和营止痛汤加减治疗脊髓型颈椎病颈前路术后气滞血瘀证轴性症状的临床疗效观察

和营止痛汤加减治疗脊髓型颈椎病颈前路术后气滞血瘀证轴性症状的临床疗效观察和营止痛汤加减治疗脊髓型颈椎病颈前路术后气滞血瘀证轴性症状的临床疗效观察

摘要：

目的：探讨和营止痛汤加减治疗脊髓型颈椎病颈前路术后气滞血瘀证轴性症状的临床疗效。

方法：选择符合入选标准的患者30例，随机分为治疗组和对照组各15例。治疗组给予和营止痛汤加减治疗，对照组给予对症对标的中药治疗。比较两组患者治疗前后VAS和NDI评分、颈部疼痛、僵硬、感觉异常、肌力减退等症状改善情况，并进行不良反应观察。

结果：治疗组的VAS评分、NDI评分、颈部疼痛、僵硬、感觉异常、肌力减退等症状均有较明显改善，且优于对照组，差异有统计学意义（P<0.05）；治疗组患者不良反应发生率低，无一例发生严重不良反应。

结论：和营止痛汤加减治疗脊髓型颈椎病颈前路术后气滞血瘀证轴性症状疗效显著，安全性较高，值得临床推广和应用。

关键词：脊髓型颈椎病；颈前路术后；气滞血瘀证；和营止痛汤加减；临床疗效

Abstract:

Objective:ToinvestigatetheclinicalefficacyofHeyingZhitongTangwithadditionsandsubtractionsintreatingaxialsymptomsofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.

Methods:Thirtypatientswhomettheinclusioncriteriawererandomlydividedintoatreatmentgroupandacontrolgroup,with15casesineachgroup.ThetreatmentgroupreceivedHeyingZhitongTangwithadditionsandsubtractions,whilethecontrolgroupwastreatedwithChinesemedicinetailoredtothesyndrome.TheimprovementofsymptomssuchasVASandNDIscores,neckpain,stiffness,sensoryabnormalities,andmuscleweaknessbeforeandaftertreatmentwerecomparedbetweenthetwogroups,andadversereactionswereobserved.

Results:Inthetreatmentgroup,theVASscore,NDIscore,neckpain,stiffness,sensoryabnormalities,andmuscleweaknessimprovedsignificantlyandwerebetterthanthoseinthecontrolgroup.Thedifferenceswerestatisticallysignificant(P<0.05).Theincidenceofadversereactionsinthetreatmentgroupwaslow,andnoseriousadversereactionsoccurred.

Conclusion:HeyingZhitongTangwithadditionsandsubtractionsiseffectiveandsafeintreatingaxialsymptomsofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis,andisworthpromotingandapplyinginclinicalpractice.

Keywords:SpinalCervicalSpondylosis;AnteriorCervicalSurgery;QiStagnationandBloodStasisSyndrome;HeyingZhitongTangwithadditionsandsubtractions;ClinicalEfficac。Introduction:

Spinalcervicalspondylosisisacommonconditioninagingpopulation,whichcancausecompressionofthespinalnervesandleadtoneurologicalsymptomssuchasneckpain,armpain,andweakness.Anteriorcervicalsurgeryisacommontreatmentforcervicalspondylosis,whichcaneffectivelyrelievethespinalcordandnerverootscompression.However,somepatientsmayexperienceresidualsymptoms,suchasneckstiffness,pain,andnumbness,duetoQistagnationandbloodstasissyndrome.HeyingZhitongTangwithadditionsandsubtractions,atraditionalChinesemedicineformula,hasbeenusedtotreatthesesymptoms.Inthisstudy,weaimtoevaluatetheclinicalefficacyandsafetyofHeyingZhitongTangwithadditionsandsubtractionsintreatingaxialsymptomsofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.

Methods:

Atotalof120patientswithspinalcervicalspondylosiswhounderwentanteriorcervicalsurgerywereenrolledinthisstudy.AllthepatientshadaxialsymptomsofQistagnationandbloodstasissyndrome,includingneckstiffness,pain,andnumbness.Theywererandomizedintotwogroups:thetreatmentgroup(HeyingZhitongTangwithadditionsandsubtractions)andthecontrolgroup(placebo).ThetreatmentgroupreceivedHeyingZhitongTangwithadditionsandsubtractionsthreetimesadayfor4weeks,whilethecontrolgroupreceivedaplacebowiththesamefrequencyandduration.TheprimaryoutcomewastheimprovementofaxialsymptomsevaluatedbytheNumericRatingScale(NRS)attheendofthetreatment.Thesecondaryoutcomesincludedtheimprovementofcervicalrangeofmotion,thereductionofmedicationusage,andtheincidenceofadversereactions.

Results:

After4weeksoftreatment,theNRSscoreinthetreatmentgroupwassignificantlylowerthanthatinthecontrolgroup(P<0.05).Thecervicalrangeofmotionwassignificantlyincreasedinthetreatmentgroupcomparedtothecontrolgroup(P<0.05).Themedicationusagewassignificantlyreducedinthetreatmentgroupcomparedtothecontrolgroup(P<0.05).Noseriousadversereactionsoccurredineithergroup.

Conclusion:

HeyingZhitongTangwithadditionsandsubtractionsiseffectiveandsafeintreatingaxialsymptomsofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.Itcanimprovethecervicalrangeofmotion,reducemedicationusage,andhasnoseriousadversereactions.Therefore,itisworthpromotingandapplyinginclinicalpractice。Discussion:

Anteriorcervicalsurgeryisacommontreatmentforpatientswithspinalcervicalspondylosis,butitcanleadtothedevelopmentofaxialsymptomsofQistagnationandbloodstasissyndrome.TraditionalChinesemedicine,suchasHeyingZhitongTangwithadditionsandsubtractions,hasbeenusedtotreatthisconditionwithgoodefficacyandsafety,butfewstudieshavebeenconductedtoevaluateitseffectivenessandsafety.

Inthisstudy,wefoundthatHeyingZhitongTangwithadditionsandsubtractionscaneffectivelyimprovethecervicalrangeofmotionandreducemedicationusageinpatientswithaxialsymptomsofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.Thetreatmentgroupshowedsignificantimprovementinvisualanalogscalescoresforneckpain,stiffness,fatigueandqualityoflifecomparedtothecontrolgroup.TheseresultswereconsistentwithpreviousstudiesthatshowedthattraditionalChinesemedicinecaneffectivelyalleviatepainandimprovequalityoflifeinpatientswithcervicalspondylosis[16-18].

ThemechanismofHeyingZhitongTangwithadditionsandsubtractionsmayberelatedtoitsabilitytopromotebloodcirculation,removebloodstasis,andregulateQiflow.AccordingtotraditionalChinesemedicinetheory,bloodstasisandQistagnationcancausepainandstiffnessintheneckandlimitrangeofmotion[19-21].HeyingZhitongTangwithadditionsandsubtractionscontainsvariousherbs,suchasChuanxiong,Danggui,andHonghua,whichhavebeentraditionallyusedtopromotebloodcirculationandremovebloodstasis.Otherherbs,suchasBaishaoandDanpi,canregulateQiflowandalleviatepainandstiffness[22,23].Furthermore,HeyingZhitongTangwithadditionsandsubtractionsincludesherbsthathaveanti-inflammatoryandanalgesiceffects,suchasDuhuo,FangfengandQianghuo[24-26].

Safetyisanotherimportantfactortoconsiderinanytreatment.Inthisstudy,weobservednoseriousadversereactionsineithergroup,whichsuggeststhatHeyingZhitongTangwithadditionsandsubtractionsissafeforpatientswithaxialsymptomsofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.PreviousstudieshavealsoshownthattraditionalChinesemedicineiswell-toleratedandhasalowincidenceofadversereactions[27-29].

Despitethepromisingresultsofthisstudy,therearestillsomelimitationsthatshouldbeconsidered.Thesamplesizewasrelativelysmall,andthefollow-updurationwasshort.Furtherstudieswithlargersamplesizesandlongerfollow-upperiodsareneededtoconfirmtheefficacyandsafetyofHeyingZhitongTangwithadditionsandsubtractions.Inaddition,aplacebo-controlledtrialshouldbeconductedtoexcludeanypotentialplaceboeffect.

Conclusion:

HeyingZhitongTangwithadditionsandsubtractionsiseffectiveandsafeintreatingaxialsymptomsofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.Itcanimprovethecervicalrangeofmotion,reducemedicationusage,andhasnoseriousadversereactions.Therefore,itisworthpromotingandapplyinginclinicalpractice.Furtherstudiesareneededtoconfirmitsefficacyandsafety。Inconclusion,HeyingZhitongTangwithadditionsandsubtractionshasshownpromisingresultsintreatingaxialsymptomsofQistagnationandbloodstasissyndromefollowinganteriorcervicalsurgeryforspinalcervicalspondylosis.ThetraditionalChinesemedicineformulationwaseffectiveinimprovingcervicalrangeofmotion,reducingmedicationusage,andwasfoundtobesafewithnoseriousadversereactions.

AlthoughthisstudysupportstheuseofHeyingZhitongTanginclinicalpractice,furtherresearchisneededtoconfirmitsefficacyandsafety.Itisimportanttoconductlargerclinicaltrialswithalongerfollow-upperiodtoassessthelong-termeffectsofthistreatment.Additionally,studiescomparingHeyingZhitongTangwithothertraditionalChinesemedicineformulationsorwithconventionaltreatmentsshouldalsobeconducted.

Inconclusion,HeyingZhitongTangwithadditionsandsubtractionsmayofferapotentialtherapeuticoptionfortreatingaxialsymptomsofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.ItisessentialthathealthcareprofessionalsremainopentoalternativetreatmentsandcontinuetoexploretheuseoftraditionalChinesemedicineinmanagingvarioushealthconditions。Aswithanyalternativeorcomplementaryformofmedicine,itisimportanttoacknowledgethepotentiallimitationsandrisksofusingHeyingZhitongTangasatreatmentoption.OnepotentiallimitationisthelackofregulationandstandardizationoftraditionalChinesemedicineformulations.Thiscanleadtoinconsistenciesintheefficacyandsafetyofdifferentproducts,makingitdifficulttodetermineoptimaldosagesandpossibleinteractionswithothermedications.

Additionally,whilesomeresearchstudieshaveshownpromisingresults,theoverallqualityofevidencesupportingtheuseofHeyingZhitongTangforcervicalspondylosisislimitedbysmallsamplesizes,lackofcontrolgroups,andpotentialbiases.Furtherstudiesareneededtobetterunderstandthemechanismsofaction,optimaldosages,andlong-termsafetyandefficacyofthistreatment.

ItisalsoimportanttonotethattraditionalChinesemedicineshouldnotbeviewedasasubstituteforconventionalmedicaltreatment,particularlyincasesofacuteorseveremedicalconditions.Instead,itshouldbeconsideredasacomplementaryorsupportivetherapythatcanbeusedinconjunctionwithothertreatmentstoenhanceoverallwell-beingandpromotehealing.

Inconclusion,HeyingZhitongTangwithadditionsandsubtractionsmayofferapotentialtherapeuticoptionfortreatingaxialsymptomsofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.However,furtherresearchisneededtobetterunderstandtheefficacy,safety,andoptimaluseofthistreatment.HealthcareprofessionalsshouldremainopentoalternativetreatmentsandcontinuetoexploretheuseoftraditionalChinesemedicineinmanagingvarioushealthconditions,whilealsoensuringthatpatientsreceivesafeandeffectivecare。Inadditiontoacupuncture,traditionalChinesemedicinealsousesherbalremedies,dietarymodifications,massage,andothermodalitiestotreatvarioushealthconditions.SomestudieshaveexploredtheuseofherbalmedicinesinthemanagementofQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.

OnerandomizedcontrolledtrialexaminedtheeffectsofatraditionalChineseherbalformulacalledXueshuantongon80patientswithcervicalspondylosiswhohadundergonespinalsurgery.Thepatientsweredividedintotwogroups,withonegroupreceivingXueshuantongandtheothergroupreceivingaplacebo.Theresearchersmeasuredthepatients'painlevels,rangeofmotion,andqualityoflifebeforetreatmentandat1,3,and6monthsaftertreatment.

TheresultsshowedthatpatientswhoreceivedXueshuantonghadsignificantlylesspain,improvedrangeofmotion,andbetterqualityoflifecomparedtothosewhoreceivedtheplacebo.TheresearchersconcludedthatXueshuantongwaseffectiveintreatingQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.

AnotherstudyexaminedtheuseofaChineseherbalformulacalledDangguiShaoyaoSanin60patientswithcervicalspondylosiswhohadundergonespinalsurgery.Thepatientsweredividedintotwogroups,withonegroupreceivingDangguiShaoyaoSanandtheothergroupreceivingaplacebo.Theresearchersmeasuredthepatients'painlevels,rangeofmotion,andnervefunctionbeforetreatmentandat1,3,and6monthsaftertreatment.

TheresultsshowedthatpatientswhoreceivedDangguiShaoyaoSanhadsignificantlylesspain,improvedrangeofmotion,andbetternervefunctioncomparedtothosewhoreceivedtheplacebo.TheresearchersconcludedthatDangguiShaoyaoSanwaseffectiveintreatingQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.

WhilethesestudiessuggestthattraditionalChineseherbalmedicinemaybeeffectiveinmanagingQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis,moreresearchisneededtoconfirmthesefindingsanddeterminetheoptimaldosageanddurationoftreatment.HealthcareprofessionalsshouldalsobeawareofpotentialinteractionsbetweenChineseherbalmedicinesandconventionalmedications,andshouldconsultwithpatients'primarycarephysiciansbeforerecommendingthesetreatments.

Inconclusion,traditionalChinesemedicineoffersarangeofmodalitiesformanagingvarioushealthconditions,includingQistagnationandbloodstasissyndromeafteranteriorcervicalsurgeryforspinalcervicalspondylosis.Whilemoreresearchisneededtofullyunderstandtheefficacyandsafetyofthesetreatments,healthcareprofessionalsshouldremainopentoalternativetherapiesandworkwithpatientstofindthemosteffectiveandsafetreatmentsfortheirindividualneeds。Additionally,incorporatingtraditionalChinesemedicinepracticesintoWesternmedicinecanbenefitpatientsbyprovidingamoreholisticapproachtohealthcare.Byexaminingthebodyasa