穴位推拿联合益气定眩汤治疗颈性眩晕的临床研究
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摘要
目的:观察穴位推拿联合益气定眩汤治疗颈性眩晕(CV)的疗效及对血浆内皮素(ET)和椎动脉血流动力学的影响。方法:将126例CV患者随机分为治疗组和对照组各63例,两组患者均给予健康教育、饮食、运动等基础干预,在此基础上对照组给予穴位推拿治疗,治疗组在对照组基础上采用益气定眩汤治疗。观察两组患者中医证候积分、眩晕程度、临床疗效,检测ET和降钙素基因相关肽(CGRP)水平,测定基底动脉(BA)、左侧椎动脉(LVA)、右侧椎动脉(RVA)血流速度。结果:两组患者治疗后中医证候积分均显著低于治疗前(P<0.05),且治疗组患者治疗后中医证候积分显著低于对照组(P<0.05);两组患者治疗后眩晕程度、颈肩痛、日常生活及工作、心理及社会适应评分显著高于治疗前(P<0.05),且治疗组患者治疗后眩晕程度、颈肩痛、日常生活及工作、心理及社会适应评分均显著高于对照组(P<0.05);治疗组总有效率(90.48%)显著高于对照组(76.19%),差异有统计学意义(P<0.05);两组患者治疗后ET水平显著低于治疗前(P<0.05),且治疗组患者治疗后ET水平显著低于对照组(P<0.05);两组患者治疗后CGRP水平显著高于治疗前(P<0.05),且治疗组患者治疗后CGRP显著高于对照组(P<0.05);两组患者治疗后BA、LVA、RVA速度显著高于治疗前(P<0.05),且治疗组患者治疗后BA、LVA、RVA速度显著高于对照组(P<0.05)。结论:穴位推拿联合益气定眩汤可有效改善CV患者椎动脉血流动力学,提高临床疗效。
Objective: To explore the influence of acupoint massage combined with Yiqi Dingxuan decoction in treatment of cervical vertigo(CV) on efficacy, plasma endothelin(ET) and vertebral artery hemodynamics.Methods: A total of 126 cases of patients with CV were divided into treatment and control groups, 63 cases in each group. All the patients were given basic intervention such as health education, diet and exercise in two groups. And on the basis of that, the control group were given acupoint massage treatment, and the observation group were combined with Yiqi Dingxuan decoction on the basis of the control group. TCM symptom scores,vertigo degree and clinical effect were observed, and ET and calcitonin gene-related peptide(CGRP) levels were detected, and basal artery(BA), the left vertebral artery(LVA) and the right vertebral artery(RVA) flow velocity were detected in the two groups. Results: After treatment, TCM symptom scores were significantly lower than those before treatment in the two groups(P<0.05), and the treatment group showed lower TCM symptom scores than the control group(P<0.05). After treatment, vertigo, neck pain, daily life and work, psychological and social adaptation scores were significantly higher than those before treatment in the two groups(P<0.05), and the treatment group showed higher vertigo, neck pain, daily life and work, psychological and social adaptation scores than the control group(P<0.05). The total effective rate was 90.48% in treatment group and 76.19% in control group, and the treatment group showed better efficacy than the control group(P<0.05). After treatment, ET level was significantly lower than that before treatment in the two groups(P<0.05), and the treatment group showed lower ET level than the control group(P<0.05). CGRP level was significantly higher than that before treatment in the two groups(P<0.05), and the treatment group showed higher CGRP level than the control group(P<0.05). After treatment, BA, LVA and RVA rate was significantly higher than that before treatment in the two groups(P<0.05), and the treatment group showed higher BA, LVA and RVA rate than the control group(P<0.05). Conclusion: Acupoint massage combined with Yiqi Dingxuan decoction can effectively improve vertebral hemodynamics of patients with CV, and improve clinical efficacy.
Objective: To explore the influence of acupoint massage combined with Yiqi Dingxuan decoction in treatment of cervical vertigo(CV) on efficacy, plasma endothelin(ET) and vertebral artery hemodynamics.Methods: A total of 126 cases of patients with CV were divided into treatment and control groups, 63 cases in each group. All the patients were given basic intervention such as health education, diet and exercise in two groups. And on the basis of that, the control group were given acupoint massage treatment, and the observation group were combined with Yiqi Dingxuan decoction on the basis of the control group. TCM symptom scores,vertigo degree and clinical effect were observed, and ET and calcitonin gene-related peptide(CGRP) levels were detected, and basal artery(BA), the left vertebral artery(LVA) and the right vertebral artery(RVA) flow velocity were detected in the two groups. Results: After treatment, TCM symptom scores were significantly lower than those before treatment in the two groups(P<0.05), and the treatment group showed lower TCM symptom scores than the control group(P<0.05). After treatment, vertigo, neck pain, daily life and work, psychological and social adaptation scores were significantly higher than those before treatment in the two groups(P<0.05), and the treatment group showed higher vertigo, neck pain, daily life and work, psychological and social adaptation scores than the control group(P<0.05). The total effective rate was 90.48% in treatment group and 76.19% in control group, and the treatment group showed better efficacy than the control group(P<0.05). After treatment, ET level was significantly lower than that before treatment in the two groups(P<0.05), and the treatment group showed lower ET level than the control group(P<0.05). CGRP level was significantly higher than that before treatment in the two groups(P<0.05), and the treatment group showed higher CGRP level than the control group(P<0.05). After treatment, BA, LVA and RVA rate was significantly higher than that before treatment in the two groups(P<0.05), and the treatment group showed higher BA, LVA and RVA rate than the control group(P<0.05). Conclusion: Acupoint massage combined with Yiqi Dingxuan decoction can effectively improve vertebral hemodynamics of patients with CV, and improve clinical efficacy.
引文
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[12]马江涛,张银刚,袁启令,等.颈性眩晕的发病机制、诊断和治疗研究进展[J].中医正骨,2016,28(10):32-37.
[13]梁芳,魏德芝,王宇新,等.颈复汤对颈性眩晕患者血浆内皮素和降钙素基因相关肽水平影响的研究[J].现代中西医结合杂志,2013,22(4):343-345.
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[15]陈达祥,梁庆华.颈椎手法推拿结合针灸治疗颈性眩晕的临床研究[J].世界中医药,2013,8(5):549-551.
[16]张英丹,杜娟.中药热敷结合推拿手法治疗颈性眩晕临床分析及护理对策[J].中国保健营养,2016,26(28):156.
[17]唐臻一,任守平,陈福林,等.益气定眩汤治疗颈性眩晕气虚血瘀证的临床研究[J].光明中医,2017,32(5):661-663.
[18]陈泉峰.葛根定眩汤治疗颈性眩晕68例临床观察[J].中医临床研究,2015,7(13):111-112.
[2]王玉华,杨建.中医药治疗颈性眩晕研究进展[J].河南中医,2014,34(2):362-364.
[3]周肃陵,安建原.针刺结合正骨手法治疗椎动脉型颈椎病的临床研究[J].中医药导报,2015,21(20):72-74.
[4]纪传荣,程丽.定眩汤治疗颈性眩晕30例临床观察[J].湖南中医杂志,2016,32(3):44-45.
[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]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:228-229.
[7]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.
[8]金坚,赵玲丹.手法推拿联合针灸治疗老年颈性眩晕的效果及对椎-基底动脉血流动力学的影响[J].中国老年学杂志,2014,34(9):2403-2405.
[9]程肖芳,曹雪梅,刘书田.内热针对椎动脉型颈椎病患者改良ESCV评分及血流动力学的影响[J].针灸临床杂志,2017,33(3):34-36.
[10]陈剑.太极云手对颈性眩晕患者的血液流变学和椎动脉血流动力学影响:随机对照研究[D].福州:福建中医药大学,2013.
[11]王歆婷,郑士立,潘胜莲,等.针刺项三穴对60例颈性眩晕患者椎-基底动脉血流速度的影响[J].福建中医药,2016,47(4):64-65.
[12]马江涛,张银刚,袁启令,等.颈性眩晕的发病机制、诊断和治疗研究进展[J].中医正骨,2016,28(10):32-37.
[13]梁芳,魏德芝,王宇新,等.颈复汤对颈性眩晕患者血浆内皮素和降钙素基因相关肽水平影响的研究[J].现代中西医结合杂志,2013,22(4):343-345.
[14]刘书勇,苏丽婷.眩晕宁对颈性眩晕患者血浆内皮素和降钙素的影响[J].中国全科医学,2010,13(2):199-200.
[15]陈达祥,梁庆华.颈椎手法推拿结合针灸治疗颈性眩晕的临床研究[J].世界中医药,2013,8(5):549-551.
[16]张英丹,杜娟.中药热敷结合推拿手法治疗颈性眩晕临床分析及护理对策[J].中国保健营养,2016,26(28):156.
[17]唐臻一,任守平,陈福林,等.益气定眩汤治疗颈性眩晕气虚血瘀证的临床研究[J].光明中医,2017,32(5):661-663.
[18]陈泉峰.葛根定眩汤治疗颈性眩晕68例临床观察[J].中医临床研究,2015,7(13):111-112.