【摘要】：目的:為了觀察綜合理筋手法配合中藥湯劑蠲痹湯加減在臨床上治療神經(jīng)根(風(fēng)寒濕型)頸椎病的臨床療效。方法:本實(shí)驗(yàn)研究以祖國傳統(tǒng)醫(yī)學(xué)中醫(yī)理論為基礎(chǔ),經(jīng)過認(rèn)真、準(zhǔn)確的中醫(yī)辨證,將神經(jīng)根型頸椎病進(jìn)行辨證,對(duì)凡是西醫(yī)診斷屬神經(jīng)根型頸椎病,中醫(yī)辨證后歸屬風(fēng)寒濕型的疾病即可納入實(shí)驗(yàn)范圍。本項(xiàng)實(shí)驗(yàn)研究擬訂納入患者120例,且全部經(jīng)過嚴(yán)格的納入標(biāo)準(zhǔn)進(jìn)行篩查,按照科研方法,將120例符合納入標(biāo)準(zhǔn)的患者隨機(jī)分為對(duì)照組和觀察組,每組患者各60例,在治療方法上給予對(duì)照組綜合理筋手法治療,觀察組需在與對(duì)照組同樣的綜合理筋手法治療的基礎(chǔ)上給予準(zhǔn)確的中醫(yī)辨證,然后加服中藥處方蠲痹湯加減口服治療,療程為14天,共2個(gè)療程。分別于治療前和治療后對(duì)兩組患者的VAS疼痛評(píng)分、椎活動(dòng)受限改善情況和田中靖久癥狀量表積分情況進(jìn)行測(cè)定,并觀察比較療效,對(duì)于同組病人進(jìn)行治療前后比較,兩組患者治療后組間進(jìn)行比較。結(jié)果:實(shí)驗(yàn)結(jié)果表明觀察組采用綜合理筋手法配合蠲痹湯加減中藥湯劑口服的總有效率達(dá)88.3%;對(duì)照組則僅采用和觀察組相同的綜合理筋手法治療的總有效率為78.3%;觀察組的總有效率明顯高于對(duì)照組,兩者比較具有統(tǒng)計(jì)學(xué)意義(P0.05),同時(shí)也說明針對(duì)神經(jīng)根風(fēng)寒濕型頸椎病兩種不同的治療方法存在著顯著性差異,相比于對(duì)照組,觀察組的優(yōu)勢(shì)較為明顯;其次是兩組對(duì)于改善頸椎關(guān)節(jié)活動(dòng)受限、疼痛與麻木、手指疼痛與麻木、工作和生活能力、手的功能上面均有療效,但觀察組的療效明顯優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:對(duì)于神經(jīng)根風(fēng)寒濕型頸椎病的治療,綜合理筋手法配合蠲痹湯加減中藥湯劑口服取得了較好的臨床療效,對(duì)比單用綜合理筋手法治療在許多癥狀改善等發(fā)面都有良好的效果,整個(gè)實(shí)驗(yàn)過程中也并未出現(xiàn)不良反應(yīng)及副作用,從而證明了本實(shí)驗(yàn)藥物的安全性,在臨床治療上也是值得采用和推廣的有效治療方法,期待針對(duì)神經(jīng)根風(fēng)寒濕型頸椎病的治療取得新的突破。
[Abstract]:Objective: to observe the clinical curative effect of treating cervical spondylosis of nerve root (wind-cold and dampness type) with comprehensive manipulation of muscle and traditional Chinese medicine decoction Juanbi decoction. Methods: on the basis of the traditional Chinese medicine theory of traditional Chinese medicine, this experiment made the syndrome differentiation of nerve root type cervical spondylosis by careful and accurate TCM differentiation, and diagnosed the cervical spondylopathy of nerve root type by western medicine. The disease that belongs to wind, cold and dampness type after syndrome differentiation can be included in the scope of experiment. 120 patients were included in this experimental study, and all were screened by strict inclusion criteria. According to scientific research methods, 120 patients who met the inclusion criteria were randomly divided into control group and observation group, with 60 patients in each group. In the treatment method, the control group was given comprehensive manipulation therapy, and the observation group was treated with traditional Chinese medicine syndrome differentiation on the basis of the same comprehensive treatment as the control group, and then was treated by oral administration of Juanbi decoction, a prescription of traditional Chinese medicine. The course of treatment was 14 days. Before and after treatment, the VAS pain score, the improvement of vertebral movement limitation and the score of Tianzhong Jingjiu symptom scale were measured, and the curative effects were observed and compared before and after treatment, and the same group patients were compared before and after treatment. Comparison was made between the two groups after treatment. Results: the experimental results showed that the total effective rate of the observation group was 88.30.The total effective rate of the observation group was 88.3in addition and subtractive decoction of Juanbi decoction, while the total effective rate of the control group was 78.3%, which was only the same as that of the observation group. The total effective rate of the observation group was significantly higher than that of the control group (P0.05). It also showed that there were significant differences between the two different treatment methods for the nerve root wind-cold and dampness type cervical spondylosis, compared with the control group. The advantages of the observation group were obvious. Secondly, the two groups were effective in improving cervical joint movement limitation, pain and numbness, finger pain and numbness, work and life ability, hand function, but the curative effect of the observation group was significantly better than that of the control group. The difference was statistically significant (P0.05). Conclusion: for the treatment of cervical spondylopathy of nerve root with wind-cold and dampness type, the comprehensive manipulation of regulating tendons combined with Juanbi decoction plus and subtraction of traditional Chinese medicine decoction has obtained better clinical curative effect. Compared with the treatment with comprehensive manipulation of reinforcing muscles alone, it has a good effect on many symptoms, such as improvement of symptoms, and no adverse reactions and side effects occurred in the whole process of the experiment, thus proving the safety of the drugs in this experiment. In clinical treatment is also worthy of use and promotion of effective treatment, looking forward to a new breakthrough in the treatment of nerve root rheumatism and dampness type cervical spondylopathy.
【學(xué)位授予單位】：長春中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R274.9

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