王志琼

目的：探讨苗药塌渍结合颊针治疗颈型颈椎病的临床疗效，并通过超声弹性成像技术客观评价其对颈部肌肉硬度的影响。方法：采用随机对照试验设计，纳入60例颈型颈椎病患者，随机分为干预组（苗药塌渍结合颊针，n=30）和对照组（常规针刺，n=30）。两组均接受20天治疗（隔日1次，共10次）。主要评价指标包括超声剪切波弹性成像测定的斜方肌、斜角肌、胸锁乳突肌和肩胛提肌的杨氏模量值，次要指标为Northwick Park颈痛量表（NPQ）评分和视觉模拟评分（VAS）。疗效评估在治疗前、治疗中期（第5次）和疗程结束后进行。结果：干预后，两组患者颈部肌肉杨氏模量值、NPQ评分和VAS评分均显著改善（P<0.05）。组间比较显示，干预组斜方肌杨氏模量值降低更显著（23.43±1.01 kPa vs 24.57±2.45 kPa，P<0.05）。NPQ评分干预组从24.00±3.59降至11.87±4.22，对照组从24.00±3.38降至12.93±4.78（均P <0.001）；VAS评分干预组从3.00(4.00,7.00)降至2.00(2.00,4.00)，对照组从2.00(4.50,8.00)降至1.00(3.00,5.00)（均P <0.001）。结论：苗药塌渍结合颊针能有效改善颈型颈椎病患者的颈部肌肉硬度、疼痛症状和生活质量，其疗效优于常规针刺，尤其在改善斜方肌硬度方面更具优势。该联合疗法为颈型颈椎病的治疗提供了新选择，其作用机制可能与改善局部微循环和调节气血运行有关。未来需进一步开展大样本、多中心研究验证其长期疗效。

颈型颈椎病；苗药塌渍；颊针；超声弹性成像；杨氏模量值

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