【作者】 关凤嫦（Kuan Fong Seong）；

【导师】 许建安；

【作者基本信息】 南京中医药大学 ， 中医骨伤科学， 2013， 博士

【摘要】 背景与目的：随着我国人口的日益老龄化,颈椎病的发病率呈逐年上升趋势。神经根型颈椎病在颈椎病中占较大比例,本文通过对历年相关文献的回顾和总结,旨在加强对神经根型颈椎病病因病机及治疗方法的认识,并观察非手术综合疗法治疗神经根型颈椎病的临床疗效,为防治神经根型颈椎病提供有效可行的治疗方案。方法：将90例由澳门关栢中医诊疗所收治神经根型颈椎病患者随机分成2组,对照组采用单纯针刺治疗,针刺颈部夹脊穴、大椎、肩井、列缺、合谷、阿是穴等,采用平补平泄针法,留针30min,每日1次。治疗组采用颈椎牵引、针刺疗法(穴位同对照组)、推拿疗法及中药外敷的非手术综合疗法治疗,分别于治疗前和治疗后7d,14d对所有患者疼痛程度、主要症状、总症状、焦虑情绪及中医临床疗效进行判定,并运用SPSS16.0软件对所得数据集临床疗效评定结果进行统计分析。结果：1.治疗组治疗前VAS平均分为7.30,治疗1周时VAS评分为6.52,治疗2周时为5.66；对照组治疗前VAS评分为7.38,治疗1周评分为7.06,治疗2周评分为6.64,方差分析显示VAS评分有显著性差异(P=0.00<0.05),治疗组与对照组的VAS评分比较有显着性差异(P=0.00<0.05),提示治疗组的疼痛缓解程度优于对照组。2.治疗组治疗前症状量表评分为9.56,治疗1周时评分为11.52,治疗2周时评分为12.40；对照组治疗前评分为9.59,治疗1周评分为10.94,治疗2周评分为11.40,方差分析显示症状量表评分有显著性差异(P=0.00<0.05),治疗组与对照组的症状量表评分有统计学意义(P=0.00<0.05),提示治疗组的症状改善优于对照组。3.治疗组治疗前焦虑自评量表积分为55.93,治疗2周时评分为33.26；对照组治疗前评分为55.70,治疗2周评分为32.51,方差分析显示焦虑自评量表积分无显著性差异(P=0.317>0.05)。4.治疗组治愈8例,有显著疗效17例,有效18例,无效2例,总有效率为95.6%；对照组治愈3例,显效16例,有效18例,无效8例,总有效率82.2%。结果显示治疗组总有效率高于对照组,有显著性差异(P=0.044<0.05)。结论：非手术综合疗法可有效消除改善神经根型颈椎病引起的疼痛,上肢放射痛或麻木及感觉障碍和激励减退等症状和体征,疗效明确,且优于单纯针刺治疗,为防止神经根型颈椎病提供了一种有效的治疗手段。更多还原

【Abstract】 Background and Objective:As the population aging increasingly in our country. The morbidity of cervical spondylotic radiculopathy(CSR) has been significantly increasing. By retrieving literatures, the cause of disease pathogenesis and treatment of cervical spondylotic radiculopathy were deeply realized in this paper.To observe the clinical effects of Non-Operative Composite Therapy for CSR. Provide validable scheme in treating CSR.Methods:The research selected90patients who come from Macau GuanBai Chinese medicine clinic and were divided into two groups randomly. Control group and Experiment group. The control treatment group received acupuncture about30minutes to jingjiaji corresponding points, dazhui, jianjing,lieque,hegu and ashi point once a day, the experiment group were given cervical vertebra traction, acupuncture, massage and external application of Chinese medicine, all the patients have to go through on the7day and14day treatment in order to observe the change in the state of the pain degree(VAS), cardinal symptompoints and the clinical symptoms(20score method chart). Then all the data and the clinical effect were analyzed by SPSS16.0.Results:This clinical study has not occurred during an adverse reactions and safety accidents.1. Before the treatment, The experiment group’s average VAS score is7.30, treating one week,the score is6.52, two weeks, the score is diminish to5.66. As same as the experiment group, the control group’VAS score is also reduces gradually. Before the cure, the control group’s mean VAS score is7.38, treating one week,the score is7.06, two weeks, the score is diminish to6.64, Statistic shows the experiment group was better than control group in pain relieving(P<0.05).2. Before the treatment, The experiment group’s average score of symptoms(20score method chart) is9.56, treating one week,the score is11.52, two weeks, the score is rise to12.40. As same as the experiment group, the control group’score is also rise gradually. Before the treatment, The control group’s average score is9.59, treating one week,the score is10.94, two weeks, the score is up to11.40.Statistic shows the experiment group’result was better than control group (P<0.01).3. Before the treatment, The experiment group’s average score of anxiety is55.93, two weeks, the score is33.26.Meanwhile. Before the treatment, The control group’s average score is55.70, two weeks, the score is32.51.Compare with the control group, the anxiety scores of the experiment group did not indicate much differentiation after14day’s treatment(P>0.05).4. In experiment group, Cure case number were8,17cases were markedly effective,18 effective,2ineffective; In control group, Cure case number were3,16cases were markedly effective,18effective,8ineffective, The total effective rate was95.6%in experiment group and82.2%in control group with significant difference.Conelusions:Non-Operative Composite Therapy can relieve the pain which cause by CSR after a fully course.it can effectively change the cervical clinical symptoms and signs of CRS and the pain has good curative effect. And it better than control group.Provide validable scheme in treating CSR.更多还原