神经根型颈椎病(cervical spondylotic radiculopathy,CSR)是颈椎病最常见的临床证型,严重影响了人们的日常生活.推拿作为临床上治疗颈椎病的常用中医外治法之一,疗效肯定.本文对推拿治疗CSR机制进行综述,发现:(1)通过改善颈部的受力结构缓解颈椎失稳、减轻椎间关节的错位及紊乱从而缓解机械压迫,纠正病变解剖结构改善疼痛;(2)通过降低肿瘤细胞坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1α(interleukin-1α,IL-1α)、白细胞介素-6(interleukin-6,IL-6)等促炎因子表达,上调白细胞介素-4(interleukin-4,IL-4)、白细胞介素-10(interleukin-10,IL-10)、转化生长因子(transforming growth factor,TGF)-β1 等抗炎因子的表达,缓解炎性浸润产生镇痛作用;(3)通过调节外周及中枢β-EP等神经递质的表达,发挥镇痛效果;(4)恢复胸腺T细胞、分化抗原(cluster of differentiation,CD)4+免疫细胞的平衡,以缓解疼痛反应.可见,推拿可通过"多水平—多途径—多靶点"从而发挥对CSR的镇痛作用.本文通过回顾推拿治疗CSR的相关文献,以期为日后临床应用或实验研究提供参考依据.
Research progress on analgesic mechanism of massage intervention in radiculopathy of cervical spondylopathy
Cervical spondylotic radiculopathy(CSR)is the most common clinical syndrome of cervical spondylosis,which severely affects daily life.As one of the commonly used external treatment methods of traditional Chinese medicine in clinical treatment of cervical spondylosis,massage has definite curative effect.This article reviewed the mechanism of massage treatment for CSR.(1)By improving the force structure of the neck to relieve cervical instability,reduce the dislocation and disorder of intervertebral joints,massage can relieve mechanical compression,correct pathological anatomical structure to reduce pain;(2)By reducing the expression of pro-inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-1α(IL-1α),interleukin-6(IL-6),etc.,massage can up-regulate the expression of anti-inflammatory factors such as interleukin-4(IL-4),interleukin-10(IL-10),transforming growth factor(TGF)-β1,etc.,to relieve inflammatory infiltration and produce analgesic effect;(3)By regulating the expression of peripheral and central β-EP and other neurotransmitters,massage can play an analgesic effect;(4)Restoring the balance of thymus T cells,differentiation antigen(cluster of differentiation,CD)4+immune cells,to relieve pain response.It can be seen that massage can play an analgesic effect on CSR through"multi-level-multi-pathway-multi-target".This article reviewed the related literature of massage treatment for CSR in order to provide references for future clinical application and experimental research.
万方数据
维普
