不同远端取穴针刺治疗颈型颈椎病的临床随机对照试验

Clinical randomized controlled trial of different distal acupoint selection in the treatment of cervical spondylosis

关键词:  针刺  远端取穴  颈型颈椎病  随机对照研究

Key words:  acupuncture  distal point selection  cervical spondylosis  randomized controlled trial

摘要:

[目的] 探讨不同远端取穴针刺治疗颈型颈椎病的临床疗效。[方法] 选取 2020 年 8 月—2022 年 4 月在天津市天津医院接受治疗的颈型颈椎病患者 147 例， 按 1∶1∶1 比例随机分为治疗 1 组（局部联合后溪穴针刺）， 治疗 2 组（局部联合合谷穴针刺）和对照组（仅局部针刺）。3 组患者均接受治疗 2 周治疗后随访 1 个月。比较两组患者简式麦吉尔疼痛问卷（ MPQ）评分、颈椎功能障碍指数量表（ NDI）评分、生活质量评价量表（ SF-36）评分和总有效率。[结果] 3 组患者在治疗后和随访时的 MPQ 评分、NDI 评分、SF-36 评分均优于治疗前（P＜0.05）； 治疗组 1 和治疗 2 组在治疗后和随访时的 MPQ 评分、NDI 评分优于对照组， 差异具有统计学意义（P＜0.05）； 治疗 1 组在治疗后的 MPQ 评分、NDI 评分优于治疗 2 组， 差异具有统计学意义（P＜0.05）， 随访时两组没有统计学差异（P＞0.05）； 3 组患者在治疗后和随访时的 SF-36 评分均无统计学差异（P＞0.05）； 在总有效率方面， 治疗 1 组优于对照组， 差异具有统计学意义（P<0.05）， 治疗 1 组与治疗 2 组、治疗 2 组与对照组比较， 差异无统计学意义（P>0.05）。[结论] 局部取穴联合后溪穴远端取穴治疗颈型颈椎病的疗效最好， 远期疗效可靠。

Abstract:

[Objective] To investigate the clinical efficacy of different distal acupoint selection in the treatment of cervical spondylosis. [Methods] A total of 147 patients with cervical spondylosis who received treatment in our hospital from August 2020 to April 2022 were randomly divided into treatment group 1（local acupoint selection combined with Houxi），treatment group 2（local acupoint selection combined with Hegu） and control group （local acupoint selection only） at a ratio of 1∶1∶1. All patients in the three groups were treated for 2 weeks and followed up for 1 month. The score of simple McGill Pain Questionnaire（MPQ），cervical Spine Dysfunction Index Scale （NDI），Quality of Life Assessment Scale（SF-36） and total response rate were compared between the two groups. [Results] The MPQ score，NDI score and SF-36 score of the three groups after treatment and during follow-up were all better than before treatment （P<0.05）. MPQ scores and NDI scores of treatment groups 1 and 2 were better than those of control group after treatment and at follow-up （P<0.05）. The MPQ score and NDI score of treatment group 1 were better than those of treatment group 2 after treatment（P<0.05），and there was no statistical difference between the two groups at follow-up （P>0.05）. There were no significant differences in SF-36 scores among the three groups after treatment and at follow-up（P>0.05）. In terms of total effective rate，treatment group 1 was better than control group（P< 0.05），but there was no statistical difference between treatment group 1 and treatment group 2，and between treatment group 2 and control group（P>0.05）. [Conclusion] Local acupoint selection combined with distal acupoint selection at Houxi has the best curative effect in the treatment of cervical spondylosis，and the long-term curative effect is reliable.