本文選題：頸椎病 + 神經(jīng)根型�。� 參考：《福建中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：目的：采用三組不同的方法對神經(jīng)根型頸椎病進行治療,通過其療效的比較與分析研究,為該病的臨床治療提供一種更合理有效的治療方案。方法：本研究采用隨機數(shù)字表法,先將90位患者按照中醫(yī)辨證分型分為風(fēng)寒濕痹型、氣血不足型、氣滯血瘀型和肝腎虧虛型。然后再隨機將90人分成A、B、C3組,每組30人。A組采用針刺配合手法治療,B組采用手法配合理療治療,C組采用針刺配合理療法治療,療程為三個月。以SF-36健康調(diào)查量表及頸椎病治療成績評分表CASCS,輔以X-線檢查,觀察3組不同治療方法的臨床療效。采用統(tǒng)計軟件SPSS-21.0對所收集數(shù)據(jù)進行統(tǒng)計分析,得出結(jié)論。結(jié)果：(1)年齡分組與中醫(yī)辨證分型：從三組的年齡分布來看,患者以35-49歲年齡段占最多；三組中醫(yī)辨證分型中以肝腎虧虛型患者占最多病例,由此可見神經(jīng)根型頸椎病常見于中年及中老年,且多以肝腎虧虛為其主要病機。(2)三組在性別、年齡分布、中醫(yī)辨證分型、治療效果及痛閾(VAS)綜合積分、治療前后癥狀體征比較,經(jīng)統(tǒng)計學(xué)分析均無明顯差異(P0.05),說明三組間具有可比性。(3)通過臨床評價量表評價三組治療神經(jīng)根型頸椎病的效果,A組治療后有效率為72.%,C組有效率為71.4%,B組的為50.7%。(4)三組間的SF-36健康調(diào)查簡表顯示：A組治療后34.57%的有效率,優(yōu)于C組的27.15%及B組的25.71%。(5)三組治療前后的痛閾(VAS)綜合積分結(jié)果相當(dāng),但均顯示疼痛程度上有3度的減輕；A組治療前均數(shù)-治療后均數(shù)為5.87-2.87=3,B組為5.90-3.20=3.7,C組為5.37-2.77=2.6。結(jié)論：針刺配合手法治療比手法配合理療和針刺配合理療的效果更佳,更能有效地緩解神經(jīng)根型頸椎病所引起的疼痛、麻木等臨床癥狀。
[Abstract]:Objective: three groups of different methods were used to treat cervical spondylopathy of nerve root type, and to provide a more reasonable and effective treatment scheme for the treatment of cervical spondylopathy by comparison and analysis of its curative effect. Methods: 90 patients were divided into wind-cold and dampness type, Qi and blood deficiency type, Qi stagnation and blood stasis type and liver and kidney deficiency type according to TCM syndrome differentiation. Then 90 patients were randomly divided into three groups: group A (n = 30) were treated with acupuncture plus manipulation, group B (n = 30) were treated with acupuncture and physiotherapy, group C (n = 30) were treated with acupuncture and therapy for three months. The clinical effects of different treatment methods were observed with SF-36 health survey scale and score scale of treatment score of cervical spondylosis (CASCS), supplemented by X- ray examination. The statistical software SPSS-21.0 was used to analyze the collected data, and the conclusion was drawn. Results (1) Age group and TCM syndrome differentiation: according to the age distribution of the three groups, the majority of the patients were aged 35-49, and the most of the three groups were the patients with deficiency of liver and kidney. It can be seen that cervical spondylosis of nerve root type is common in middle and middle age, and the main pathogenesis of cervical spondylosis is deficiency of liver and kidney as its main pathogenesis. (2) in sex, age distribution, TCM syndrome differentiation, treatment effect and pain threshold VAS-integrated integral, the symptoms and signs before and after treatment are compared. Statistical analysis showed that there was no significant difference between the three groups (P 0.05), indicating that the effectiveness of the three groups in the treatment of cervical spondylosis of nerve root type was evaluated by clinical evaluation scale. The effective rate of group A was 72.30%. The effective rate of group C was 71.4%. The effective rate of group B was 50.7%. A summary of the SF-36 health survey showed that the effective rate was 34.57% in group A after treatment. Compared with group C (27.15%) and group B (25.71%), the scores of VASs before and after treatment were similar, but they showed that there were 3 degrees of pain relief in group A before and after treatment. The mean of group B was 5.90-3.203.73.7C was 5.37-2.772.6. Conclusion: acupuncture combined with manipulation is more effective than manipulation combined with physical therapy and acupuncture combined with physiotherapy, and can effectively relieve the clinical symptoms such as pain and numbness caused by cervical spondylosis of nerve root type.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R274.9
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本文編號：2004497