病120例 [J]. 中国中医骨伤科杂志 , 2019 , 27 ( 6 ): 48 - 50 .
李鸿昌 . 对中药羌活化学成分及药理作用的研究 [J]. 当代医药论丛 , 2019 , 17 ( 15 ): 195 - 197 .
廖禹程 , 丁一 , 王文军 , 等 . 基于网络药理学探讨独活镇痛的分子作用机制 [J]. 中国药师 , 2021 , 24 ( 1 ): 1 - 6 .
SHIMODAIRA T , MIKOSHIBA S , TAGUCHI T . Nonsteroidalanti-inflammatory drugs andacetaminophen amelioratemuscular mechanical hyperalgesia developed after length-eningcontractionsvia cyclooxygenase-2 independent mechanisms in rats [J]. PLoS One , 2019 , 14 ( 11 ) : e224809 .
刘沛霖 . 活血通络中药内服+穴位注射治疗气虚血瘀证神经根型颈椎病疗效及对炎性细胞因子水平的影响 [J]. 现代中西医结合杂志 , 2017 , 26 ( 34 ): 3861 - 3864 .
张宜默 , 张莉 , 于春鹏 , 等 . 夹脊穴电针配合雷火灸法治疗风寒湿型神经根型颈椎病的临床观察 [J]. 世界中西医结合杂志 , 2021 , 16 ( 9 ): 1577 - 1580,1588 .
宋海瑞 , 孙刚 , 布尔古德 , 等 . 针灸治疗对神经根型颈椎病患者的疗效及炎症因子、氧化应激及血液流变学的影响 [J]. 湖南师范大学学报:医学版 , 2020 , 17 ( 6 ): 188 - 191 .
ZHOU Y H , YU J P , LIU Y F , et al . Effects of ginkgo biloba extract on inflammatory mediators(SOD, MDA, TNF- α , NF- κ B p65, IL-6 )in TNBS-induced colitis in rats [J]. Mediat Inflamm , 2017 , 2006 : 1 - 9 .
涂国卿 , 邹来勇 , 朱玉辉 , 等 . 整体平衡疗法对神经根型颈椎病 β -内啡肽表达的影响 [J]. 中国中医药现代远程教育 , 2015 , 13 ( 3 ): 67 - 68 .
0
浏览量
20
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621