温经通络药枕联合牵引治疗神经根型颈椎病的临床研究(硕士)(论文17000字)
Clinical Research on the Treatment
of Cervical SpondyloticRadiculo
-pathy by Warming and Activating
MeridianChinese Medicine Pillow
with Traction Therapy
中文摘要
目的：本课题拟将自制温经通络药枕联合牵引与单纯使用颈椎牵引疗法治疗神经根型颈椎病进行临床治疗效果的观察及对比，验证温经通络药枕对神经根型颈椎病治疗的临床疗效，为患者提供一种方便快捷、价格低廉、安全有效的治疗方法。
方法：①收集并整理神经根型颈椎病临床治疗方法的文献资料，并对该资料进行分析总结。②选取2017年1月至2017年10月期间江西中医药大学附属医院骨科神经根型颈椎病患者作为研究对象，将符合纳入标准的60例神经根型颈椎病患者，随机分为治疗组及对照组两组，每组各30例患者。治疗组选用自制温经通络药枕联合牵引治疗，对照组单纯使用颈椎牵引疗法治疗。两组治疗疗程均为2周。两组患者在开始治疗前、治疗结束时（2周）及治疗结束后3个月分别进行指标观察。最后利用SPSS 17.0软件包进行数据处理，得出研究结果。
结果：①治疗结束时，治疗组30例病人中，共有12例患者治愈，11例患者显效，6例患者有效，1例患者无效；对照组30例病人中，共有5例患者治愈，11例患者显效，10例患者有效，4例患者无效。治疗组有效率为96.7%，对照组有效率为90%，经t检验P<0.05，具有显著性差异，说明温经通络药枕联合牵引比单纯使用牵引疗法疗效更优。②治疗后3个月，治疗组与对照组NDI评分及临床症状体征改善情况比较有显著性差异（P<0.05），说明温经通络药枕联合牵引比单纯使用牵引疗法具有更好的远期疗效。
结论：药枕联合牵引治疗神经根型颈椎病安全有效，具有良好的近期和远期疗效，能显著改善和缓解神经根型颈椎病的临床症状及体征；同时，中药外治法还避免了口服西药带来的毒副作用。此法方便简单、经济实惠，患者乐于接受，治疗依从性高，可以在临床上大力推广应用。
关键词：药枕；牵引；神经根型颈椎病；治疗；临床研究
Clinical Research on the Treatment of Cervical Spondylotic Radiculopathy by Warming and Activating Meridian Chinese Medicine Pillow with Traction Therapy
[Abstract]
Objective:This paper will be made warming and activating meridian Chinese medicine pillow combined with traction and simple traction treatment of nerve root type cervical spondylosis clinical curative effect observation, comparison, clinical verification warming and activating meridian Chinese medicine pillow for treating cervical spondylotic radiculopathy, to provide convenient, economical and effective method for the treatment of patients.
Methods:①The literature of the clinical treatment of cervical spondylotic radicular spondylosis was collected and arranged in the early stage, and the data were analyzed and summarized.②From January 2017 to October 2017, patients with cervical spondylotic radicular disease in Department of orthopedics affiliated to Jiangxi University of traditional Chinese medicine were selected as subjects.60 patients who met the inclusion criteria were randomly divided into treatment group and control group, two cases, 30 cases in each group. The treatment group used pillow combined with traction therapy, the control group used traction therapy. The two groups were treated for 2 weeks. The two groups were observed before the beginning of treatment, at the end of the treatment (2 weeks) and 3 months after the end of the treatment. At last, data processing is carried out by SPSS 17.0 software package, and the results are obtained.
Results:①At the end of the treatment, 30 cases in the observation group were cured, 12 cases were cured, 11 cases were markedly effective, 6 cases were effective, 1 cases were invalid, 30 cases in the control group were cured, 5 cases were effective, 11 cases were effective, 10 cases were effective, and 4 cases were invalid. The observation group was 96.7%, the control group was 90%, by t test P<0.05, with significant differences, indicating the meridians of traditional Chinese medicine combined with traction pillow is better than the simple use of traction therapy.②After 3 months of treatment, the treatment group had significant difference compared with the control group the improvement of NDI score and clinical symptoms and signs (P<0.05), which shows that the long-term curative effect of Tongluo Chinese medicine pillow combined with traction is better than using traction therapy alone.
Conclusion:Chinese herbal medicine pillow with tractionfor treating nerve root type cervical spondylosis is safe and effective, with good short-term and long-term effectiveness, clinical symptoms and signs can significantly improve and alleviate the nerve root type cervical spondylosis,external medicine and avoid the side effects of oral administration of Western medicine. This method is economical and simple, and the compliance of patients is high. It is worth popularizing in clinical practice.
Keyword：Chinese medicine pillow；Tractiontherapy；Cervical Spondylotic Radiculopathy（CSR）；Treatment；Clinical Research
目 录
引 言 1
历史回顾 3
1.现代医学对神经根型颈椎病的认识 3
2.现代医学对神经根型颈椎病的治疗 4
3.祖国传统医学对神经根型颈椎病的认识 5
4.祖国传统医学对神经根型颈椎病的治疗 6
5.睡枕法治疗颈椎病的现状 8
正文 9
1.临床资料 9
1.1病例来源 9
1.2诊断标准 9
1.3纳入标准 9
1.4排除标准 9
1.5中止和退出临床标准 10
1.6签署知情同意书 10
2.临床研究方法及评定标准 11
2.1随机分组 11
2.2研究方法 11
2.3临床观察 12
2.4统计方法 13
2.5技术路线图 13
3.研究结果 14
3.1患者年龄分布情况（见表1） 14
3.2患者性别分布情况（见表2） 14
3.3患者体重分布情况（见表3） 14
3.4患者病程分布情况（见表4） 14
3.5患者总疗效比较（见表5） 14
3.6患者各疗程NDI评分的比较（见表6） 15
3.7不良反应 15
3.8结论 15
讨 论 16
1.颈椎病的中西医认识 16
2.恢复颈椎正常生理弧度的临床意义 16
3.颈椎病的治疗现状 17
4.温经通络药枕设计思路 18
5.温经通络药枕的治疗机理 19
6.预防保健操的作用机理 20
7.存在的问题与展望 20
结 论 21
参考文献 22 |
