针刀同时松解枕后三角和肩胛提肌与单独松解枕后三角治疗颈性眩晕的效果比较
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摘要
目的比较针刀同时松解枕后三角和肩胛提肌与针刀单独松解枕后三角治疗颈性眩晕的效果。方法选取2015年5月~2016年12月在广西壮族自治区人民医院推拿科就诊的颈性眩晕患者42例,按照随机数字表法分为两组。治疗组采用针刀同时松解枕后三角和肩胛提肌,对照组采用针刀单独松解枕后三角,两组均治疗5次,每次治疗间隔2 d。治疗前后比较两组颈性眩晕症状与功能评估量表评分,评价两组临床疗效。结果治疗后,治疗组和对照组颈性眩晕症状与功能评估量表评分[(24.29±3.57)、(21.14±2.95)分]均较治疗前[(16.90±4.30)、(16.76±3.73)分]显著升高,且治疗组治疗后颈性眩晕症状与功能评估量表评分显著高于对照组,差异均有统计学意义(P<0.05)。两组疗效评估,治疗组治愈15例,有效5例,无效1例,对照组治愈6例,有效13例,无效2例,两组比较差异有统计学意义(Z=2.62,P<0.05)。结论针刀同时松解枕后三角和肩胛提肌治疗颈性眩晕临床效果更佳。
Objective To compare the effect of acupotomy in the treatment of cervical vertigo with simultaneous release of posterior occipital triangle and levator scapular muscle and the single release of posterior occipital triangle. Methods From May 2015 to December 2016, 42 patients with cervical vertigo treated in Department of Tuina, the People's Hospital of Guangxi Zhuang Autonomous Region were selected and divided into two groups according to the random number table method. In the treatment group, both posterior occipital triangle and levator scapular were loosened by acupotomy at the same time. In the control group, single posterior occipital triangle was loosened by acupotomy, both groups were treated for 5 times, with each treatment interval of 2 days. Before and after treatment, the cervical vertigo symptoms and function evaluation scale of two groups were compared, and the clinical efficacy of the two groups was evaluated. Results After treatment, the scores of cervical vertigo symptoms and function evaluation scale of treatment group and control group [(24.29±3.57),(21.14±2.95) points] were significantly higher than those before treatment [(16.90±4.30),(16.76±3.73) points], and the scores of cervical vertigo symptoms and function evaluation scale of treatment group were significantly higher than those of control group, the differences were statistically significant(P < 0.05). The curative effect of the two groups was evaluated, there were 15 cases of cure, 5 cases of effective, 1 case of invalid in the treatment group and 6 cases of cure, 13 cases of effective, 2 cases of invalid in the control group, the difference was statistically significant(Z = 2.62, P <0.05). Conclusion The effect of acupotomy in the treatment of cervical vertigo with simultaneous release of posterior occipital triangle and levator scapular muscle is better.
Objective To compare the effect of acupotomy in the treatment of cervical vertigo with simultaneous release of posterior occipital triangle and levator scapular muscle and the single release of posterior occipital triangle. Methods From May 2015 to December 2016, 42 patients with cervical vertigo treated in Department of Tuina, the People's Hospital of Guangxi Zhuang Autonomous Region were selected and divided into two groups according to the random number table method. In the treatment group, both posterior occipital triangle and levator scapular were loosened by acupotomy at the same time. In the control group, single posterior occipital triangle was loosened by acupotomy, both groups were treated for 5 times, with each treatment interval of 2 days. Before and after treatment, the cervical vertigo symptoms and function evaluation scale of two groups were compared, and the clinical efficacy of the two groups was evaluated. Results After treatment, the scores of cervical vertigo symptoms and function evaluation scale of treatment group and control group [(24.29±3.57),(21.14±2.95) points] were significantly higher than those before treatment [(16.90±4.30),(16.76±3.73) points], and the scores of cervical vertigo symptoms and function evaluation scale of treatment group were significantly higher than those of control group, the differences were statistically significant(P < 0.05). The curative effect of the two groups was evaluated, there were 15 cases of cure, 5 cases of effective, 1 case of invalid in the treatment group and 6 cases of cure, 13 cases of effective, 2 cases of invalid in the control group, the difference was statistically significant(Z = 2.62, P <0.05). Conclusion The effect of acupotomy in the treatment of cervical vertigo with simultaneous release of posterior occipital triangle and levator scapular muscle is better.
引文
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[10]李少芳,黄漫华,林卓鹏,等.枕下缘针刀松解治疗颈性眩晕疗效观察[J].中国针灸,2017,37(3):297-300.
[11]中华医学会神经病学分会,中华神经科杂志编辑委员会.眩晕诊治专家共识[J].中华神经科杂志,2010,43(5):369-374.
[12]王楚怀,卓大宏.颈性眩晕患者症状与功能评估的初步研究[J].中国康复医学杂志,1998,13(6):246.
[13]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:86.
[14]叶洁,顾小华,许金海,等.颈性眩晕的中医证型与脑血流动力学的相关性研究[J].中国中医骨伤科杂志,2014,22(3):7-10.
[15]唐汉英.颈性眩晕的中医治疗进展[J].中医杂志,2011,52(6):192-193.
[16]王昭斌,郝卫宾.水针刀配合手法治疗椎动脉型颈椎病的临床疗效及安全性分析[J].世界最新医学信息文摘,2015,11(31):174-175.
[17]唐占英,胡志俊,肖静,等.针刀松解枕下肌群治疗颈性眩晕的临床随机对照研究[J].上海中医药杂志,2015,49(1):41-43.
[18]李霞,房连强,李里,等.以肩胛提肌起止点为刃针作用靶点治疗颈性眩晕的临床观察[J].针灸临床杂志,2013,29(11):27-29.
[19]李新志,李必强.闭式肩胛提肌止点小针刀部分松解术治疗颈椎病的临床探讨[J].实用临床医学,2001,15(4):26-27.
[20]舒剑锋,范炳华.范炳华运用三部推拿法治疗颈性眩晕经验[J].浙江中医杂志,2013,48(2):81-82.
[2]朱俊琛,宋阳春,聂勇,等.针刀松解对颈性眩晕的疗效分析[J].颈腰痛杂志,2012,33(5):396-397.
[3]Morunaka S.Musculoskeletal diseases as a causal factor of cervical vertigo[J].Auris Nasus Larynx,2009,36(6):649-654.
[4]张军,孙树椿,于栋,等.交感神经及其递质在椎动脉型颈椎病中的调控机制[J].中国骨伤,2005,18(7):413-415.
[5]陈军,李静.推拿对椎动脉型颈椎病患者血液流变学及血清一氧化氮与血清内皮素的影响[J].时珍国医国药,2008,19(8):2028-2029.
[6]舒剑锋,范炳华,叶树良,等.三部推拿法治疗颈性眩晕技术多中心评价研究[J].浙江中医药大学学报,2016,40(9):705-709.
[7]冯诚,郭杨,董维,等.益气活血化痰法治疗颈性眩晕的研究进展[J].中国中医基础医学杂志,2016,20(10):1417-1419.
[8]王非,张京兰,潘微.针刺四神聪穴为主对颈性眩晕患者中医症候量表评分的评价[J].时珍国医国药,2015,26(6):1426-1427.
[9]王慧敏,曾浩彬,陈文治,等.刃针松解术治疗颈性眩晕[J].广东医学,2012,33(3):366-368.
[10]李少芳,黄漫华,林卓鹏,等.枕下缘针刀松解治疗颈性眩晕疗效观察[J].中国针灸,2017,37(3):297-300.
[11]中华医学会神经病学分会,中华神经科杂志编辑委员会.眩晕诊治专家共识[J].中华神经科杂志,2010,43(5):369-374.
[12]王楚怀,卓大宏.颈性眩晕患者症状与功能评估的初步研究[J].中国康复医学杂志,1998,13(6):246.
[13]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:86.
[14]叶洁,顾小华,许金海,等.颈性眩晕的中医证型与脑血流动力学的相关性研究[J].中国中医骨伤科杂志,2014,22(3):7-10.
[15]唐汉英.颈性眩晕的中医治疗进展[J].中医杂志,2011,52(6):192-193.
[16]王昭斌,郝卫宾.水针刀配合手法治疗椎动脉型颈椎病的临床疗效及安全性分析[J].世界最新医学信息文摘,2015,11(31):174-175.
[17]唐占英,胡志俊,肖静,等.针刀松解枕下肌群治疗颈性眩晕的临床随机对照研究[J].上海中医药杂志,2015,49(1):41-43.
[18]李霞,房连强,李里,等.以肩胛提肌起止点为刃针作用靶点治疗颈性眩晕的临床观察[J].针灸临床杂志,2013,29(11):27-29.
[19]李新志,李必强.闭式肩胛提肌止点小针刀部分松解术治疗颈椎病的临床探讨[J].实用临床医学,2001,15(4):26-27.
[20]舒剑锋,范炳华.范炳华运用三部推拿法治疗颈性眩晕经验[J].浙江中医杂志,2013,48(2):81-82.
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