整脊推拿结合化痰祛瘀方治疗颈源性眩晕伴颈动脉斑块43例
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摘要
目的:观察整脊推拿结合中药化痰祛瘀方治疗颈源性眩晕伴颈动脉斑块的的效果及安全性。方法:伴有颈动脉斑块的颈源性眩晕患者按随机数字表法分为两组,对照组45例采用基础治疗联合中药化痰祛瘀方,观察组43例在对照组基础上结合整脊推拿干预,治疗后统计比较两组眩晕指征和血脂改善情况。结果:治疗后两组患者眩晕、耳鸣、恶心欲呕、头痛、视力障碍、猝倒发作、颈项不适、反应迟钝等症状的恢复率比较,差异有统计学意义(P<0.01);治疗结束后观察组的总有效率为95.35%,明显优于对照组的77.78%,差异有统计学意义(P<0.05);疗程结束后两组患者血脂均较治疗前有所改善(P<0.05),观察组中的总胆固醇(TC)、低密度脂蛋白(LDL)明显低于对照组,高密度脂蛋白(HDL)明显高于对照组,差异均有统计学意义(P<0.05),但三酰甘油(TG)和对照组比较差异无统计学意义(P> 0.05)。结论:整脊推拿结合化痰祛瘀方治疗颈源性眩晕伴颈动脉斑块,在改善眩晕相关指征和血脂方面疗效较好。
Objective:To observe the therapeutic effect and safety of chiropractic tuina combined with Huatan Quyu Decoction in treating cervical vertigo with carotid plaque. Methods:Patients with cervical vertigo with carotid plaque were randomized into 2 groups. The control group with 45 patients received basic treatment and Huatan Quyu Decoction while the treatment group with 43 cases patients received basic treatment,Huatan Quyu Decoction combined with chiropractic tuina. Vertigo indications and blood lipid were recorded after the total treatment. Results:The main indications including:vertigo,tinnitus,nausea,headache,visual disturbance,sudden attack,neck discomfort and slow reaction were improved significantly after treatment and the differences of recovery rate in the two groups were statistically significant(P< 0.01). The total effective rate in the treatment group was 95.35% which was better than 77.78% in the control group,there was statistical significance(P< 0.05). After treatment,the blood lipid levels in both groups were improved significantly(P< 0.05),total cholesterol(TC) and low density lipoprotein(LDL) in the treatment group were lower than those in the control group,and high density lipoprotein(HDL) in the treatment group was higher than that in the control group(P< 0.05). Trilaurate glycerin(TG) in both groups did not change significantly(P> 0.05). Conclusion:Chiropractic tuina combined with Huatan Quyu Decoction treating patients with cervical vertigo with carotid plaque could safely and effectively improve vertigo related indications and blood lipid.
Objective:To observe the therapeutic effect and safety of chiropractic tuina combined with Huatan Quyu Decoction in treating cervical vertigo with carotid plaque. Methods:Patients with cervical vertigo with carotid plaque were randomized into 2 groups. The control group with 45 patients received basic treatment and Huatan Quyu Decoction while the treatment group with 43 cases patients received basic treatment,Huatan Quyu Decoction combined with chiropractic tuina. Vertigo indications and blood lipid were recorded after the total treatment. Results:The main indications including:vertigo,tinnitus,nausea,headache,visual disturbance,sudden attack,neck discomfort and slow reaction were improved significantly after treatment and the differences of recovery rate in the two groups were statistically significant(P< 0.01). The total effective rate in the treatment group was 95.35% which was better than 77.78% in the control group,there was statistical significance(P< 0.05). After treatment,the blood lipid levels in both groups were improved significantly(P< 0.05),total cholesterol(TC) and low density lipoprotein(LDL) in the treatment group were lower than those in the control group,and high density lipoprotein(HDL) in the treatment group was higher than that in the control group(P< 0.05). Trilaurate glycerin(TG) in both groups did not change significantly(P> 0.05). Conclusion:Chiropractic tuina combined with Huatan Quyu Decoction treating patients with cervical vertigo with carotid plaque could safely and effectively improve vertigo related indications and blood lipid.
引文
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[11]袁海光,鲁刚,冯卫星.触骨针法配合一指禅缠揉治疗椎动脉型颈椎病疗效观察[J].陕西中医,2016,37(7):905-906.
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[14]李黎,吴山,范志勇.推拿手法抗眩晕效应的量化及作用机制[J].医用生物力学,2016,31(6):562-565.
[15]谌祖江,李义凯.颈部推拿引起脑卒中的临床概况及其发生机制[J].颈腰痛杂志,2014,35(1):50-53.
[16]刘燕妮,闫咏梅,谢福恒.化痰祛瘀方治疗缺血性脑卒中临床观察[J].陕西中医,2017,38(11):1578-1580.
[2]高旭萍,谢高生,闫荣.眩晕与椎基底动脉血管变异(病变)的研究进展[J].临床神经病学杂志,2016,29(3):232-234.
[3]李永超,彭宝淦.颈性眩晕的发病机制及诊治新进展[J].中国矫形外科杂志,2015,23(3):250-253.
[4]樊春秋,陈瑾,黄小钦,等. 1000例眩晕患者的疾病谱[J].中风与神经疾病杂志,2016,33(5):445-447.
[5]中华医学会神经病学分会.眩晕诊治专家共识[J].中华神经科杂志,2010,43(5):369-374.
[6]董亚贤,尧慧燕,石红婷,等.缺血性脑卒中患者颈动脉斑块稳定性的影响因素分析[J].中国动脉硬化杂志,2015,23(7):717-721.
[7]中国中西医结合学会心血管病专业委员会血脂与动脉粥样硬化学组.动脉粥样硬化中西医结合诊疗专家共识[J].中国全科医学,2017,20(5):507-511.
[8]俞文骏,王剑波,黄娟,等.阿托伐他汀钙、阿司匹林联合中药血府逐瘀汤治疗颈动脉斑块60例疗效观察[J].上海医药,2017,38(18):20-24.
[9]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:186.
[10]冯卫星,袁海光,王斌,等.刘智斌推拿整脊手法治疗颈性眩晕经验[J].辽宁中医药大学学报,2013,15(11):112-114.
[11]袁海光,鲁刚,冯卫星.触骨针法配合一指禅缠揉治疗椎动脉型颈椎病疗效观察[J].陕西中医,2016,37(7):905-906.
[12]王文彪,卢巍,钟世荣,等.中医推拿手法治疗寰枢椎错位颈性眩晕的临床研究[J].时珍国医国药,2016,27(5):1150-1152.
[13]秦大平,张晓刚,宋敏.中医手法治疗椎动脉型颈椎病作用机制的生物力学研究进展[J].中国中医骨伤科杂志,2012,20(1):70-72.
[14]李黎,吴山,范志勇.推拿手法抗眩晕效应的量化及作用机制[J].医用生物力学,2016,31(6):562-565.
[15]谌祖江,李义凯.颈部推拿引起脑卒中的临床概况及其发生机制[J].颈腰痛杂志,2014,35(1):50-53.
[16]刘燕妮,闫咏梅,谢福恒.化痰祛瘀方治疗缺血性脑卒中临床观察[J].陕西中医,2017,38(11):1578-1580.