| 摘要: |
| 目的:探讨筋骨平衡理论下舒筋正骨手法联合中医定向透药治疗寒湿痹阻证神经根型颈椎病(CSR)的临床效果。方法:选取2024年1月—12月本院收治的92例寒湿痹阻证CSR患者，采用随机数字表法分为观察组和透药组两组，每组各46例。透药组采用自拟散寒止痛散进行定向透药，观察组在透药组基础上，采用集清宫正骨手法和川派何氏手法之所长的舒筋正骨手法。观察治疗前和治疗2周后的中医症候分值(颈项疼痛、上肢麻木、肢冷恶寒、头颈沉重)、颈椎主动关节活动度(前屈、后伸、患侧侧屈、患侧旋转)、颈椎功能障碍指数(NDI)、红外成像温度差、白细胞介素-6(IL-6)、脂蛋白关联磷脂酶A2(LpPLA2)，并评估两组治疗后的临床疗效。结果:治疗2周后，观察组的中医症候在颈项疼痛、上肢麻木、头颈沉重3项分值均低于透药组(P <0.05)，两组间肢冷恶寒症候分值差异无统计学意义(P >0.05)；观察组患者的NDI低于透药组，在关节活动度(前屈、后伸、患侧侧屈和旋转)均高于透药组(P <0.05)。观察组的红外成像温度差、IL-6和LpPLA2均低于透药组(P <0.05)。两组的有效率比较无统计学差异(χ2=1.425，P >0.05)；但观察组的整体临床疗效优于透药组(Z=3.212，P <0.05)。结论:筋骨平衡理论下舒筋正骨手法联合中医定向透药治疗寒湿痹阻证CSR，可以缓解患者疼痛、麻木等相关症状，改善功能障碍，还能够纠正温度的失衡和炎症反应。 |
| 关键词: 筋骨平衡 舒筋正骨手法 中医定向透药 神经根型颈椎病 寒湿痹阻证 |
| DOI：10.3969/j.issn.1007-6948.2025.05.021 |
| 投稿时间：2025-03-01 |
| 基金项目:四川省中医药管理局中医药科研专项课题(2023104) |
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| Clinical observation on the treatment of nerve root type cervical spondylosis (cold dampness obstruction syndrome) with the combination of relaxing muscles and bone setting techniques under the theory of muscle bone balance and traditional Chinese medicine directional penetration therapy |
| GUO Long,HU Yu-hui,ZHOU Yue-hui |
| Chengdu Bayi Orthopedic Hospital Orthopedics Department, Chengdu, Sichuan610075, China |
| Abstract: |
| Objective To explore the clinical effect of combining the theory of muscle bone balance with targeted traditional Chinese medicine for the treatment of cervical spondylotic radiculopathy (CSR) caused by cold dampness obstruction syndrome. Methods 92 patients with cold dampness obstruction syndrome CSR admitted to our hospital from January 2024 to December 2024 were selected as the study subjects and randomly divided into an observation group and a medication group. The medication group used a self-designed Sanhan Zhitong Poutler for targeted medication penetration, while the observation group used the Shujin technique, which combines the strengths of the Qinggong Zhenggu technique and the Chuanpai He's technique, on the basis of the medication penetration group. Observe the traditional Chinese medicine symptom scores (neck pain, upper limb numbness, limb cold aversion, head and neck heaviness), cervical active joint range of motion (flexion, extension, lateral flexion, rotation), cervical dysfunction index (NDI), infrared imaging temperature difference, interleukin-6 (IL-6), lipoprotein associated phospholipase A2 (LpPLA2) before and after 2 weeks of treatment, and evaluate the clinical efficacy of both groups after treatment. Results In terms of traditional Chinese medicine symptom scores, the observation group had lower scores in neck pain, upper limb numbness, and head and neck heaviness than the transparent medicine group (P <0.05). There was no statistically significant difference in the score of limb cold and chills symptom between the two groups (P >0.05); In terms of functional impairment, the observation group had lower NDI than the drug permeable group, and higher joint range of motion (flexion, extension, lateral flexion, and rotation) than the drug permeable group (P <0.05). In terms of physical and chemical indicators, the observation group had lower levels of infrared imaging temperature difference, IL-6, and LpPLA2 than the transdermal group (P <0.05). In terms of clinical efficacy, there was no significant difference in the effective rate between the two groups (χ2=1.425, P >0.05). In terms of overall clinical efficacy, the observation group was higher than the transdermal group (Z=3.212, P <0.05). Conclusion Under the theory of muscle bone balance, the combination of relaxing muscles and bone setting techniques with traditional Chinese medicine targeted penetration therapy can alleviate symptoms such as pain and numbness in patients with cervical spondylotic radiculopathy (cold dampness obstruction syndrome), improve functional impairment, and correct temperature symmetry imbalance and inflammatory reactions. |
| Key words: Muscle bone balance Shujin Zhenggu technique traditional Chinese medicine targeted permeation cervical spondylotic radiculopathy cold dampness obstruction syndrome |
