痧点放血结合针刺治疗气滞血瘀型神经根型颈椎病急性发作期：随机对照试验

王玮; 邱东升; 刘珈均; 左姣姣; 许雪婷; 蔡昌梅; 叶国平

doi:10.13703/j.0255-2930.20241126-k0001

您当前的位置：

首页 >

文章列表页 >

痧点放血结合针刺治疗气滞血瘀型神经根型颈椎病急性发作期：随机对照试验

临床研究 | 更新时间：2026-01-16

- 痧点放血结合针刺治疗气滞血瘀型神经根型颈椎病急性发作期：随机对照试验
- Bloodletting at guasha marks combined with acupuncture for cervical spondylotic radiculopathy of acute phase with qi stagnation and blood stasis: a randomized controlled trial
- 中国针灸 2026年46卷第1期页码：22-28
- 作者机构：
  
  福建中医药大学附属厦门中医院针灸科二区，厦门　361015
  福建中医药大学第一临床医学院，福州　350122
  厦门市中医院，福建厦门　361015
  北京中医药大学东直门医院厦门医院，福建厦门　361015
  厦门市中医医疗技术质量控制中心，福建厦门　361015
- 作者简介：
  
  王玮，福建中医药大学硕士研究生。E-mail：1962168783@qq.com
  ✉叶国平，主治医师。E-mail：810626322@qq.com
- 基金信息：
  
  厦门市自然科学基金青年项目(3502Z20227109);福建省自然科学基金面上项目(2023J011635);北京中医药大学校级课题自然科学项目(2022-BUCMXJKY051)
- DOI：10.13703/j.0255-2930.20241126-k0001
  中图分类号：
- 收稿：2024-11-26，
  
  网络首发：2025-05-22，
  
  纸质出版：2026-01-12
- 稿件说明：
移动端阅览
王玮, 邱东升, 刘珈均, 等. 痧点放血结合针刺治疗气滞血瘀型神经根型颈椎病急性发作期：随机对照试验[J]. 中国针灸, 2026,46(1):22-28.

WANG Wei, QIU Dongsheng, LIU Jiajun, et al. Bloodletting at guasha marks combined with acupuncture for cervical spondylotic radiculopathy of acute phase with qi stagnation and blood stasis: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2026, 46(1): 22-28. DOI: 10.13703/j.0255-2930.20241126-k0001.
王玮, 邱东升, 刘珈均, 等. 痧点放血结合针刺治疗气滞血瘀型神经根型颈椎病急性发作期：随机对照试验[J]. 中国针灸, 2026,46(1):22-28. DOI： 10.13703/j.0255-2930.20241126-k0001.

WANG Wei, QIU Dongsheng, LIU Jiajun, et al. Bloodletting at guasha marks combined with acupuncture for cervical spondylotic radiculopathy of acute phase with qi stagnation and blood stasis: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2026, 46(1): 22-28. DOI: 10.13703/j.0255-2930.20241126-k0001. DOI：

摘要

目的：

观察痧点放血结合针刺治疗气滞血瘀型神经根型颈椎病急性发作期的临床疗效及其对血清炎性因子的影响。

方法：

将120例气滞血瘀型神经根型颈椎病急性发作期患者随机分为放痧组（40例，脱落1例）、放椎组（40例，剔除2例、脱落1例）和西药组（40例，剔除2例）。放痧组予针刺配合肩颈部痧点放血治疗，针刺穴取双侧C

-C

颈夹脊、风池、颈百劳、肩井、肩外俞及大椎、阿是穴，每日1次，每周5次；刮痧部位以C

-T

双侧斜方肌体表区域为主，选取2～3个最明显的痧点进行刺络拔罐放血，隔3 d治疗1次，每周2次。放椎组予针刺（选穴及疗程同痧点放血组）配合大椎穴刺络拔罐放血（隔3 d治疗1次，每周2次）治疗。西药组口服双氯芬酸钠缓释片，每天1次。各组均治疗1周为一疗程，共治疗2个疗程。分别于治疗前、治疗后及治疗结束后1个月随访观察各组患者颈椎疼痛视觉模拟量表（VAS）、颈部功能障碍指数（NDI）和日本骨科学会（JOA）评分，于治疗前后采用ELISA法检测各组患者血清炎性因子[白细胞介素（IL）-1β、IL-6、肿瘤坏死因子-α（TNF-α）

]

含量，并于治疗后评定各组临床疗效。

结果：

治疗后及随访时，3组患者疼痛VAS、NDI评分较治疗前降低（

0.05），JOA评分较治疗前升高（

0.05）。治疗后及随访时，放痧组患者疼痛VAS及NDI评分低于、JOA评分高于放椎组和西药组（

0.05），放椎组患者NDI评分低于西药组（

0.05）；随访时，放椎组患者疼痛VAS评分低于西药组（

0.05）。治疗后，3组患者血清IL-1β、IL-6、TNF-α含量较治疗前降低（

0.05）；放痧组患者血清IL-1β、IL-6、TNF-α含量低于放椎组及西药组（

0.05），放椎组患者血清IL-1β、IL-6含量高于西药组（

0.05）。放痧组总有效率为97.4%（38/39），高于放椎组的86.5%（32/37）和西药组的89.5%（34/38，

0.05）；放痧组痊愈率为84.6%（33/39），高于放椎组的67.6%（25/37）和西药组的63.2%（24/38，

0.05）。

结论：

痧点放血结合针刺可有效治疗气滞血瘀型神经根型颈椎病急性发作期，改善患者颈椎疼痛及功能障碍，降低血清炎性因子含量，且具有较好的远期疗效。

Abstract

Objective

To observe the clinical effect of bloodletting at

guasha

marks (petechiae after scraping therapy) combined with acupuncture on acute attack of cervical spondylotic radiculopathy (CSR) differentiated as

stagnation and blood stasis

and the effect of this combined therapy on serum inflammatory factors.

Methods

A total of 120 patients with CSR at the acute phase

differentiated as

stagnation and blood stasis were randomly assigned into three groups

a group of bloodletting at guasha marks combined with acupuncture (guasha-mark bloodletting group

40 case

1 case dropped out)

a group of the bloodletting at Dazhui (GV14) combined with acupuncture (GV14 bloodletting group

40 cases

2 cases were eliminated

1 case dropped out)

and a western medication group (40 cases

2 cases were eliminated). In the guasha-mark bloodletting group

acupuncture was operated

combined with bloodletting at

guasha

marks on the shoulder and neck regions. Acupuncture was delivered at bilateral neck-Jiaji (EX-B2) from C

to C

Fengchi (GB20)

Jing-bailao (EX-HN15)

Jianjing (GB21)

Jianwai

shu (SI14)

Dazhui (GV14) and

ashi

points

once daily

5 treatments a week. Scraping therapy was operated on the superficial area of the trapezius muscle from C

to T

and 2 or 3 spots with the most clear

guasha

marks were selected for bloodletting

delivered once every 3 days

twice a week. In the GV14 bloodletting group

the acupoint selection and the treatment procedure of acupuncture intervention were the same as the guasha-mark bloodletting group

but bloodletting was delivered at Dazhui (GV14) instead

once every 3 days

twice a week. In the western medication group

sodium diclofenac sustained release tablets were administered orally

once daily. One course of treatment was composed of 1 week of interventions

and 2 courses were required in each group. Before and after treatment

as well as in follow-up of 1 month after treatment completion

the scores of visual analogue scale (VAS) for cervical pain

neck disability index (NDI) and Japan Orthopaedic association (JOA) were observed in each group separately. Before and after treatment

using ELISA

the levels of serum inflammatory factors

i.e. interleukin (IL)-1β

IL-6 and tumor necrosis factor-α (TNF-α) were detected; and the clinical effect was evaluated after treatment in each group.

Results

After treatment and during follow-up

the VAS and NDI scores were all reduced in comparison with those before treatment in the three groups (

0.05)

and the JOA scores were elevated (

0.05). Besides

the VAS and NDI scores in the guasha-mark bloodletting group were lower than those in the GV14 bloodletting group and the western medication group (

0.05)

while

the JOA scores were higher (

0.05). In the follow-up

the VAS score in the GV14 bloodletting group was lower than that of the western medication group (

0.05). After treatment

in each group

the levels of serum IL-1β

L-6 and TNF-α were reduced in comparison with those before treatment (

0.05); and the levels of serum IL-1β

IL-6 and TNF-α in the guasha-mark bloodletting group were lower than those in either the GV14 bloodletting group or the western medication group (

0.05). The levels of serum IL-1βand IL-6 in the GV14 bloodletting group were higher than those of the western medication group (

0.05). The total effective rate was 97.4% (38/39) in the guasha-mark bloodletting group

which was higher than that (86.5%

32/37) in the GV14 bloodletting group and that (89.5%

34/38) in the western medication group (

0.05). The healing rate was 84.6% (33/39) in the guasha-mark bloodletting group

higher than that (67.6%

25/37) in the GV14 bloodletting group and that (63.2%

24/38) in the western medication group (

0.05).

Conclusion

Guasha-mark bloodletting combined with acupuncture is effective on acute attack of CSR with

stagnation and blood stasis. This combined therapy can reduce cervical pain

functional disorders

and the levels of serum inflammatory factors

showing a favorable long-term therapeutic effect.

关键词

Keywords

references

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

“升清降浊”法针刺治疗脓毒症胃肠功能障碍：随机对照试验

火针治疗膝骨关节炎的远期临床疗效观察

基于“肺与大肠相表里”理论针刺对支气管哮喘急性发作期的影响

不同频率捻转手法针刺廉泉治疗缺血性卒中后失语的临床量效研究

针刺治疗慢性荨麻疹随机对照试验的结局指标现状分析