目的 观察筋骨并举手法治疗神经根型颈椎病（cervical spondylotic radiculopathy，CSR）的疗效。方法 将60例CSR患者按随机数字表分为观察组和对照组各30例。对照组采用常规推拿治疗，观察组在常规推拿操作的基础上行筋骨并举手法治疗。治疗前后分别采用视觉模拟评分（visual analogue scale，VAS）和持续疼痛指数（persistent pain index，PPI）评价患者疼痛程度，采用肌电诱发电位仪检测尺神经和正中神经传导速度，采用酶联免疫吸附法检测血清白细胞介素-1（interleukin-1，IL-1）、IL-6、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）水平，并观察两组患者临床疗效。结果 与治疗前比较，两组患者治疗后VAS、PPI评分均显著降低（P＜0.05），尺神经和正中神经传导速度显著升高（P＜0.05），血清IL-1、IL-6、TNF-α含量显著降低（P＜0.05）；观察组患者VAS、PPI评分和血清IL-1、IL-6、TNF-α含量降低程度以及尺神经传导速度升高程度均显著大于对照组（P＜0.05）。结论 国医大师李业甫筋骨并举手法治疗CSR临床疗效确切，能明显缓解患者的疼痛症状，降低患者血清炎症因子水平，促进患者神经修复。
Objective To investigate the clinical effect of tendon-bone manipulation in the treatment of cervical spondylotic radiculopathy (CSR). Methods A total of 60 patients with CSR were randomly divided into observation group and control group, with 30 patients in each group. The patients in the control group were given conventional massage, while those in the observation group were given tendon-bone manipulation in addition to the conventional massage in the control group. Visual analogue scale (VAS) and present pain index (PPI) were used to evaluate the degree of pain before and after treatment; an EMG/EP system was used to measure the nerve conduction velocity of the ulnar nerve and the median nerve; ELISA was used to measure the content of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in serum. Clinical outcome was observed and compared between the two groups. Results After treatment, both groups had significant reductions in VAS and PPI scores (P<0.05), significant increases in the nerve conduction velocity of the ulnar nerve and the median nerve (P<0.05), and significant reductions in serum IL-1, IL-6, and TNF-α (P<0.05); compared with the control group, the observation group had significantly greater reductions in VAS and PPI scores and serum IL-1, IL-6, and TNF-α, as well as a significantly greater increase in the nerve conduction velocity of the ulnar nerve (P<0.05). Conclusion Chinese Medicine Master Li Yefu's tendon-bone manipulation has a marked clinical effect in the treatment of CSR and can significantly alleviate patients' pain symptoms, reduce the serum levels of inflammatory factors, and promote nerve repair.
陈 飞,李业甫,郭庆军,王 坤,倪 璐,蒋 涛,吴志东,陶 龙.李业甫筋骨并举手法治疗神经根型颈椎病临床研究[J].安徽中医药大学学报,2020,39(2):46-49复制