腹针结合颈椎弧度牵引治疗椎动脉型颈椎病的临床疗效评价
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摘要
目的观察腹针结合颈椎弧度牵引治疗椎动脉型颈椎病的临床疗效。方法将80例椎动脉型颈椎病患者按照随机数表法分为两组,每组40例,治疗组采用腹针结合颈椎弧度牵引法治疗,对照组予西药氟桂利嗪口服,比较两组患者治疗前后的颈椎病临床评价量表评分、颈性眩晕症状与功能评估量表评分、血流动力学等指标。结果两组治疗椎动脉型颈椎病均取得较好疗效,治疗组总有效率为92.5%,明显高于对照组的77.5%(P<0.05);治疗组治疗后颈椎病临床评价量表评分高于对照组,两者比较差异有统计学意义(P<0.05);两组治疗后眩晕、颈肩痛、头痛、日常生活及工作、心理及社会适应方面各指标均较治疗前有明显好转(P<0.01)。结论腹针结合颈椎弧度牵引可明显改善椎动脉型颈椎病患者的眩晕、颈肩痛、头痛、日常生活及工作、心理及社会适应等症状,明显提高椎基底动脉的血流速度,其疗效与腹针结合颈椎弧度牵引改善椎基底动脉供血有关。
Objective To observe the clinical efficacy of abdominal acupuncture plus cervical curvature traction in treating cervical spondylosis of vertebral artery type. Method Eighty patients with cervical spondylosis of vertebral artery type were divided by the random number table into two groups, with 40 cases in each group. The treatment group was intervened by abdominal acupuncture plus cervical curvature traction, and the control group was given oral administration of flunarizine. The two groups were compared before and after treatment in terms of clinical symptom score, cervical vertigo symptom and function assessment scale, and hemodynamics, etc. Result Both groups attained significant efficacy, and the total effective rate was 92.5% in the treatment group, markedly higher than 77.5% in the control group(P<0.05); the score of cervical spondylosis symptom scale in the treatment group was higher than that in the control group after treatment, and the difference was statistically significant(P<0.05); after treatment, the evaluations of vertigo, neck-shoulder pain, headache, daily living and work, mental and social adaptation were significantly improved in both groups(P<0.01). Conclusion Abdominal acupuncture plus cervical curvature traction can obviously improve symptoms such as vertigo, neck-shoulder pain, headache, daily living and work, and mental and social adaptation, and boost the blood flow velocity of vertebrobasilar artery in patients with cervical spondylosis of vertebral artery type. The achievement of therapeutic efficacy is associated with the improvement of vertebrobasilar blood supply.
Objective To observe the clinical efficacy of abdominal acupuncture plus cervical curvature traction in treating cervical spondylosis of vertebral artery type. Method Eighty patients with cervical spondylosis of vertebral artery type were divided by the random number table into two groups, with 40 cases in each group. The treatment group was intervened by abdominal acupuncture plus cervical curvature traction, and the control group was given oral administration of flunarizine. The two groups were compared before and after treatment in terms of clinical symptom score, cervical vertigo symptom and function assessment scale, and hemodynamics, etc. Result Both groups attained significant efficacy, and the total effective rate was 92.5% in the treatment group, markedly higher than 77.5% in the control group(P<0.05); the score of cervical spondylosis symptom scale in the treatment group was higher than that in the control group after treatment, and the difference was statistically significant(P<0.05); after treatment, the evaluations of vertigo, neck-shoulder pain, headache, daily living and work, mental and social adaptation were significantly improved in both groups(P<0.01). Conclusion Abdominal acupuncture plus cervical curvature traction can obviously improve symptoms such as vertigo, neck-shoulder pain, headache, daily living and work, and mental and social adaptation, and boost the blood flow velocity of vertebrobasilar artery in patients with cervical spondylosis of vertebral artery type. The achievement of therapeutic efficacy is associated with the improvement of vertebrobasilar blood supply.
引文
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[13]贾妮,刘淑霞.中医综合治疗方案干预椎动脉型颈椎病眩晕症的临床研究[J].现代中医药,2017,(5):21-22,25.
[14]李少敏,谢继萍,徐向阳,等.穴位埋线结合养血清脑颗粒治疗椎动脉型颈椎病中眩晕的近期效果[J].宁夏医学杂志,2013,35(8):693-695.
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[16]范大鹏,孙波,金哲峰.椎动脉型颈椎病发病机制研究进展[J].中国中医骨伤科杂志,2012,20(10):76-78.
[17]汪东颖,陆军达,裴建.动静平衡思想对颈椎病防治的指导作用[J].中国中医骨伤科杂志,2012,20(4):60-62.
[18]于栋,陈兆军,徐凡平,等.颈椎动力性失衡致早期颈椎病的相关研究进展[J].中国中医骨伤科杂志,2013,21(3):72-74.
[19]薄智云.谈谈腹针疗法[J].中国针灸,2001,21(8):474.
[20]徐贞杰,胡幼平.腹针疗法临床研究概况[J].辽宁中医杂志,2010,(S1):252-254.
[21]王曙辉,许明珠,郭元琦,等.腹针疗法治疗痛证临床研究进展[J].新中医,2009,(11):106-108.
[22]徐勇刚,宣丽华,华江,等.腹针治疗椎动脉型颈椎病的临床疗效评价[J].中华中医药学刊,2011,29(7):1572.
[23]陈静,黄泳,李求实,等.薄氏腹针疗法治疗颈性眩晕的临床观察[J].辽宁中医杂志,2010,37(2):340.
[24]何智泉,肖落,曹哲,等.薄氏腹针疗法治疗颈性眩晕的临床研究[J].中西医结合心脑血管病杂志,2011,9(12):1446-1447.
[25]高宏,李雪珍.腹针治疗椎动脉型颈椎病的临床观察[J].浙江临床医学,2008,12(10):1592.
[26]高宏,李晓一,徐松泉,等.腹针治疗椎动脉型颈椎病机理浅析[J].浙江中医杂志,2017,52(4):286.
[27]Haynes MJ,Milne N.Color duplex sonographic findings in human vertebral arteries during cervical rotation[J].JClin Ultrasound,2001,29:14.
[28]童正一,叶洁,许金海,等.颈椎运动负荷试验对不同中医证型颈性眩晕患者血流动力学指标的影响[J].中国中医急症,2015,24(6):981-983,998.
[29]席莉,周桂桐,张选国,等.针药结合治疗气虚血瘀型颈性眩晕临床研究[J].现代中西医结合杂志,2018,27(4):381-383.
[30]艾宙,刘光德,熊小翠,等.腹针对椎动脉型颈椎病椎动脉血流的影响[J].中国针灸,2013,33(7):601-604.
[31]周宏图,谭文捷,袁建国,等.高压氧及颈椎牵引综合治疗椎动脉型颈椎病的疗效观察[J].中华物理医学与康复杂志,2006,28(7):484-485.
[32]李建成,付有芽,陆小平,等.不同角度颈椎牵引配合仰卧位手法治疗颈椎病临床观察[J].中医正骨,2003,15(5):22-23.
[33]麻国尧,汪芳俊,魏威,等.不同角度牵引治疗颈椎病的生物力学研究[J].中华全科医学,2015,13(8):1225.
[2]蒋学余,任祥,李黎,等.针灸治疗椎动脉型颈椎病研究概况[J].护理学,2017,6(5):171-175.
[3]刘智勇,郝阳泉.椎动脉型颈椎病的病因病机研究进展[J].实用中西医结合临床,2015,15(4):88-90.
[4]陈诚,丁吉林,资昌艳,等.近年针刀治疗椎动脉型颈椎病的进展[J].内蒙古中医药,2017,(20):137-138.
[5]杨宝焱,刘亚欣,井夫杰,等.中医外治法治疗椎动脉型颈椎病的临床研究进展[J].按摩与康复医学,2017,8(18):7-9.
[6]刘涛,宋敏,龚彦龙,等.椎动脉型颈椎病的中医临床研究进展[J].甘肃中医学院学报,2016,(5):78-80.
[7]孙宇,陈琪福.第二届颈椎病专题座谈会记要[J].中华外科杂志,1993,31(8):472-476.
[8]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,1994:18.
[9]张鸣生,许伟成,林仲民,等.颈椎病临床评价量表的信度与效度研究[J].中华物理医学与康复杂志,2003,25(3):151-154.
[10]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,(6):245-247.
[11]彭东,黄锦如.桂枝汤化裁治疗椎动脉型颈椎病引起头痛头昏疗效观察[J].内蒙古中医药,2014,(20):14-15.
[12]王晓东,朱立国,于杰,等.椎动脉型颈椎病眩晕症状的临床研究概述[J].中国中医骨伤科杂志,2016,(3):80-82.
[13]贾妮,刘淑霞.中医综合治疗方案干预椎动脉型颈椎病眩晕症的临床研究[J].现代中医药,2017,(5):21-22,25.
[14]李少敏,谢继萍,徐向阳,等.穴位埋线结合养血清脑颗粒治疗椎动脉型颈椎病中眩晕的近期效果[J].宁夏医学杂志,2013,35(8):693-695.
[15]戚记伟,全仁夫.中医药治疗椎动脉型颈椎病近况[J].云南中医中药杂志,2009,30(9):66-68.
[16]范大鹏,孙波,金哲峰.椎动脉型颈椎病发病机制研究进展[J].中国中医骨伤科杂志,2012,20(10):76-78.
[17]汪东颖,陆军达,裴建.动静平衡思想对颈椎病防治的指导作用[J].中国中医骨伤科杂志,2012,20(4):60-62.
[18]于栋,陈兆军,徐凡平,等.颈椎动力性失衡致早期颈椎病的相关研究进展[J].中国中医骨伤科杂志,2013,21(3):72-74.
[19]薄智云.谈谈腹针疗法[J].中国针灸,2001,21(8):474.
[20]徐贞杰,胡幼平.腹针疗法临床研究概况[J].辽宁中医杂志,2010,(S1):252-254.
[21]王曙辉,许明珠,郭元琦,等.腹针疗法治疗痛证临床研究进展[J].新中医,2009,(11):106-108.
[22]徐勇刚,宣丽华,华江,等.腹针治疗椎动脉型颈椎病的临床疗效评价[J].中华中医药学刊,2011,29(7):1572.
[23]陈静,黄泳,李求实,等.薄氏腹针疗法治疗颈性眩晕的临床观察[J].辽宁中医杂志,2010,37(2):340.
[24]何智泉,肖落,曹哲,等.薄氏腹针疗法治疗颈性眩晕的临床研究[J].中西医结合心脑血管病杂志,2011,9(12):1446-1447.
[25]高宏,李雪珍.腹针治疗椎动脉型颈椎病的临床观察[J].浙江临床医学,2008,12(10):1592.
[26]高宏,李晓一,徐松泉,等.腹针治疗椎动脉型颈椎病机理浅析[J].浙江中医杂志,2017,52(4):286.
[27]Haynes MJ,Milne N.Color duplex sonographic findings in human vertebral arteries during cervical rotation[J].JClin Ultrasound,2001,29:14.
[28]童正一,叶洁,许金海,等.颈椎运动负荷试验对不同中医证型颈性眩晕患者血流动力学指标的影响[J].中国中医急症,2015,24(6):981-983,998.
[29]席莉,周桂桐,张选国,等.针药结合治疗气虚血瘀型颈性眩晕临床研究[J].现代中西医结合杂志,2018,27(4):381-383.
[30]艾宙,刘光德,熊小翠,等.腹针对椎动脉型颈椎病椎动脉血流的影响[J].中国针灸,2013,33(7):601-604.
[31]周宏图,谭文捷,袁建国,等.高压氧及颈椎牵引综合治疗椎动脉型颈椎病的疗效观察[J].中华物理医学与康复杂志,2006,28(7):484-485.
[32]李建成,付有芽,陆小平,等.不同角度颈椎牵引配合仰卧位手法治疗颈椎病临床观察[J].中医正骨,2003,15(5):22-23.
[33]麻国尧,汪芳俊,魏威,等.不同角度牵引治疗颈椎病的生物力学研究[J].中华全科医学,2015,13(8):1225.