谌利+杨顺露+杨志华

摘 要 目的：明确健身气功八段锦联合针刺和火罐治疗神经根型颈椎病的临床疗效。方法：收集2013年10月至2014年3月60例神经根型颈椎病患者，随机分为对照组30例，接受针刺和火罐治疗，观察组30例，给予火罐和针灸治疗，并练习健身气功八段锦。两组均治疗3周。在治疗前和治疗1、2、3周时，采用简化McGill疼痛评分表和田中靖久量表进行评估，并比较两组疗效。结果：对照组治疗总有效率为63.30%，观察组为93.30%，组间差异有统计学意义（P<0.05）。治疗后，两组患者疼痛分级评分（PRI）、目测类比定级法（VAS）和现在疼痛程度（PPI）评分均有明显下降，但观察组均优于对照组（P<0.05）。两组生存质量评分亦较前上升（P<0.05），观察组评分提高更为明显。在PRI、VAS、PPI和生存质量评分方面，两组在治疗第2周后组间差异有统计学意义（P<0.05）。结论：健身气功八段锦是辅助治疗神经根根型颈椎病的有效方法，值得在社区推广应用。

关键词 神经根型颈椎病 针刺 健身气功八段锦 时效关系

中图分类号：R247.9/R681.5+5 文献标志码：A 文章编号：1006-1533（2016）22-0029-03

Therapeutic effect of health qigong baduanjin combined with acupuncture and cupping in the treatment of sixty cases of cervical spondylotic radiculopathy

CHEN Li， YANG Shunlu， YANG Zhihua（Juyuan Community Health Service Center of Jiading District， Shanghai 201800， China ）

ABSTRACT Objective： To identify the therapeutic effect of health qigong baduanjin（HQBDJ） combined with acupuncture and cupping in the treatment of cervical spondylotic radiculopathy（CSR）. Methods： From Oct 2013 to March 2014， 60 cases of CSR were collected and randomly divided into a control group with 30 cases who were treated with acupuncture and cupping and an observation group with 30 cases who were treated with HQBDJ in addition to acupuncture and cupping. Both groups were treated for 3 weeks. Before and after 1， 2， and 3 weeks of treatment， the simplified McGill pain questionnaire and Tanaka Yasushi cervical spondylosis symptom Scale were used for evaluation. The efficacies in the two groups were compared. Results： The total effective rates of the control group and the observation group were 63.30%， and 93.30%， and the differences between the groups were statistically significant（P<0.05）. After treatment， the scores of the pain rating score（PRI）， visual analogue scale（VAS） and present pain intensity（PPI） of the two groups of the patients decreased significantly， but the observation group was better than the control group（P<0.05）. The score of quality of life of the two groups was higher than before（P<0.05）， and the score of the observation group was improved more obviously. In terms of the scores of PRI， VAS， PPI and quality of life， there were statistically significant differences between the two groups in the second week of treatment（P<0.05）. Conclusion： HQBDJ is an affective auxiliary method in the treatment of CSR and is worthy of popularization and application in the community.

KEY WORDS cervical spondylotic radiculopathy； acupuncture； health qigong baduanjin； time-effect relationship

神经根型颈椎病（cervical spondy-lotic radiculopathy）是以颈椎间盘退行性改变为病理基础，包括周围肌肉和关节的继发性改变和相邻椎体增生导致神经根受压引起相应节段神经根刺激或功能障碍的疾病[1]。目前，对于神经根颈椎病，西医学以手术和物理治疗为主[2]，以减轻患者的疼痛和功能障碍，但疗效差、容易复发。根据中医理论，神经根颈椎病属于“骨痹”、“痹症”等疾病范畴[3]。因此，行气活血、疏经通络是该病的常见治疗思路[4]。中医治疗神经根型颈椎病方法多样，有针刺[5]、火罐[6]、推拿[7]、小针刀[7]等，养生气功八段锦是其中重要的功法，研究发现其能通过改善人体气血运行，延缓炎症刺激因子的表达[8]。本文报道采用养生气功八段锦联合针灸和火罐治疗神经根颈椎病的疗效。

1 资料与方法

1.1 一般资料

2013年10月—2014年4月，收集上海市嘉定区菊园社区服务中心收治的60例40～60岁神经根型颈椎病患者，均符合《康复医学诊断规范》[9]中神经根型颈椎病的诊断标准。……