目的 探讨根痛平颗粒联合穴位注射腺苷钴胺治疗神经根型颈椎病的临床疗效。方法 选取2018年1月—2020年1月在安阳市第六人民医院进行治疗的82例神经根型颈椎病患者，根据治疗措施的差别分为对照组和治疗组，每组41例。对照组将1 mg注射用腺苷钴胺同0.9%氯化钠注射液2 mL配伍，然后分别对风池穴、后溪穴进行消毒，垂直进针，回抽无回血，每个穴位注射1 mL，5次/周，间歇2 d进行下1周期；治疗组在对照组基础上口服根痛平颗粒，12 g/次，2次/d。两组均经14 d治疗。观察两组的临床疗效，比较临床症状改善时间、相关评分和炎症介质。结果 治疗后，治疗组总有效率97.56%，显著高于对照组的80.49%（P<0.05）。经治疗，治疗组在颈肩疼痛、上肢疼痛麻木、手指疼痛麻木及感觉异常等症状改善时间上短于对照组（P<0.05）。经治疗，两组颈椎病临床评价量表（CASCS）评分显著升高，但疼痛（VAS）评分、颈痛量表（NPQ）评分、匹茨堡睡眠质量指数量表（PSQI）评分、颈椎功能障碍指数（NDI）评分均显著降低（P<0.05），且治疗后，治疗组相关评分优于对照组（P<0.05）。经治疗，两组血清白细胞介素-1β（IL-1β）、前列腺素E₂（PGE₂）、白细胞介素-6（IL-6）、环氧化酶-2（COX-2）均显著降低（P<0.05）；治疗后，治疗组炎症介质水平低于对照组（P<0.05）。结论 根痛平颗粒联合穴位注射腺苷钴胺治疗神经根型颈椎病可有效改善患者临床症状，调节机体炎症反应，改善颈椎活动障碍，促进患者心理弹性及睡眠质量的提高，有着良好的临床应用价值。

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

河南省医学科技攻关计划项目（LHGJ20191400）