Abstract:

Objective　To observe the therapeutic effect of fast filiform needling method to improve the upper limb dysfunction in patients with cervical spondylotic radiculopathy. Methods　This study was a randomized controlled trial. A total of 72 patients with cervical spondylotic radiculopathy admitted to Lianyungang Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2021 to December 2022 were divided into two groups according to the block randomization method. In the experimental group, there were 20 males and 16 females, aged (47.94±6.16) years, with the course of disease of (27.25±9.49) months. In the control group, there were 18 males and 18 females, aged (46.73±5.14) years, with the course of disease of (26.02±7.58) months. The experimental group was treated with fast filiform needling method, and the penetrating release stimulation was given to the neck soft tissue injury site, once every other day, and alternately with massage treatment, 6 times in each group. The control group was treated with traditional acupuncture, once a day, 6 times as a course of treatment, and rested for 1 day every other course of treatment, for a total of 2 courses of treatment. The Tanaka Jingjiu cervical symptom score and cervical dysfunction index (NDI) were compared between the two groups 1 day before treatment and 1 day after treatment, and the clinical efficacies of the two groups were evaluated. t test and χ² test were used. Results　Compared with those 1 day before treatment, the Tanaka Jingjiu cervical symptom scores in both groups were increased on the 1st day after treatment [(14.93±2.74) points vs. (9.70±2.45) points in the experimental group and (12.70±2.93) points vs. (9.40±2.01) points in the control group], but the NDI scores were decreased [(15.92±4.21) points vs. (38.19±5.86) points in the experimental group and (25.46±3.84) points vs. (36.76±7.25) points in the control group], with statistically significant differences (all P<0.05). The improvement of scores of the experimental group was better than that of the control group [Tanaka Jingjiu cervical symptom score: (5.23±1.89) points vs. (3.30±1.25) points, NDI score: (22.27±4.67) points vs. (11.30±3.97) points, both P<0.05]. The total effective rate of the experimental group was higher than that of the control group [91.7% (33/36) vs. 72.2% (26/36)], with a statistically significant difference (χ²=4.560, P=0.032). Conclusions　The fast filiform needling method can relieve the clinical symptoms in patients with cervical spondylotic radiculopathy, relieve the patients' pain, achieve the benign regulation of upper limb function, and reduce the impact of disease on living ability. It has certain advantages over traditional acupuncture treatment, and is worthy of further popularization and application in clinic.

Key words:

Cervical spondylotic radiculopathy, Fast filiform needling method, Muscle fascia release, Upper limb function

摘要：

目的　观察毫针速刺法松解肌筋膜改善神经根型颈椎病患者上肢功能障碍的治疗效果。方法　本研究为随机对照试验，纳入2021年1月至2022年12月南京中医药大学连云港附属医院收治的72例神经根型颈椎病患者，以区组随机方法进行分组。试验组36例中男20例，女16例，年龄（47.94±6.16）岁，病程（27.25±9.49）个月；对照组36例中男18例，女18例，年龄（46.73±5.14）岁，病程（26.02±7.58）个月。试验组采用毫针速刺法治疗，针对颈项部软组织损伤部位予以穿透性松解刺激，隔日1次，并与推拿治疗交替进行，各治疗6次；对照组予传统针刺治疗，每日1次，6次为1个疗程，每隔1个疗程休息1 d，共治疗2个疗程。分别于治疗前1 d、治疗结束后第1天比较两组患者的田中靖久颈椎症状评分、颈椎功能障碍指数（NDI），并评定两组临床疗效。采用t检验、χ²检验。结果　与治疗前1 d比较，治疗结束后第1天两组患者的田中靖久颈椎症状评分均升高［试验组（14.93±2.74）分比（9.70±2.45）分，对照组（12.70±2.93）分比（9.40±2.01）分］，NDI评分均降低［试验组（15.92±4.21）分比（38.19±5.86）分，对照组（25.46±3.84）分比（36.76±7.25）分］，差异均有统计学意义（均P<0.05）；且试验组各评分改善程度均优于对照组［田中靖久颈椎症状评分（5.23±1.89）分比（3.30±1.25）分，NDI评分（22.27±4.67）分比（11.30±3.97）分，均P<0.05］。试验组患者的治疗总有效率高于对照组［91.7%（33/36）比72.2%（26/36）］，差异有统计学意义（χ²=4.560，P=0.032）。结论　毫针速刺法松解肌筋膜治疗能够缓解神经根型颈椎病患者的临床症状，减轻患者痛苦，并实现对上肢功能的良性调节，降低疾病对生活能力的影响，相对传统针刺治疗方案具有一定优势，值得在临床上进一步推广应用。

关键词:

神经根型颈椎病, 毫针速刺法, 肌筋膜松解, 上肢功能