Objective  To analyze the influencing factors of pregabalin (PGB) combined with celecoxib (CLX) on the prognosis of cervical spondylotic radiculopath (CSR) and to construct a nomogram model.

Methods  The clinical data of CSR patients who received PGB combined with CLX in the treatment of CSR in Zhejiang Provincial people's Hospital from January 1, 2022 to January 1, 2024 were retrospectively analyzed. According to the efficacy results after 4 weeks, the patients were divided into an effective group and an ineffective group. Multivariate Logistic regression was used to analyze the influencing factors of prognosis, and a prognostic nomogram model was constructed. The receiver operating characteristic (ROC) curve and its area under the curve (AUC) and the calibration curve were used to evaluate the predictive efficiency of the model.

Results  A total of 107 patients were included, with 84 in the effective group and 23 in the ineffective group. The effective rate of PGB combined with CLX in the treatment of CSR was approximately 78.50%. Multivariate logistic regression showed that age≥60 years [OR=5.291, 95%CI(1.507, 18.582), P<0.05] and neck trauma [OR=9.211, 95%CI(2.051, 41.373), P<0.05] were risk factors for prognosis, while sleep time≥8  h [OR=0.135, 95%CI(0.037, 0.496), P<0.05] and exercise>3 times/week [OR=0.169, 95%CI(0.042, 0.679), P<0.05] were protective factors for prognosis. The AUC of the prognostic nomogram model was 0.816, and the calibration curve showed that the prognostic nomogram model had good calibration ability.

Conclusion  This study successfully constructed a prognostic nomogram model for PGB combined with CLX in the treatment of CSR. The model has good predictive efficiency and can provide help for clinical practice.

1.詹吉恒, 廖少君, 侯宇, 等. 中西医结合神经根型颈椎病诊断与非手术治疗指南(2023年)计划书[J]. 医学新知, 2024, 34(1): 79-87. [Zhan JH, Liao SJ, Hou Y, et al. A protocol to develop a guideline for the diagnosis and non-surgical treatment of cervical spondylotic radiculopathy with integrated traditional Chinese and Western medicine(2023) [J]. Yixue Xinzhi Zazhi, 2024, 34(1): 79-87.] DOI: 10.12173/j.issn.1004-5511.202305025.

2.李柯. 颈部伸屈肌群静力增强训练对神经根型颈椎病患者疼痛状态及颈椎活动度的影响[J]. 数理医药学杂志, 2022, 35(4): 612-614. [Li K. Effect of static strengthening training of neck extensor and flexor muscles on pain status and cervical mobility of patients with cervical spondylotic radiculopathy[J]. Journal of Mathematical Medicine, 2022, 35(4): 612-614.] DOI: 10.3969/j.issn.1004-4337.2022.04.046.

3.Radhakrishnan K, Litchy WJ, O'Fallon WM, et al. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990[J]. Brain, 1994, 117(Pt 2): 325-335. DOI: 10.1093/brain/117.2.325.

4.邓越, 王桂玲, 姚金, 等. 颈神经不同支配区合谷刺治疗神经根型颈椎病(气滞血瘀证)的临床研究[J]. 中国中医急症, 2023, 32(6): 978-982. [Deng Y, Wang GL, Yao J, et al. Clinical observation on the treatment of cervical spondy lotic radiculopathy (Syndrome of Qi stagnation and blood stasis) by hegu acupuncture in different cervical nerve innervated regions[J]. Journal of Emergency in Traditional Chinese Medicine, 2023, 32(6): 978-982.] DOI: 10.3969/j.issn.1004-745X.2023.06.009.

5.瞿强. 神经根型颈椎病的治疗研究进展[J]. 医学理论与实践, 2020, 33(3): 377-378, 384. [Qu Q. Progress in the treatment of cervical radiculopathy[J]. The Journal of Medical Theory and Practice, 2020, 33(3): 377-378, 384.] DOI: 10.19381/j.issn.1001-7585.2020.03.012.

6.韩柄秋, 闫素敏, 闫利敏. 外用臭氧联合普瑞巴林治疗带状疱疹后神经痛的临床疗效观察[J]. 数理医药学杂志, 2022, 35(5): 723-725. [Han BQ, Yan SM, Yan LM. Clinical efficacy observation of external ozone combined with pregabalin in the treatment of post-herpetic neuralgia[J]. Journal of Mathematical Medicine, 2022, 35(5): 723-725.] DOI: 10.3969/j.issn.1004-4337.2022.05.029.

7.朝博, 任君浩, 苏优勒. 塞来昔布通过MAPK/ERK信号通路抑制炎症反应改善急性脑出血大鼠神经功能的机制研究[J]. 中国药师, 2023, 26(11): 181-188. [Chao B, Ren JH, Su YL. Mechanism study of celecoxib to improve neurological function in rats with acute intracerebral hemorrhage by inhibiting inflammation through the MAPK/ERK signal pathway[J]. Frontiers in Pharmaceutical Sciences, 2023, 26(11): 181-188.] DOI: 10.12173/j.issn.1008-049X.202310025.

8.陈小彪. 普瑞巴林联合塞来昔布治疗神经根型颈椎病的临床观察[J]. 海峡药学, 2021, 33(8): 140-141. [Chen XB. Clinical observation of pregabalin combined with celecoxib in the treatment of cervical radiculopathy[J]. Strait Pharmaceutical Journal, 2021, 33(8): 140-141.] DOI: 10.3969/j.issn.1006-3765.2021.08.062.

9.莫航沣, 陈亚萍, 韩慧, 等. 临床预测模型研究方法与步骤[J]. 中国循证医学杂志, 2024, 24(2): 228-236. [Mo HF, Chen  YP, Han  H, et al. Methods and steps of clinical prediction model research [J]. Chinese Journal of Evidence-Based Medicine, 2024, 24(2): 228-236.] DOI: 10.7507/1672-2531.202308135.

10.神经根型颈椎病诊疗规范化研究专家组. 神经根型颈椎病诊疗规范化的专家共识[J]. 中华外科杂志, 2015, 53(11): 812-814. [Expert group on standardized diagnosis and treatment of cervical radiculopathy. Expert consensus on the standardization of the diagnosis and treatment of cervical spondylosis[J]. Chinese Journal of Surgery, 2015, 53(11): 812-814.] DOI: 10.3760/cma.j.issn.0529-5815.2015.11.004.

11.邹可言, 王淑平, 贺青涛, 等. 浮针联合穴位推拿对血瘀气滞型神经根型颈椎病患者颈椎活动度、血液流变学和红外热成像温度的影响[J]. 现代生物医学进展, 2024, 24(16): 3066-3069, 3180. [Zou KY, Wang SP, He QT, et al. Effect of floating needle combined with acupoint massage on cervical mobility, hemorheology and infrared thermal imaging temperature in patients with cervical spondylotic radiculopathy of blood stasis and qi stagnation type[J]. Progress in Modern Biomedicine, 2024, 24(16): 3066-3069, 3180.] DOI: 10.13241/j.cnki.pmb.2024.16.012.

12.陈智志, 王井泉. 薏苡仁汤加减联合牵引手法治疗神经根型颈椎病的效果及对颈椎功能和预后的影响[J]. 临床合理用药, 2024, 17(33): 65-68. [Chen ZZ, Wang JQ. The effect of coix seed soup plus and subtraction combined traction technique in the treatment of cervical radiculopathy and its influence on cervical spine function and prognosis[J]. Chinese Journal of Clinical Rational Drug Use, 2024, 17(33): 65-68.] DOI: 10.15887/j.cnki.13-1389/r.2024.33.017.

13.林纯瑾, 邹丽芬, 骆雍阳, 等. 独活寄生汤加减联合塞来昔布对急性期神经根型颈椎病患者的临床疗效[J]. 中成药, 2021, 43(12): 3552-3555. [Lin CJ, Zou LF, Luo YY, et al. Clinical efficacy of live parasitic decoction and celecoxib in patients with radiculopathy in the acute phase[J]. Chinese Traditional Patent Medicine, 2021, 43(12): 3552-3555.] DOI: 10.3969/j.issn.1001-1528.2021.12.058.

14.许标, 刘国庆, 孙科研, 等. 神经根型颈椎病行前路减压融合手术预后的行为风险因素分析[J]. 颈腰痛杂志, 2021, 42(2): 181-184. [Xu B, Liu GQ, Sun KY, et al. Analysis of behavioral risk factors for the outcomes of anterior decompression and fusion surgery for cervical radiculopathy[J]. The Journal of Cervicodynia and Lumbodynia, 2021, 42(2): 181-184.] DOI: 10.3969/j.issn.1005-7234.2021.02.009.

15.孙云平. 围绝经期神经根型颈椎病患者预后影响因素及列线图模型构建[J]. 中国妇幼保健, 2024, 39(13): 2507-2511. [Sun YP. Prognostic factors and nomogram model construction in patients with peri-menopausal cervical spondylosis[J]. Maternal & Child Health Care of China, 2024, 39(13): 2507-2511.] DOI: 10.19829/j.zgfybj.issn.1001-4411.2024.13.044.

16.钟灵, 冉小烽, 高琼. 综合康复训练治疗神经根型颈椎病效果及影响预后的相关因素分析[J]. 解放军医药杂志, 2019, 31(8): 53-56. [Zhong L, Ran XF, Gao Q. Efficacy of comprehensive rehabilitation training in treatment of patients with cervical spondylotic radicu-lopathy and analysis of related factors affecting prognosis[J]. Medical & Pharmaceutical Journal of Chinese People's Liberation Army, 2019, 31(8): 53-56.] DOI: 10.3969/j.issn.2095-140X.2019.08.012.

17.王晋德, 郭海龙. 退行性下颈椎不稳症的研究进展[J]. 临床医学进展, 2024, 14(3): 1056-1061. [Wang JD, Guo HL. Progress in the study of degenerative lower cervical spine instability[J]. Advances in Clinical Medicine, 2024, 14(3): 1056-1061.] DOI: 10.12677/acm.2024.143809.

18.畅美季. 老年人的药效变化特点及老年疾病对药物作用的影响[J]. 中国社区医师, 2009, 25(3): 16. [Chang MJ. Characteristics of efficacy changes in the elderly and the effects of geriatric diseases on drug effects[J]. Chinese Community Doctors, 2009, 25(3): 16.] http://qikan.cqvip.com/Qikan/Article/Detail?id=29911414.

19.Irwin MR, Olmstead R, Bjurstrom MF, et al. Sleep disruption and activation of cellular inflammation mediate heightened pain sensitivity: a randomized clinical trial[J]. Pain, 2023, 164(5): 1128-1137. DOI: 10.1097/j.pain.0000000000002811.

20.邹首琴, 戴康乐, 刘钰祯, 等. 颈椎病的运动疗法及机制研究进展[J].中国疗养医学, 2024, 33(7): 71-76. [Zou SQ, Dai KL, Liu YZ, et al. Research progress on exercise therapy of cervical spondylosis and its mechanism[J]. Chinese Journal of Convalescent Medicine, 2024, 33(7): 71-76.] DOI: 10.13517/j.cnki.ccm.2024.07.017.