目的 探讨刮贴疗法联合塞来昔布对气滞血瘀型颈肩综合征患者疼痛评分的影响及意义。方法 采用随机数字表法将2022年1月—2024年12月在我院收治的219例气滞血瘀型颈肩综合征患者分为西医组（塞来昔布治疗）、中医组（刮贴治疗）及联合组（塞来昔布联合刮贴治疗）,各73例,疗程均为 4 周。比较三组不同时间点颈椎疼痛评分[视觉模拟评分（visual analogue scale,VAS）、颈椎功能障碍指数评分（neck disability index,NDI）]、疼痛介质[β-内啡肽（β-eendorphin,β-EP）、环氧化酶-2（cyclooxygenase-2,COX-2）]、颈椎活动度（range of motion,ROM）以及中医证候评分、Barthel指数、临床疗效及安全性评估。结果 整体分析显示,三组治疗前VAS及NDI评分差异无统计学意义。随疗程推进,各组VAS及NDI评分呈逐步下降趋势,治疗2周和4周均低于治疗前,且联合组在各时间点的评分均低于西医组和中医组;治疗4周后,联合组较西医、中医组β-EP水平更高,COX-2水平更低,ROM各方向改善明显,中医证候评分更低,Barthel指数更高,组间差异均有统计学意义。联合组临床总有效率明显高于西医组及中医组。各组未见严重不良反应,仅部分患者出现轻度瘀斑。结论 刮贴疗法联合塞来昔布可随疗程逐步缓解气滞血瘀型颈肩综合征患者颈肩疼痛,改善颈椎活动度及生活质量,值得推广。

Objective To evaluate the effect and clinical significance of scraping and auricular point pressing therapy combined with celecoxib on pain scores in patients with cervical-shoulder syndrome of the qi-stagnation and blood-stasis type. Methods From January 2022 to December 2024, 219 patients were enrolled and randomly assigned to three groups: a Western medicine group treated with celecoxib, a traditional Chinese medicine group treated with scraping and auricular point pressing, and a combination group treated with both approaches (n=73 each). The treatment course lasted 4 weeks. Cervical pain was assessed using the visual analogue scale (VAS) and neck disability index (NDI). Levels of pain mediators [β-endorphin (β-EP) and cyclooxygenase-2 (COX-2)], cervical range of motion (ROM), traditional Chinese medicine (TCM) syndrome scores, Barthel index, clinical efficacy, and safety were also compared. Results The overall analysis showed no statistically significant differences in VAS and NDI scores among the three groups before treatment. As the treatment course progressed, the VAS and NDI scores in each group showed a gradual downward trend, with scores at 2 weeks and 4 weeks of treatment being lower than before treatment. Moreover, the scores in the combination group were lower than those in the Western medicine group and the traditional Chinese medicine group at all time points. After 4 weeks of treatment, compared with the Western medicine group and the traditional Chinese medicine group, the combination group showed an increase in β-EP levels, a decrease in COX-2 levels, significant improvement in ROM in all directions, lower traditional Chinese medicine syndrome scores, and higher Barthel Index scores, with all intergroup differences being statistically significant. The overall clinical effective rate of the combined group was significantly higher than that of the Western medicine group and the traditional Chinese medicine group. No serious adverse events were observed; only mild subcutaneous bruising occurred in a few patients. Conclusion Scraping and auricular point pressing therapy combined with celecoxib provides progressive relief of cervical-shoulder pain in patients with qi-stagnation and blood-stasis type syndrome. The therapy improves cervical mobility, enhances quality of life, and demonstrates good safety, supporting its clinical application.