基于VAS评分评价点揉缺盆、天宗、肩贞治疗臂丛神经痛的临床疗效
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摘要
目的用VAS评分评价点揉缺盆、天宗、肩贞治疗臂丛神经痛的临床疗效,探讨其作用机理。方法将71例臂丛神经痛的患者病例,按就诊顺序用随机数字表法分为点揉治疗组和针刺对照组。治疗组37例,常规推拿后于缺盆、天宗、肩贞上行点揉手法治疗;对照组34例,常规推拿后行传统针刺治疗;2组均治疗1周为1个疗程,均连续治疗3个疗程,以VAS评分作为观察指标,以治疗前、治疗后1周、治疗后3周、治疗后6周作为疗效观察节点;同时对2组在治疗前、第3个疗程结束后分阶段评分,统计各段的人数并对比。结果 2组的治疗结果均有效,治疗组有效率为91.89%,对照组有效率为85.29%,2组比较,差异有统计学意义(P <0.05);在观测周期内,2组的VAS评分均呈下降趋势,但治疗组的评分下降明显,表明其近期疗效优于对照组,差异有统计学意义(P <0.05);2组治疗后6个月及12个月电话随访统计表明,治疗组VAS评分低于对照组及治疗后6周,对照组VAS评分总体呈上升趋势,表明治疗组远期疗效较好,复发可能性较小,差异有统计学意义(P <0.05);治疗后分阶段评分表明,治疗组治疗后的分阶段评分较对照组变化更明显,对比有明显的差异性。结论点揉缺盆、天宗、肩贞可有效缓解臂丛神经痛,近、远期疗效均优于传统针刺治疗,复发可能性较小。
Objective To evaluate the clinical efficacy and mechanism of VAS score in treating brachial plexus neuralgia by pointing and kneading Quepen(ST12), Tianzong(SI11) and Jianzhen(SI9). Methods 71 patients with brachial plexus neuralgia were randomly divided into study group(n = 37) and control group(n = 34). The study group received pointing and kneading at Quepen, Tianzong and Shouzhen points after routine massage, while the control group received traditional acupuncture after routine massage. One week was a course of treatment in both groups, with three consecutive courses of treatment. The VAS score was used as the observation index, and the curative effect was observed before treatment, one week after treatment, three weeks after treatment and six weeks after treatment. At the same time, the groups were graded in stages before treatment and after the third course of treatment, and the number of people in each section was compared. Results Both groups were effective. The effective rate was 91.89% of the study group versus 85.29% of the control group. During the observation period, the VAS scores of the two groups showed a downward trend. The score of the study group was significantly lower than that of the control group, and the difference was statistically significant(P < 0.05). The telephone follow-up statistics of 6 months and 12 months after treatment in the two groups showed that: the VAS scores of the study group were significantly lower than those of the control group and 6 weeks after treatment(P < 0.05), the grading of the study group changed more obviously than that of the control group, and there were significant differences between the two groups. Conclusion Pointing and kneading Quepen(ST12), Tianzong(SI11) and Jianzhen(SI9) can effectively alleviate brachial plexus neuralgia. The short-term and long-term curative effects are better than those of traditional acupuncture treatment, and the possibility of recurrence is low.
Objective To evaluate the clinical efficacy and mechanism of VAS score in treating brachial plexus neuralgia by pointing and kneading Quepen(ST12), Tianzong(SI11) and Jianzhen(SI9). Methods 71 patients with brachial plexus neuralgia were randomly divided into study group(n = 37) and control group(n = 34). The study group received pointing and kneading at Quepen, Tianzong and Shouzhen points after routine massage, while the control group received traditional acupuncture after routine massage. One week was a course of treatment in both groups, with three consecutive courses of treatment. The VAS score was used as the observation index, and the curative effect was observed before treatment, one week after treatment, three weeks after treatment and six weeks after treatment. At the same time, the groups were graded in stages before treatment and after the third course of treatment, and the number of people in each section was compared. Results Both groups were effective. The effective rate was 91.89% of the study group versus 85.29% of the control group. During the observation period, the VAS scores of the two groups showed a downward trend. The score of the study group was significantly lower than that of the control group, and the difference was statistically significant(P < 0.05). The telephone follow-up statistics of 6 months and 12 months after treatment in the two groups showed that: the VAS scores of the study group were significantly lower than those of the control group and 6 weeks after treatment(P < 0.05), the grading of the study group changed more obviously than that of the control group, and there were significant differences between the two groups. Conclusion Pointing and kneading Quepen(ST12), Tianzong(SI11) and Jianzhen(SI9) can effectively alleviate brachial plexus neuralgia. The short-term and long-term curative effects are better than those of traditional acupuncture treatment, and the possibility of recurrence is low.
引文
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[16]张艺,李雪松,孙滨,等.牵引态下针刺夹脊穴治疗神经根型颈椎病临床疗效观察及对炎症因子的影响[J].吉林中医药, 2018, 38(4):465-467.
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[22]黎汝定.电针加穴位注射在神经根型颈椎病中的应用及对肌电图的影响[J].吉林中医药, 2017, 37(2):205-208.
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[26]郑春水,黄萍萍,廖军.推拿治疗神经根型颈椎病研究概述[J].亚太传统医药, 2014, 10(19):54-55.
[27]李正言,王宽,邓真,等.颈部手法治疗神经根型颈椎病机制研究[J].吉林中医药, 2017, 37(12):1283-1285.
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[29]任耀龙,黄景峰.小针刀结合推拿手法治疗椎动脉型颈椎病疗效分析[J].实用中医药杂志, 2017, 33(5):557-558.
[30]楚云杰,张文远,吴运明.仰卧位定点牵伸法治疗神经根型颈椎病[J].长春中医药大学学报, 2016, 32(3):574-575.
[2]赵英霖,黄琳.中西医结合治疗臂丛神经痛1例[J].风湿病与关节炎, 2015, 4(3):28, 31.
[3]王晓灿.王蓉.高永祥.痹症的病因及证治探讨[J].光明中医, 2015, 30(12):2544.
[4]付升旗,游言文,汪永锋.系统解剖学[M].北京:中国医药科技出版社, 2017.
[5]邵水金.腧穴解剖学[M].北京:中国中医药出版社, 2017.
[6]孔垂成.经穴释义教程[M].北京:中国医药科技出版社,2007.
[7]王蔚文.临床疾病诊断与疗效判断标准[M].北京:科学技术文献出版社, 2010.
[8]李焰生.张瑛.徐群.神经系统疾病诊断标准(中英文对照)[M].北京:人民军医出版社, 2010.
[9]王正琴,杜建明.推拿治疗神经根型颈椎病的临床应用进展[J].解放军医学院学报, 2014, 35(8):873-875.
[10]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社, 2002.
[11]刘继茂.中医推拿治疗神经根型颈椎病的临床研究进展[J].内蒙古中医药, 2018, 37(8):123-124.
[12]汤昌华.推拿治疗神经根型颈椎病的作用机理探讨[J].中医临床研究, 2012, 4(5):58-59.
[13]柳少逸.经络腧穴原始[M].北京:中国中医药出版社,2015.
[14]王德深.中国针灸穴位通鉴[M].青岛:青岛出版社,1994.
[15]张琪,金鸿宾,范桐顺,等.推拿手法治疗颈椎病机制研究[J].河南中医, 2018, 38(8):1248-1251.
[16]张艺,李雪松,孙滨,等.牵引态下针刺夹脊穴治疗神经根型颈椎病临床疗效观察及对炎症因子的影响[J].吉林中医药, 2018, 38(4):465-467.
[17]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.
[18]胡亚南,杨家祥.参附注射液穴位注射联合甲钴胺片治疗脊髓型颈椎病的疗效及对血清炎性因子的影响[J].现代中西医结合杂志, 2017, 26(34):3801-3803.
[19]宋柏林,于天源.推拿治疗学[M].北京:人民卫生出版社,2012.
[20]朱国庆,苏慧.松筋针治疗经筋痹痛症的临床应用(慢性软组织损伤肌筋膜病)[C]//中国针灸学会.第八届全国中青年针灸推拿学术研讨会论文集,大连:2008.
[21]金福兴.慢性软组织损伤环链理论与实践[C]//中华中医药学会.2011国际针刀医学学术交流暨针刀医学创立35周年纪念大会论文集,北京:2011.
[22]黎汝定.电针加穴位注射在神经根型颈椎病中的应用及对肌电图的影响[J].吉林中医药, 2017, 37(2):205-208.
[23]刘学勇.腰椎管狭窄症所致神经源性间歇跛行机理的实验研究[D].辽宁:中国医科大学, 2002.
[24]王正琴,杜建明.推拿治疗神经根型颈椎病的临床进展[C]//中华中医药学会推拿分会.中华中医药学会推拿分会第十四次推拿学术交流会论文汇编,深圳:2013.
[25]王珍珍,张春红.针刺颈夹脊穴的临床应用概述[J].中医药学报, 2016, 44(5):89-91.
[26]郑春水,黄萍萍,廖军.推拿治疗神经根型颈椎病研究概述[J].亚太传统医药, 2014, 10(19):54-55.
[27]李正言,王宽,邓真,等.颈部手法治疗神经根型颈椎病机制研究[J].吉林中医药, 2017, 37(12):1283-1285.
[28]陈道洪.推拿治疗颈型颈椎病筋结处超微结构及α-SMA的实验研究[D].成都:成都中医药大学, 2013.
[29]任耀龙,黄景峰.小针刀结合推拿手法治疗椎动脉型颈椎病疗效分析[J].实用中医药杂志, 2017, 33(5):557-558.
[30]楚云杰,张文远,吴运明.仰卧位定点牵伸法治疗神经根型颈椎病[J].长春中医药大学学报, 2016, 32(3):574-575.
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