CAJ | 학술논문

目的：探讨在神经根型颈椎病治疗过程中实施中医临床路径的效果。方法收集2012年10月至2013年4月郏县中医院颈肩腰腿痛科110例神经根型颈椎病患者，并在治疗中实施中医临床路径：中药溻渍(羌活、当归、防风、红花、白芷、没药、木瓜、透骨草等）-针灸-颈椎牵引-推拿治疗神经根型颈椎病患者，1次/d，10次为1个疗程。2个疗程后统计评分及临床疗效。结果110例患者中，治愈35例（31.82%）、显效53例（48.18%）、有效17例（15.45%）、无效5例（4.55%），总有效率95.45%(105/110）；患者性别（U＝0.023）、年龄（χ2＝0.296）、病程（χ2＝0.577）对临床路径的疗效无显著影响（P＞0.05）；治疗后患者颈部疼痛、颈背疼痛、上肢疼痛、上肢麻木、颈项压痛、颈部活动、椎间孔挤压试验、肢体感觉障碍、上肢肌力、肌腱反射等指标评分均明显改善，与治疗前比较差异有统计学意义（t值分别为16.355、11.958、7.755、4.927、11.780、8.647、10.485、3.190、3.873、3.367，P＜0.05）。结论运用中医临床路径治疗神经根型颈椎病疗效明确，且可提高医疗质量。
목적：탐토재신경근형경추병치료과정중실시중의림상로경적효과。방법수집2012년10월지2013년4월겹현중의원경견요퇴통과110례신경근형경추병환자，병재치료중실시중의림상로경：중약탑지(강활、당귀、방풍、홍화、백지、몰약、목과、투골초등）-침구-경추견인-추나치료신경근형경추병환자，1차/d，10차위1개료정。2개료정후통계평분급림상료효。결과110례환자중，치유35례（31.82%）、현효53례（48.18%）、유효17례（15.45%）、무효5례（4.55%），총유효솔95.45%(105/110）；환자성별（U＝0.023）、년령（χ2＝0.296）、병정（χ2＝0.577）대림상로경적료효무현저영향（P＞0.05）；치료후환자경부동통、경배동통、상지동통、상지마목、경항압통、경부활동、추간공제압시험、지체감각장애、상지기력、기건반사등지표평분균명현개선，여치료전비교차이유통계학의의（t치분별위16.355、11.958、7.755、4.927、11.780、8.647、10.485、3.190、3.873、3.367，P＜0.05）。결론운용중의림상로경치료신경근형경추병료효명학，차가제고의료질량。
Objective To investigate the effect of treating cervical spondylotic radiculopathy with traditional Chinese medicine. Methods 110 patients with cervical spondylotic radiculopathy were treated with traditional Chinese medical pathway: Chinese herbal medicine soaking (incised notoptetygium rhizome, Chinese angelica, divaricate saposhnikovia root, safflower, dahurian angelica root, myrrh, common floweringqince fruit, and tuberculate speranskia herb, etc.)-Acupuncture-cervical traction-massage, once daily, 10 times as a course of treatment. After two courses, therapeutic effect score was analyzed. Results Of all 110 cases, 35 cases(31.82%)were cured; 53 cases(48.18%)had obvious effectiveness; 17 cases(15.45%)had effectiveness; 5 cases(4.55%)had no effectiveness. The total efficiency was 95.45%. The patient's age(χ2=0.296), sex(U=0.023), and duration of disease(χ2=0.577)had no significant effect on the efficacy(P>0.05);After the treatment, neck pain, upper extremity pain, upper extremity numbness, neck tenderness, intervertebral foramina compression test, sensory disturbances limbs, myodynamia of upper limbs, and tendon reflexes were significantly improved compared with before treatment, with significant difference(t=16.355、11.958、7.755、4.927、11.780、8.647、10.485、3.190、3.873、3.367,P<0.05). Conclusion The use of traditional Chinese medicine clinical pathway in treating cervical spondylotic radiculopathy was effective and it could improve the quality of medical care.