«上一篇/Previous Article|本期目錄/Table of Contents|下一篇/Next Article»

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:

第24卷

期數(shù):

2012年03期

頁碼:

20-22

欄目:

臨床研究

出版日期:

2012-03-01

文章信息/Info

Title:

Observation on the curative effect of typing and staging treatment on cervicogenic shoulder and back pain

作者:

陳鵬¹; 金肖青¹; 范炳華²; 鄭勝明¹; 胡軍飛¹

1.浙江醫(yī)院,浙江 杭州 310013;
2.浙江中醫(yī)藥大學(xué)附屬第三醫(yī)院,浙江 杭州 310009

Author(s):

CHEN Peng^*; JIN Xiao-qing; FAN Bing-hua; ZHENG Sheng-ming; HU Jun-fei.^*

Zhejiang Hospital,Hangzhou 310013,Zhejiang,China

關(guān)鍵詞:

肩痛 背痛 頸椎病 椎間盤移位 受體; 白細胞介素1Ⅱ型;  白細胞介素6;  腫瘤壞死因子類;  治療; 臨床研究性

Keywords:

Shoulder pain;  Back pain;  Cervical spondylosis;  Intervertebral disk displacement;  Receptors; interleukin-1 type Ⅱ;  Interleukin-6;  Tumor necrosis factors;  Therapies; investigational

摘要:

目的:觀察分型分期治療頸源性肩背痛的臨床療效。方法:采用隨機數(shù)字表將符合要求的76例頸源性肩背痛患者隨機分為 治療組和對照組,每組38例。治療組按照分型分期原則治療:頸椎間盤源型患者,急性期采用手法配合藥物治療,緩解期采用手法 治療; 頸椎椎體失穩(wěn)型患者,采用手法治療。對照組采用牽引配合藥物治療。分別于治療前和治療結(jié)束后采用酶聯(lián)免疫吸附法測 定所有患者血清中白細胞介素-1β受體拮抗劑、白細胞介素-6及腫瘤壞死因子的濃度; 同時于治療后以參照《中醫(yī)病證診斷療 效標準》中頸椎病的療效標準擬定的臨床療效評定標準評定患者的臨床療效。結(jié)果:①白細胞介素-1β受體拮抗劑濃度。治療前 2組患者血清白細胞介素-1β受體拮抗劑濃度比較,差異無統(tǒng)計學(xué)意義(t=1.021,P=0.308); 治療后2組患者血清白細胞介素-1β 受體拮抗劑濃度均增加,治療組的增加程度大于對照組(t=3.477,P=0.001)。②血清白細胞介素-6濃度。治療前2組患者血清白細 胞介素-6濃度比較,差異無統(tǒng)計學(xué)意義(t=0.497,P=0.621); 治療后2組患者血清白細胞介素-6濃度均降低,治療組的降低程度大 于對照組(t=2.637,P=0.010)。③血清腫瘤壞死因子濃度。治療前2組患者血清腫瘤壞死因子濃度比較,差異無統(tǒng)計學(xué)意義 (t=1.547,P=0.126); 治療后2組患者血清腫瘤壞死因子濃度均降低,治療組的降低程度大于對照組(t=2.201,P=0.031)。④臨床 療效。2組患者臨床療效比較,治療組優(yōu)于對照組(Z=-2.230,P=0.020)。結(jié)論:分型分期治療能提高頸源性肩背痛患者血清中白細 胞介素-1β受體拮抗劑的濃度,降低白細胞介素-6和腫瘤壞死因子的濃度,臨床療效顯著,是治療頸源性肩背痛的有效方法。

Abstract:

Objective:To observe the clinical curative effect of typing and staging treatment on cervicogenic shoulder and back pain.Methods:Seventy-six patients with cervicogenic shoulder and back pain were randomly divided into treatment group and control group according to the random number table,38 cases in each group.Patients in the treatment group were treated according to the following typing and staging principles as:cases in cervical discogenic type were administrated with manipulation combined with medicine in the acute stage and were administrated with manipulation during catabasis; while the others in cervical vertebral instability type were administrated with manipulation.And patients in the control group were treated by traction combined with medicine.The concentration of interleukin-1beta(IL-1beta)receptor antagonist,interleukin-6(IL-6)and tumor necrosis factor(TNF)in blood serum of all the patients were measured according to enzyme linked immunosorbent assay before and after the treatment respectively.And the clinical curative effects were evaluated according to the self-designed evaluation standards of the curative effects for cervical spondylosis referring to the standards specified in Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes after the treatment.Results:①Concentration of IL-1beta receptor antagonist:There was no statistical difference in the concentration of IL-1beta receptor antagonist between the 2 groups before the treatment(t=1.021,P=0.308); while the concentration of IL-1beta receptor antagonist of the 2 groups were all increased after the treatment,and the increasing degree of treatment group was higher than that of the control group(t=3.477,P=0.001).②IL-6 concentration:There was no statistical difference in IL-6 concentration between the 2 groups before the treatment(t=0.497,P=0.621); while the IL-6 concentration of the 2 groups were all decreased after the treatment,and the reducing degree of treatment group was higher than that of the control group(t=2.637,P=0.010).③TNF concentration:There was no statistical difference in TNF concentration between the 2 groups before the treatment(t=1.547,P=0.126); while the TNF concentration of the 2 groups were all decreased after the treatment, and the reducing degree of treatment group was higher than that of the control group (t=2.201,P=0.031).④Clinical curative effect:The clinical curative effect of treatment group was better than that of the control group(Z=-2.230,P=0.020).Conclusion:Typing and staging treatment can improve the concentration of IL-1beta receptor antagonist and reduce the concentration of IL-6 and TNF in blood serum of patients with cervicogenic shoulder and back pain while,and it is an effective method for cervicogenic shoulder and back pain.

備注/Memo

備注/Memo:

2011-01-04收稿 2011-04-18修回
基金項目:浙江省中醫(yī)藥青年課題研究計劃(2009YA015)

常用功能

更新日期/Last Update: 2012-03-30