目的 探討根痛平顆粒聯(lián)合穴位注射腺苷鈷胺治療神經(jīng)根型頸椎病的臨床療效。方法 選取2018年1月—2020年1月在安陽市第六人民醫(yī)院進行治療的82例神經(jīng)根型頸椎病患者，根據(jù)治療措施的差別分為對照組和治療組，每組41例。對照組將1 mg注射用腺苷鈷胺同0.9%氯化鈉注射液2 mL配伍，然后分別對風(fēng)池穴、后溪穴進行消毒，垂直進針，回抽無回血，每個穴位注射1 mL，5次/周，間歇2 d進行下1周期；治療組在對照組基礎(chǔ)上口服根痛平顆粒，12 g/次，2次/d。兩組均經(jīng)14 d治療。觀察兩組的臨床療效，比較臨床癥狀改善時間、相關(guān)評分和炎癥介質(zhì)。結(jié)果 治療后，治療組總有效率97.56%，顯著高于對照組的80.49%（P<0.05）。經(jīng)治療，治療組在頸肩疼痛、上肢疼痛麻木、手指疼痛麻木及感覺異常等癥狀改善時間上短于對照組（P<0.05）。經(jīng)治療，兩組頸椎病臨床評價量表（CASCS）評分顯著升高，但疼痛（VAS）評分、頸痛量表（NPQ）評分、匹茨堡睡眠質(zhì)量指數(shù)量表（PSQI）評分、頸椎功能障礙指數(shù)（NDI）評分均顯著降低（P<0.05），且治療后，治療組相關(guān)評分優(yōu)于對照組（P<0.05）。經(jīng)治療，兩組血清白細胞介素-1β（IL-1β）、前列腺素E₂（PGE₂）、白細胞介素-6（IL-6）、環(huán)氧化酶-2（COX-2）均顯著降低（P<0.05）；治療后，治療組炎癥介質(zhì)水平低于對照組（P<0.05）。結(jié)論 根痛平顆粒聯(lián)合穴位注射腺苷鈷胺治療神經(jīng)根型頸椎病可有效改善患者臨床癥狀，調(diào)節(jié)機體炎癥反應(yīng)，改善頸椎活動障礙，促進患者心理彈性及睡眠質(zhì)量的提高，有著良好的臨床應(yīng)用價值。

Objective To investigate the clinical efficacy of Gentongping Granules combined with cobamamide in treatment of cervical spondylopathy of radiculopathy. Methods A total of 82 patients with cervical spondylotic radiculopathy treated in Anyang People's Hospital No.6 from January 2018 to January 2020 were selected and divided into control group and treatment group according to treatment measures (41 cases in each group). Patients in the control group were given Cobamamide for injection, 1 mg Cobamamide for injection was mixed with 0.9% sodium chloride injection 2 mL, and then Fengchi and Houxi acupoints were disinfected respectively. Vertical injection was carried out, and no blood was recovered. 1 mL Cobamamide for injection was injected into each acupoint, 5 times weekly, and the next cycle was carried out for 2 d. Patients in the treatment group were po administered with Gentongping Granules on the basis of the control group, 12 g/time, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and clinical symptom improvement time, associated score, and inflammatory mediators were compared.Results After treatment, the total effective rate of the treatment group was 97.56%, which was significantly higher than that of the control group (80.49%, P<0.05). After treatment, the improvement time of neck and shoulder pain, upper limb pain and numbness, finger pain and numbness and paresthesia in the treatment group was shorter than that in the control group (P<0.05). After the treatment, speed clinical assessment scale for cervical spondylosis (CASCS) score was significantly higher, but pain, neck pain scale (VAS), score (NPQ) score, Pittsburgh sleep quality index scale (PSQI) score, cervical dysfunction index (NDI) scores of two groups were significantly lower (P<0.05), and after treatment, the treatment group scores were better than those of the control group (P<0.05). After treatment, the serum interleukin-1β (IL-1β), prostaglandin E₂ (PGE₂), interleukin-6 (IL-6) and cyclooxygenase-2 (COX-2) in two groups were significantly decreased (P<0.05). After treatment, the levels of inflammatory mediators in treatment group were lower than those in control group (P<0.05). Conclusion Gentongping Granules combined with cobamamide can effectively improve the clinical symptoms in treatment of cervical spondylopathy of radiculopathy, and can regulate the inflammatory response of the body, improve cervical motion disorders, and also can promote the improvement of mental resilience and sleep quality of patients, which has a good clinical application value.

R971

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（LHGJ20191400）