[Randomized controlled trial on cervical spondylotic radiculopathy of wind-cold-damp type treated with acupuncture and thunder-fire moxibustion].

To explore the therapeutic effect of acupuncture combined with thunder-fire moxibustion on cervical spondylotic radiculopathy of wind-cold-damp type and its impacts on the conduction velocity of F wave of median nerve and ulnar nerve, as well as hypersensitive C-responsive protein (hs-CRP), interleukin 6 (IL-6), IL-1β and tumor necrosis factor α (TNF-α) in serum.A total of 94 patients with cervical spondylotic radiculopathy of wind-cold-damp type were randomly divided into a control group and a combined therapy group, 47 cases in each group. In the control group, acupuncture was applied to Fengchi (GV20), Tianzhu (BL10), Neck-Jiaji (EX-B5), Dazhui (GV14) and others, 30 min each time, once daily, 5 times a week, totally for 4 weeks. In the combined therapy group, on the base of the treatment as the control group, the thunder-fire moxibustion was adopted over GV20, EX-B5, GV14, Jianjing (ST21) and Tianzong (SI11), 20 min each time, once every other day, for 4 weeks in total. After the treatment, the curative effect was compared in the patients between two groups. The short-form McGill pain questionnaire (SF-MPQ), the neck specificity scale and the MOS 36-item short form health survey (SF-36) were scored. The conduction velocity of F wave in median nerve and ulnar nerve was detected by electromyography. The expression of hs-CRP was measured by immunoturbidimetry. IL-6, IL-1β and TNF-α in serum were determined by enzyme linked immunosorbent assay.The total effective rate in the combined therapy group was 95.7% (45/47), which was higher than 80.9% (38/47) in the control group (P<0.05). Compared with their own pretreatment, the scores of SF-MPQ, neck specificity scale and SF-36 were all obviously improved after treatment in the patients of either group (P<0.05), while the conduction velocity of F wave in median nerve and ulnar nerve was accelerated and hs-CRP, IL-6, IL-1β and TNF-α in serum were decreased (P<0.05). Compared with the control group, the improvements in the scores of SF-MPQ, neck specificity scale and SF-36 were more obvious (P<0.05), the increase of the conduction velocity of F wave in median nerve and ulnar nerve and the decrease of hs-CRP, IL-6, IL-1β and TNF-α in serum were more remarkable (P<0.05) in the combined therapy group.Acupuncture combined with thunder-fire moxibustion relieves the clinical symptoms of cervical spondylotic radiculopathy of wind-cold-damp type.目的：探讨针刺联合雷火灸治疗风寒湿型神经根型颈椎病(CSR)的疗效及对正中神经、尺神经F波的传导速度和血清中超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、IL-1β、肿瘤坏死因子α(TNF-α)的影响。方法：将94例风寒湿型神经根型颈椎病患者随机分为对照组和联合组，每组47例。对照组选取风池、天柱、颈夹脊、大椎等穴针刺治疗，30 min/次，1次/日，5次/周，共4周。联合组在对照组基础上采用雷火灸风池、颈夹脊、大椎、肩井和天宗，20 min/次，隔日1次，共4周。治疗结束后，比较两组患者疗效，对简化McGill问卷(SF-MPQ)、颈部特异性量表和健康状况调查表(SF-36)进行评分，利用肌电图诱发电位仪检测患者正中神经和尺神经F波的传导速度，免疫比浊法检测血清中hs-CRP含量，酶联免疫吸附法检测血清中IL-6、IL-1β、TNF-α的含量。结果：联合组的总有效率为95.7%(45/47)高于对照组80.9%(38/47，P<0.05)。与本组治疗前比较，两组患者SF-MPQ、颈部特异性量表和SF-36量表评分明显改善(P<0.05)，正中神经和尺神经的F波传导速度加快（P<0.05），血清中hs-CRP、IL-6、IL-1β和TNF-α下降(P<0.05)。与对照组比较，联合组SF-MPQ、颈部特异性量表和SF-36量表评分的改善更为明显(P<0.05)，正中神经和尺神经的F波传导速度更快（P<0.05），血清中hs-CRP、IL-6、IL-1β和TNF-α含量下降亦更为显著(P<0.05)。结论：针刺联合雷火灸可以改善风寒湿型神经根型颈椎病患者的临床症状，减轻炎性反应。.