Abstract:

Objective　To observe the efficacy and safety of visual acupotomy assisted with nonsteroidal anti-inflammatory drugs in the treatment of patients with cervical spondylosis. Methods　One hundred and six patients with cervical spondylosis treated at First Hospital, Nanyang Medical College were selected for the randomized controlled trial, and were divided into a conventional group and an acupotomy group by the random number table method. There were 30 males and 23 females in the conventional group; they were (35.44±5.17) years old. There were 31 males and 22 females in the acupotomy group; they were (36.15±5.22) years old. The conventional group were treated with manual manipulation and nonsteroidal anti-inflammatory drugs, and the acupotomy group with visual acupotomy and nonsteroidal anti-inflammatory drugs. The pain relief, improvement in cervical mobility, and improvement in cervical physiological structure and function before and after the treatment and incidences of complications were compared between the two groups. t and χ² tests were applied. Results　The scores of Visual Analogue Scale (VAS) 1, 2, and 4 weeks after the treatment in the acupotomy group were lower than those in the conventional group [(4.55±1.27) vs. (5.65±2.08), (3.24±0.38) vs. (4.41±1.09), and (2.56±0.21) vs. (3.07±0.46)], with statistical differences (t=3.286, 7.379, and 7.343; all P<0.05). After the treatment, the cervical spine flexion activity, backward extension activity, and left and right rotation activity in the acupotomy group were higher than those in the conventional group [(62.41±10.27)° vs. (55.46±10.27)°, (60.45±10.24)° vs. (54.33±10.25)°, and (45.22±10.36)° vs. (39.16±10.21)°], with statistical differences (t=3.484, 3.075, and 3.046; all P<0.05). After the treatment, the Cobb angle of cervical spine, the curvature of cervical spine, and the score of Japanese Orthopedic Association (JOA) in the acupotomy group were higher than those in the conventional group [(18.24±4.41)° vs. (15.45±4.36)°, (7.63±2.25)° vs. (6.42±2.07)°, and (23.36±5.41) vs. (20.18±5.22)], with statistical differences (t=3.275, 2.881, and 3.080; all P<0.05). There was no statistical difference in the incidence of complications between the acupotomy group and the conventional group [11.32% (6/53) vs. 7.55% (4/53); χ²=0.832; P=0.362]. Conclusions　Visual acupotomy assisted with nonsteroidal anti-inflammatory drugs in the treatment of patients with cervical spondylosis can effectively relieve their pain and has positive significance in promoting their recovery of cervical activity, physiological structure, and function. This treatment does not significantly increase the risk of related complications, with high safety.

Key words:

Nonsteroidal anti-inflammatory drugs, Cervical spondylosis, Visual needle knife, Cervical structure, Cervical function

摘要：

目的　观察可视化针刀辅助非甾体抗炎药治疗颈型颈椎病的效果及安全性。方法　本研究为随机对照试验，选取2022年1月至12月南阳医学高等专科学校第一附属医院收治的106例颈型颈椎病患者作为研究对象，采用随机数字表法分为常规组（53例）和针刀组（53例）。常规组男30例、女23例，年龄（35.44±5.17）岁，予以手法推拿辅助非甾体抗炎药治疗；针刀组男31例、女22例，年龄（36.15±5.22）岁，采用可视化针刀辅助非甾体抗炎药治疗。对比两组患者治疗前后的疼痛缓解情况、颈椎活动度改善情况、颈椎生理结构及功能改善情况、并发症发生情况。统计学方法采用t检验、χ²检验。结果　治疗1周、2周、4周后，针刀组的视觉模拟评分法（VAS）评分［（4.55±1.27）分、（3.24±0.38）分、（2.56±0.21）分］均低于常规组［（5.65±2.08）分、（4.41±1.09）分、（3.07±0.46）分］，差异均有统计学意义（t=3.286、7.379、7.343，均P<0.05）。治疗后，针刀组的颈椎前屈活动度［（62.41±10.27）°］、后伸活动度［（60.45±10.24）°］、左右旋转活动度［（45.22±10.36）°］均高于常规组［（55.46±10.27）°、（54.33±10.25）°、（39.16±10.21）°］，差异均有统计学意义（t=3.484、3.075、3.046，均P<0.05）。治疗后，针刀组的颈椎Cobb角［（18.24±4.41）°］、颈椎曲度［（7.63±2.25）°］、日本骨科协会评估治疗分数（JOA）［（23.36±5.41）分］均高于常规组［（15.45±4.36）°、（6.42±2.07）°、（20.18±5.22）分］，差异均有统计学意义（t=3.275、2.881、3.080，均P<0.05）。针刀组治疗相关并发症发生率与常规组比较［11.32%（6/53）比7.55%（4/53）］，差异无统计学意义（χ²=0.832，P=0.362）。结论　可视化针刀辅助非甾体抗炎药治疗颈型颈椎病能有效缓解患者疼痛，对促进颈椎活动度、生理结构及功能恢复均有积极意义，此疗法未明显增加相关并发症发生风险，安全性较高。

关键词:

非甾体抗炎药, 颈型颈椎病, 可视化针刀, 颈椎结构, 颈椎功能