小针刀神经根松解术治根性疼痛随机双盲对照临床研究2012.12.09.docVIP

小针刀神经根管直接松解术治疗根性疼痛随机双盲对照临床研究 田和炳 吴 蓉▲ 李兴勇 蒋小明 郭 旗 谢 弢 石 军 黄德军 四川省德阳市旌阳区中医院（人民医院）康复科，四川德阳618000 ［摘要］目的 评价“小针刀神经根管松解术”治疗根型颈椎病及腰突症的疗效、安全性。方法 将根型颈椎病及腰突症各50例按分层随机双盲对照法分为治疗组及对照组各25例，两组均予针灸、推拿、牵引及中药辨证论治，治疗组加载小针刀神经根管松解术，对照组加载小针刀神经根管假松解术。以无效、疗效不佳而要求结束试验为观察终点，试验中进行症状体征积分及MPQ量表评定、不良事件调查并记录，并随访半年。结果 治疗组疗效均优于对照组（P0.05），但总体治疗时间无显著差异（P0.05），根型颈椎病治疗组小针刀操作中2例出现神经根损伤。腰突症治疗组不良反应较轻，发生率较低。结论 小针刀神经根管松解术治疗腰突症具有显效快、疗效好、安全性高的优点，值得推广。而用于根型颈椎病虽总体疗效有一定优势，但其不良反应较重，潜在风险较高，尚需进一步探索更安全的技术方案。 ［关键词］小针刀神经根管直接松解术；根性疼痛；神经根型颈椎病；腰椎间盘突出症 Clinical Study of DNRCA in Treating Radiculopathy Pain Hebing Tian, Rong Wu▲, Xingyong Li, Xiaoming Jiang, Qi Guo,Tao Xie,Jun Shi,Dejun Huang Rehabilitation Department, The Traditional Chinese Medicine Hospital of Jing yang District, Si chuan, De yang. 618000 ［Abstract］Objective To study the effect and security of neurolysis on radicular canal with acupotomy(DNRCA) treating the radicular type cervical spondylosis and lumbar disc protrusion. Methods 50 cases of the radicular type cervical spondylosis and 50 cases of the lumbar disc protrusion were separately randomly divided into two groups: the treatment group and the control group. On the basis of both groups were all treated with the acupuncture, massage, traction and the Traditional Chinese drugs based on differentiation, the patients of the treatment group were treated with DNRCA but the control group with the pseudo acupotomy. The study was end when the patients felt no effect or aggravated. All patients were evaluated with the cumulative score of the symptoms and signs（SS）, MPQ and the treatment and visiting period. Return visit was lasted half a year after treatment. Results The effect of treatment group was obviously superior to that of the control group(P0.05). The period of treatment had no significant difference between the two groups (P0.05). Nerve damage had occurred in two cases of the radicular type cervical spondylosis treatment group but less adverse event had occurred in the lumbar disc herni