基于腋神经分布针刺治疗神经根型颈椎病肩臂痛的临床研究

[Clinical research of shoulder-arm pain of cervical spondylotic radiculopathy treated with acupunc- ture based on the axillary nerve distribution].

作者信息

Li Yan, Wu Yaochi, Fan Xingliang, Sun Yijun

出版信息

Zhongguo Zhen Jiu. 2016 Feb;36(2):135-8.

Abstract

OBJECTIVE

To compare the difference in the efficacy on cervical spondylotic radiculopathy (CSR) between acupuncture at the acupoints on the axillary nerve distribution and the regular selection of acupoints. Methods Eighty patients of cervical spondylotic radiculopathy were randomized into an observation group and a control group, 40 ca.ses in each one. In the observation group, Jianjing (GB 21), Jianzhen (SI 9), Jianliao (TE 14) , Jianyu (LI 15) , Quyuan (SI 13), Tianzong (SI 11) and the trigger points in the scalpular region were selected along the axillary nerve distribution. The Hegu needling was adopted at the trigger points and stimulated with electric apparatus, continuous wave, 1Hz. In the control group, Dazhui (GV 14), Tianzhu (BL 10), Houxi (SI 3), cervical Jiaji (EX-B 2) were selected and stimulated with the regular acupuncture. Electric stimulation was added at cervical Jiaii (EX-B 2), with continuous wave, 1Hz. The needles were retained for 30 min in the two groups, once every two days and 10 treatments made one session. The efficacy was assessed in one session of treatment. The 20-point scale of CSR developed by Japanese scholar, Tanaka Yasuhisa, and the visual analogue scale (VAS) were adopted to score the clinical symptoms and pain degree before and after treatment in the patients and assess the efficacy of the two groups.

RESULTS

The symptom scores and VAS scores after treatment were improved apparently as compared with those before treatment in the two groups (P<0. 05, P<0. 01), and the results in the observation group were better than those in the control group (both P<0. 05). The total effective rate in the observation group was 85. 0% (34/40), better than 71. 8% (28/39) in the control group (P<0. 05).

CONCLUSION

The acupuncture at the acupoints on the axillary nerve distribution achieves the definite efficacy on CSR, better I than the regular acupuncture at cervical Jiaji (EX-B 2).

摘要

目的

比较腋神经分布区穴位针刺与常规选穴针刺治疗神经根型颈椎病（CSR）的疗效差异。方法：将80例神经根型颈椎病患者随机分为观察组和对照组，每组40例。观察组沿腋神经分布选取肩井（GB 21）、肩贞（SI 9）、肩髎（TE 14）、肩髃（LI 15）、曲垣（SI 13）、天宗（SI 11）及肩胛区激痛点，激痛点采用合谷刺法并通电针，连续波，1Hz。对照组选取大椎（GV 14）、天柱（BL 10）、后溪（SI 3）、颈夹脊（EX - B 2），采用常规针刺，颈夹脊（EX - B 2）加用电针，连续波，1Hz。两组均留针30分钟，隔日1次，10次为1个疗程，1个疗程后评定疗效。采用日本学者田中靖久制定的CSR 20分法及视觉模拟评分法（VAS）对患者治疗前后的临床症状及疼痛程度进行评分，评价两组疗效。结果：两组治疗后症状评分及VAS评分均较治疗前明显改善（P<0.05，P<0.01），且观察组改善情况优于对照组（均P<0.05）。观察组总有效率为85.0%（34/40），优于对照组的71.8%（28/39）（P<0.05）。结论：腋神经分布区穴位针刺治疗神经根型颈椎病疗效确切，优于颈夹脊（EX - B 2）常规针刺。