【作者】 王静；

【导师】 艾炳蔚；

【作者基本信息】 南京中医药大学 ， 针灸推拿学（专业学位）， 2025， 硕士

【摘要】 目的:通过分析针刺结合循经刮痧疗法治疗颈型颈椎病的治疗效果,借此可缩短NTCS患者的治疗疗程,从而提升患者的生活质量,为临床提供更为便捷、更安全有效的治疗手段。方法:本课题研究样本均来自于2023年9月至2024年12月,在仪征市马集镇卫生院中医科门诊、病房,以及南京鼓楼医院集团仪征医院的中医科门诊中,研究选取了 96名符合特定纳入条件的颈型颈椎病患者。这些参与者依据随机单盲对照原则被平均分配至三个组别:对照组1(采用针刺疗法)、对照组2(采取循经刮痧疗法)以及治疗组(结合使用针刺与循经刮痧两种方法),每个小组均包含32名患者,通过记录治疗前后的疼痛视觉模拟评分(VAS)、颈椎功能障碍指数(NDI)及颈椎活动度(CROM)的综合变化情况来评价治疗效果。结果:1、治疗组与对照组在性别、年龄、病程以及治疗前各项指标上没有显著差异(P>0.05),具有可比性。2、治疗后三组患者的VAS评分均较治疗前有降低(P<0.05)。治疗组的VAS评分明显优于对照组1和对照组2,这种差异具有统计学意义(P<0.05),证明针刺与循经刮痧相结合的治疗方法在缓解疼痛方面更有效。3、治疗后三组患者的NDI评分均较治疗前有降低(P<0.05)。治疗组的NDI评分明显优于对照组1和对照组2,这种差异具有统计学意义(P<0.05),证明针刺与循经刮痧相结合的治疗方法在改善颈椎功能、提高生活质量方面更有效。4、治疗后三组患者的CROM评分均较治疗前有提高(P<0.05)。治疗组的CROM评分明显优于对照组1和对照组2,这种差异具有统计学意义(P<0.05),证明针刺与循经刮痧相结合的治疗方法在改善颈椎活动度方面更有效。5、治疗后治疗组总有效率为93.75%,对照组1的总有效率83.871%,对照组2的总有效率87.097%,治疗组的临床有效率优于对照组1和对照组2。结论:1、针刺疗法、循经刮痧疗法、联合疗法均能有效改善NTCS患者的VAS评分、NDI评分、CROM评分。2、针刺与循经刮痧联合应用疗效比单针刺或单循经刮痧能更加有效地改善NTCS患者的相关指标,且总有效率更高,此种安全有效的传统治疗方法,值得临床推广,尤其可面向医疗资源短缺的基层医疗机构。更多还原

【Abstract】 Objective:To analyze the therapeutic effects of acupuncture combined with meridian Gua Sha(scraping)therapy in treating Neck Type Cervical Spondylosis(NTCS),thereby shortening the treatment course for NTCS patients,improving their quality of life,and providing a more convenient,safe,and effective clinical treatment method.Method:The sample of this study was collected from September 2023 to December 2024,covering the outpatient clinic and inpatient wards of the Traditional Chinese Medicine(TCM)Department of Maji Town Community Health Center in Yizheng City and the TCM outpatient clinic of Yizheng Hospital of Nanjing Drum Tower Hospital Group.A total of 96 patients with NTCS who met specific inclusion criteria were selected.Participants were evenly divided into three groups according to the randomized single-blind controlled principle:Control Group 1(received acupuncture treatment),Control Group 2(received meridian Gua Sha therapy),and the Treatment Group(received a combination treatment of acupuncture and meridian Gua Sha therapy).Each group consisted of 32 patients,and all participants underwent two treatment courses(totaling 6 sessions).To evaluate the treatment effects,comprehensive changes in the Visual Analog Scale(VAS),Neck Disability Index(NDI),and Cervical Range of Motion(CROM)scores were monitored before and after treatment.Results:1.Statistical analysis showed no significant differences in sex,age,disease course and indicators before the treatment between the treatment and control groups(P>0.05),indicating good comparability of the data.2.After treatment,both the three groups showed reductions in VAS(P<0.05).The VAS scores of the treatment group were significantly better than those of control group 1 and control group 2,and this difference was statistically significant(P<0.05),indicating that the combined treatment of acupuncture and meridian Gua Sha therapy is more effective in alleviating pain.3.After treatment,all the three groups showed reductions in NDI scores(P<0.05).The NDI scores of the treatment group were significantly better than those of control group 1 and control group 2,and this difference was statistically significant(P<0.05),indicating that the combined treatment of acupuncture and meridian Gua Sha therapy is more effective in improving cervical functions and enhancing quality of life.4.After treatment,all the three groups showed reductions in CROM scores(P<0.05).The CROM scores of the treatment group were significantly better than those of control group 1 and control group 2,and this difference was statistically significant(P<0.05),indicating that the combined treatment of acupuncture and meridian Gua Sha therapy is more effective in improving cervical range of motion.5.After treatment,the total treatment effective rate was 93.75%in the treatment group,83.871%in control group 1,and 87.097%in control group 2.The treatment group demonstrated superior clinical effective rate compared to both control group 1 and control group 2.Conclusion:1.Acupuncture therapy,meridian Gua Sha therapy,and the combined treatment of acupuncture and meridian Gua Sha therapy can all effectively improve VAS scores,NDI scores,and CROM scores in NTCS patients.2.The combined treatment of acupuncture and meridian Gua Sha therapy can improve relevant indicators in NTCS patients compared to the acupuncture therapy or meridian Gua Sha therapy alone,and has a higher overall effective rate.This safe and effective traditional treatment method is worthy of clinical promotion,particularly to primary healthcare institutions with limited medical resources.更多还原