目的:探讨影响针刺治疗颈椎病颈痛疗效的主要因素,为进一步提高针灸疗效提供参考依据。方法:将106例患者随机分为观察组(53例)、对照组(53例)。观察组接受常规针刺治疗,穴取大椎、颈百劳、肩中俞;对照组接受假穴位治疗,针刺点为百劳、肩中俞穴位各向外旁开1cm。两组均留针20min,期间予以红外线照射辅助治疗。采用颈痛量表(Northwick Park Neck Pain Ques-tionnaire,NPQ)评价患者治疗前后的生存质量并比较两组疗效,对各种有可能影响疗效的因素进行Logistic回归分析。结果:观察组的有效率为75.5%,对照组为52.8%,两组疗效差异有统计学意义(P<0.05)。Logistic回归分析提示,常规穴位针刺的疗效优于假穴位对照组(OR=2.670),患者既往的颈痛发作频率(OR=1.055)和发作持续时间(OR=2.446)均对疗效有影响。结论:针刺对于治疗颈椎病颈痛具有较好的疗效,患者既往的颈痛发作频率和持续时间是影响临床疗效的因素。
Objective To explore the main factors influencing the therapeutic effect of acupuncture on neck pain caused by cervical spondylosis, so as to provide references for further increasing the therapeutic effect of acupuncture. Methods One hundred and six cases were randomly divided into an observation group and a control group, 53 cases in each group. The observation group was treated with routine acupuncture at Dazhui （大椎GV 14）, Jingbailao （颈百劳 EX-HN 15） and Jianzhongshu （肩中俞 SI 15）; and the control group was treated with sham acupuncture at 1 cm lateral to Jingbailao （颈百劳 EX-HN 15） and Jianzhongshu （肩中俞 SI 15）. The needles were retained for 20 min in the two groups and infrared radiation was used for adjuvant treatment in this period. Northwick Park Neck Pain Questionnaire （NPQ） was used to assess the patients＇ quality of life before and after the treatment and compare the therapeutic effect between two groups. The potential influential factors were analyzed by Logistic regression. Results The effective rate was 75.5% in the observation group and 52.8% in the control group with a significant difference between the two groups （P〈0.05）. The Logistic regression analysis indicated that the therapeutic effect in the observation group was superior to that of the control group （OR=2.670）, and both the attack frequency and duration of the neck pain would influence the therapeutic effect （OR=1.055 and OR=2.446）. Conclusion Acupuncture has a preferable therapeutic effect on neck pain caused by cervical spondylosis, and patient＇s clinical history about attack frequency and duration of neck pain are factors influencing clinical therapeutic effect.
