Objective: To observe the clinical effect of acupotomy combined with warm needling on cervical spondylotic radiculopathy (CSR) of qi and blood stagnation syndrome.
Methods: A total of 90 CSR patients were randomly divided into an acupotomy group, a warm needling group and a combined treatment group, with 30 cases in each group. The patients in the acupotomy group were treated with acupotomy, once every 7 days, consecutively for 3 times. The patients in the warm needling group received warm needling, once daily, at the interval of 2 days after consecutive treatments for 5 days, 7 days as one session of treatment and 3 consecutive sessions were required. The patients in the combined treatment group were treated with acupotomy and warm needling, and the methods and the treatment session were same as the the previous two groups. Before and after the treatment, the pain rating index (PRI) of McGill pain questionnaire (MPQ) and the 20-point scale of CSR developed by Yasuhisa Tanaka (CSR20) were adopted in the assessment. The changes of clinical symptoms and functions of patients were observed and the clinical efficacy was assessed in each group.
Results: After the treatment, the PRI score was decreased (P<0.05) and the CSR20 score was increased (P<0.05) in the 3 treatment groups when compared with those before the treatment. After the treatment, compared with the acupotomy group and the warm needling group, the PRI score was decreased (P<0.05) and the CSR20 score was increased (P<0.05) in the combined treatment group. The total effective rate was 83.3% (25/30) in the acupotomy group, 76.7% (23/30) in the warm needling group and 93.3% (28/30) in the combined treatment group. The total effective rate in the combined treatment group was higher than those in the acupotomy group and the warm needling group (P<0.05).
Conclusion: The combined treatment with acupotomy and warm needling may obviously improve the clinical symptoms and physical signs, e.g. pain and numbness in the patients with CSR of qi and blood stagnation syndrome. Its efficacy is remarkably higher than that of the simple application of acupotomy or warm needling.
目的:观察针刀联合温针灸治疗神经根型颈椎病(CSR)气滞血瘀证的临床疗效。方法:将90例CSR患者按随机数字表法分为针刀组、温针灸组、联合组, 每组30例。针刀组单独应用针刀治疗, 每7 d治疗1次, 连续治疗3次;温针灸组单独应用温针灸治疗, 每天1次, 连续治疗5 d后休息2 d, 7 d为1个疗程, 连续治疗3个疗程;联合组给予针刀联合温针灸治疗, 方法及疗程同前。分别于治疗前后采用McGill疼痛问卷表中的疼痛分级指数(PRI)、田中靖久颈椎病量表20分法(CSR20)进行评分, 并评价各组患者的临床疗效。结果:与本组治疗前比较, 治疗后各组CSR患者PRI评分均降低(P<0.05), CSR20评分均升高(P<0.05)。治疗后与针刀组、温针灸组比较, 联合组PRI评分降低(P<0.05), CSR20评分升高(P<0.05)。针刀组总有效率为83.3%(25/30), 温针灸组总有效率为76.7%(23/30), 联合组总有效率为93.3%(28/30), 联合组总有效率高于针刀组及温针灸组(P<0.05)。结论:针刀联合温针灸治疗CSR气滞血瘀证可明显改善患者疼痛麻木等临床症状和体征, 疗效明显优于单纯针刀或温针灸。.
Keywords: Acupotomy; Cervical spondylotic radiculopathy; Qi and blood stagnation syndrome; Warm needling.