神经根型颈椎病患者颈神经根压迫性刺激因素的研究

张明才; 石印玉; 陈东煜; 王翔; 陈博; 王辉昊; 徐震球; 詹红生

doi:10.16305/j.1007-1334.2021.1904074

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神经根型颈椎病患者颈神经根压迫性刺激因素的研究

临床试验 | 更新时间：2022-08-02

- 神经根型颈椎病患者颈神经根压迫性刺激因素的研究
- Study on the compressive stimulation factors of cervical nerve root in patients with cervical spondylotic radiculopathy
- 上海中医药杂志 2021年55卷第1期页码：52-56
- 作者机构：
  
  1.上海中医药大学附属曙光医院石氏伤科医学中心，上海市中医药研究院骨伤科研究所（上海　200021）
- 作者简介：
  
  张明才，男，博士，副主任医师，主要从事中医骨伤科脊柱病临床研究工作
  詹红生，教授，主任医师，博士研究生导师；E-mail：zhanhongsheng2010@163.com
- 基金信息：
  
  国家自然科学基金面上项目(81473702);国家自然科学基金青年基金项目(81503596;81001528);上海市科委科研计划医学重点项目(16401970102);上海市科委科研计划项目(13401903500;15401934100);上海市卫计委中医药科技创新项目(ZYKC201602006);“中医骨伤科学”国家重点学科项目(100508);上海市中医药领军人才建设项目(2012-63-15);上海领军人才项目(041);海派中医流派传承研究基地项目(ZY3-CCCX-1-1003);上海市重中之重临床重点学科建设项目“中医骨伤科学”(2017ZZ02024);上海市中医药新兴交叉学科资助计划项目“工效筋骨学”(沪卫计中发2017（024）号);上海市中西医临床协作试点项目(ZXYXZ-201703);上海中医药大学高峰造尖行动计划高峰高原创新中医骨伤团队项目
- DOI：10.16305/j.1007-1334.2021.1904074
  中图分类号：
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张明才, 石印玉, 陈东煜, 等. 神经根型颈椎病患者颈神经根压迫性刺激因素的研究[J]. 上海中医药杂志, 2021,55(1):52-56.

Mingcai ZHANG, Yinyu SHI, Dongyu CHEN, et al. Study on the compressive stimulation factors of cervical nerve root in patients with cervical spondylotic radiculopathy[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(1):52-56.
张明才, 石印玉, 陈东煜, 等. 神经根型颈椎病患者颈神经根压迫性刺激因素的研究[J]. 上海中医药杂志, 2021,55(1):52-56. DOI： 10.16305/j.1007-1334.2021.1904074.

Mingcai ZHANG, Yinyu SHI, Dongyu CHEN, et al. Study on the compressive stimulation factors of cervical nerve root in patients with cervical spondylotic radiculopathy[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(1):52-56. DOI： 10.16305/j.1007-1334.2021.1904074.

摘要

目的,2,探讨神经根型颈椎病患者颈神经根压迫性刺激的主要因素。,方法,2,纳入神经根型颈椎病患者98例作为神经根型颈椎病组，健康受试者50例作为健康受试者组，比较两组受试者的症状体征积分、颈椎关节突关节骨错缝发生率及颈椎椎间盘突出发生率，综合分析神经根型颈椎病患者颈神经根压迫性刺激的因素。,结果,2,①两组受试者的自觉症状、体格检查、日常活动积分及症状体征总积分比较，差异均有统计学意义（,P,<,0.01）。②神经根型颈椎病组受试者颈椎关节突关节骨错缝发生率为82.65%，健康受试者组颈椎关节突关节骨错缝发生率为10.00%，两组差异具有统计学意义（,P,<,0.01）。③神经根型颈椎病组受试者颈椎椎间盘突出发生率为41.84%，健康受试者组颈椎椎间盘突出发生率为4.00%，两组差异具有统计学意义（,P,<,0.01）。④神经根型颈椎病组患者的神经根压迫性刺激因素以颈椎关节突关节骨错缝和颈椎椎间盘突出为主，其中单纯颈椎关节突骨错缝占43.88%（43/98），关节突骨错缝合并椎间盘突出占22.45%（22/98），单纯椎间盘突出占4.08%（4/98）。,结论,2,神经根型颈椎病的临床发病关键机制一方面与颈椎椎间盘突出致神经根压迫性刺激有关，另一方面与颈椎关节突关节骨错缝致神经根压迫性刺激有关，而后者在临床中往往易被忽视，应引起颈椎病临床防治工作者的重视。

Abstract

Objective,2,To investigate the main compressive stimulation factors of cervical nerve root in patients with cervical spondylotic radiculopathy.,Methods,2,Ninety-eight patients with cervical spondylotic radiculopathy were enrolled as the cervical spondylotic radiculopathy group and fifty healthy subjects were enrolled as the healthy subject group. The scores of the symptoms and signs, and the incidences of cervical zygapophyseal joint subluxation and cervical disc herniation were compared between the two groups. The compressive stimulation factors of cervical nerve root in patients with cervical spondylotic radiculopathy were synthetically analyzed.,Results,2,①There were significantly statistical differences on the scores of subjective symptoms, physical examination and daily activity, and the total scores of symptoms and signs between the two groups (,P,<,0.01) . ②The incidences of cervical zygapophyseal joint subluxation in the cervical spondylotic radiculopathy group and the healthy subject group were 82.65% and 10.00% respectively, with significantly statistical difference between the two groups (,P,<,0.01) . ③The incidences of cervical disc herniation in the cervical spondylotic radiculopathy group and the healthy subject group were 41.84% and 4.00% respectively, with significantly statistical difference between the two groups (,P,<,0.01) . ④The compressive stimulation factors of cervical nerve root in patients with cervical spondylotic radiculopathy were mainly cervical zygapophyseal joint subluxation and cervical disc herniation. The patients with only cervical zygapophyseal joint subluxation accounted to 43.88% (43/98) , the patients with cervical zygapophyseal joint subluxation and cervical disc herniation accounted to 22.45% (22/98) , and the patients with only cervical disc herniation accounted to 4.08% (4/98) .,Conclusion,2,The key clinical pathogenesis of cervical spondylotic radiculopathy on the one hand is related to cervical disc herniation leading to the compressive stimulation of cervical nerve root, on the other hand is related to cervical zygapophyseal joint subluxation leading to the compressive stimulation of cervical nerve root, while the latter is often neglected in clinical practice and should be paid more attention by clinical workers of cervical spondylosis prevention and treatment.

关键词

神经根型颈椎病颈椎关节突关节骨错缝颈椎椎间盘突出病因病机

Keywords

cervical spondylotic radiculopathycervical zygapophyseal joint subluxationcervical disc herniationetiology and pathogenesis

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