宋贵杰教授学术经验总结及治疗椎动脉型颈椎病临床研究
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摘要
全文包含三个部分
第一部分文献综述
分别对名老中医学术经验继承研究现状,全国骨伤科名家治疗椎动脉颈椎病学术经验和椎动脉型颈椎病研究进展三个方面进行了系统深入的综述。
第二部分导师宋贵杰教授学术经验总结
1.导师宋贵杰教授治疗椎动脉型颈椎病基本观点和方法：导师对颈椎的认识,导师对椎动脉型颈椎病发生机理的认识和导师对椎动脉型颈椎病引起眩晕的认识。
2.导师宋贵杰教授治疗腰椎间盘突出症手法经验总结：系统回顾了导师三步三位八法的形成过程,即三个步骤、三种体位和八种手法具体的形成过程,分析了八种手法的操作目的和作用原理,为腰椎间盘突出症辨证施法提供了可靠的理论依据。
3.总结了导师宋贵杰教授伤科用药经验：重点介绍了胸腹部损伤的辨证论治经验和外用专方的组成及作用原理。
4.通过对导师宋贵杰教授治疗胆囊摘除术后跟痛症临床经验总结：展示导师对新发疾病辨证论治的临床思维脉络,总结导师临床思维特点。
5.全面总结分析导师宋贵杰教授中医骨伤科学术思想：①天人合一的思想；②整体观念与微观辨证的思想；③手法治疗与药物治疗相结合的思想；④正骨手法与理筋手法相结合的思想；⑤医患互动的思想。
第三部分导师宋贵杰教授手法配合仙鹤决明汤治疗椎动脉型颈椎病临床研究
目的：观察宋贵杰教授手法结合仙鹤决明汤治疗椎动脉型颈椎病的临床疗效,评价其治疗方法的有效性和优效性。
方法：选取2009年5月～2011年5月门诊及住院椎动脉型颈椎病眩晕患者120例。按就诊时间顺序随机分为治疗组和对照组各60例。治疗组男33例,女27例,年龄30岁～71岁,平均年龄55岁。病程1个月～10年。对照组男35例,女25例,年龄30岁～70岁,平均年龄57岁。病程28天～11年。两组年龄、性别、病程、病情等级分布,差异均无统计学意义(p>0.05),具有可比性。治疗组采用宋贵杰教授手法结合仙鹤决明汤治疗,对照组采用颈椎坐位枕颌带牵引和西比灵胶囊(盐酸氟桂利嗪胶囊口服,国药准字H37023094)10mg,晚间顿服,10次为1个疗程,治疗2个疗程。治疗前后采用眩晕量表评分法、颈椎曲度值(弓弦距)测量和颈部彩超椎动脉阻力指数测定获得数据,利用spss17.0软件对数据进行分析。
结果：从症状评分、曲度测定和阻力指数三方面比较,两组治疗前比较均不具有统计学差异(p>0.05),表明两组病例分组合理,治疗前病情无显著性差异。三项指标组内治疗前后比较：①治疗后均具有显著性统计学差异(p<0.01),症状改善指数比较具有显著性统计学差异(p<0.01)表明两种治疗方法临床治疗效果显著；两组之间症状评分和曲度测定组内具有显著性统计学差异(p<0.01),血管阻力指数(RI)两组治疗后比较不具有统计学差异(p>0.05),表明治疗组比对照组对改善症状和曲度更具有显著治疗效果。②治疗组和对照组对椎动脉型颈椎病椎动脉血管阻力指数和治疗组均具有显著治疗意义,可能跟西比灵为钙离子拮抗剂,对解除椎动脉血管痉挛具有良好的治疗作用有关。
结论：宋贵杰教授治疗椎动脉型颈椎病方法临床效果显著,有一定的科学性和先进性,为进一步学习和研究宋贵杰教授中医骨伤科治疗经验提供一种先进的继承研究方法。
本文在全面总结宋贵杰教授中医骨伤科临床经验基础上,以椎动脉型颈椎病临床研究为中心,证实宋贵杰教授学术经验的科学性、独创性和先进性,凝练学术特色,揣摩学术脉络,提出学术思想,为形成学术流派提供初步的理论依据。
The paper consists of three parts.
The first part of the literature review were a systematic and in-depth review of the academic experience of Traditional Chinese Medicine research, the academic experience of treatment of vertebral artery cervical disease and the development of cervical vertebral artery disease research.
The second part is a summary of Professor Song Guijie's academic experience.
1. The basic ideas and methods of Professor Song Guijie's treatment of Cervical Spondylopathy of Vertebral Artery, which includes his understanding of the cervical spine, of the mechanism of vertebral artery type of cervical spondylosis, and dizziness caused by cervical spondylosis of vertebral artery type.
2. A summary of Professor Song Guijie's experience of treatment of protrasion of the lumbar intervertebral disci:the formation process of "three steps three postures and eight methods"is reviewed systematically, with the emphasis on analysis of the purpose of operation of the three methods and the mechanism of action, which provides a reliable theoretical basis for lumbar disc herniation dialectics.
3. The author summarizes Professor Song Guijie's drug experience of traumatology, focusing on the composition and role of the chest and abdomen injury diagnosis and pathogenesis, differential treatment, and specific prescriptions.
4. By introducing clinical experience of Professor Song Guijie's treatment of gallbladder removal, the author reveals his clinical thinking of new disease diagnosis and treatment.
5. A comprehensive summary of Professor Song Guijie's academic ideas of Chinese Orthopedics:①theory that man is an integral part of nature;②The overall concept and the idea of microcosmic syndrome;③idea of combining the manual therapy and drug treatment;④the idea of combining bone setting manipulation and tendon practices;⑤the idea of doctor-patient interaction.
The third part is about the clinical research of Professor Song Guijie's manipulation, combined with crane Cassia Decoction in the treatment of cervical spondylosis of vertebral artery type:
Purpose:To validate the scientific advantage professor Song GuiJie's experence treating vertebral artery cervical spondylosis.
Methods:Select120cases of vertebroarterial cervical spondylopathy vertigo patients from May2009to May2011.According to the clinical time sequence, randomly divide them into the treatment group and control group-60cases for each. In the treatment group, there were33male patients,27females, aged30to71, averagely55years old, Course1months to10year. In the control group, there were35male patients,25females, aged30to70, averagely57years old, course28d～11y. The age, sex, course, disease level distribution of there two groups showed no significant difference statistically (p>0.05), and they are comparable. In the treatment group, we applied professor Song Gui-Jie's method, in the treatment group, we used the cervical traction with occiput-jaw belt in sitting position and oral taking Xi Bi Lin capsule (flunarizine hydrochloride capsule, the Chinese medicine approved H37023094)10mg, qn,10times for a course of treatment. Before and after the treatments, we respectively collected datas with vertigo scale score method, cervical vertebra curvature measuring and vertebral artery resistance index in vertebral color dopplar ultrasound, and did the analysis with SPSS17.0.
Results:between these two groups, the comparision of symptom score, curvature measuring and resistance index showed no statistical differences before the treatment (p>0.05), which means the division o these two groups were reasonable. Comparision of these three themeters before and after the treatments in both groups:①After the treatment, all these three themeters showed significant statistical difference (p<0.01), the significant statistical difference of symptom improvement index comparison (p<0.01) means the clinical effects of both of these methods were prominant. Between these two groups of scale score and cervical vertebra curvature measuring after treatment showed significant statistical difference (p<0.01), resistance index showed no significant statistical difference (p>0.05), which means the method in the treatment group is more effective than the control group in improving symptoms and curvature.②Bothe of the groups showed therapeutic effects in improving symptoms and curvature. The reason might be the calcium antagonistic function of Flunarizine Hydrochloride Capsules, yet there were no therapeutic differences between thesee two groups.
conclusion:professor Song Gui-Jie's treatment method for vertebroarterial cervical spondylopathy has significant clinical effects, certain scientific advantage. Meanwhile, there could supply a scientific research method for further study and research of professor Song Gui-Jie's treatment experience for other orthopaedics diseases.
This paper, taking this example for the overall development of the research center of formulary clinical experience, professor of clinical experience that SongGuiJie scientific and originality, concise academic characteristic for academic context, put forward the academic thinking, and to form the academic schools provide preliminary theory basis.
On the bases of generally summarizing professor Song Gui-Jie's clinical experence in Chinese Medicine orthopaedics, by the clinical research of vertebroarterial cervical spondylopathy, we have proved the scientific mechanism and originality of his academic experience.it has provided preliminary theory basis for the formation of a new academic genre.
第一部分文献综述
分别对名老中医学术经验继承研究现状,全国骨伤科名家治疗椎动脉颈椎病学术经验和椎动脉型颈椎病研究进展三个方面进行了系统深入的综述。
第二部分导师宋贵杰教授学术经验总结
1.导师宋贵杰教授治疗椎动脉型颈椎病基本观点和方法：导师对颈椎的认识,导师对椎动脉型颈椎病发生机理的认识和导师对椎动脉型颈椎病引起眩晕的认识。
2.导师宋贵杰教授治疗腰椎间盘突出症手法经验总结：系统回顾了导师三步三位八法的形成过程,即三个步骤、三种体位和八种手法具体的形成过程,分析了八种手法的操作目的和作用原理,为腰椎间盘突出症辨证施法提供了可靠的理论依据。
3.总结了导师宋贵杰教授伤科用药经验：重点介绍了胸腹部损伤的辨证论治经验和外用专方的组成及作用原理。
4.通过对导师宋贵杰教授治疗胆囊摘除术后跟痛症临床经验总结：展示导师对新发疾病辨证论治的临床思维脉络,总结导师临床思维特点。
5.全面总结分析导师宋贵杰教授中医骨伤科学术思想：①天人合一的思想；②整体观念与微观辨证的思想；③手法治疗与药物治疗相结合的思想；④正骨手法与理筋手法相结合的思想；⑤医患互动的思想。
第三部分导师宋贵杰教授手法配合仙鹤决明汤治疗椎动脉型颈椎病临床研究
目的：观察宋贵杰教授手法结合仙鹤决明汤治疗椎动脉型颈椎病的临床疗效,评价其治疗方法的有效性和优效性。
方法：选取2009年5月～2011年5月门诊及住院椎动脉型颈椎病眩晕患者120例。按就诊时间顺序随机分为治疗组和对照组各60例。治疗组男33例,女27例,年龄30岁～71岁,平均年龄55岁。病程1个月～10年。对照组男35例,女25例,年龄30岁～70岁,平均年龄57岁。病程28天～11年。两组年龄、性别、病程、病情等级分布,差异均无统计学意义(p>0.05),具有可比性。治疗组采用宋贵杰教授手法结合仙鹤决明汤治疗,对照组采用颈椎坐位枕颌带牵引和西比灵胶囊(盐酸氟桂利嗪胶囊口服,国药准字H37023094)10mg,晚间顿服,10次为1个疗程,治疗2个疗程。治疗前后采用眩晕量表评分法、颈椎曲度值(弓弦距)测量和颈部彩超椎动脉阻力指数测定获得数据,利用spss17.0软件对数据进行分析。
结果：从症状评分、曲度测定和阻力指数三方面比较,两组治疗前比较均不具有统计学差异(p>0.05),表明两组病例分组合理,治疗前病情无显著性差异。三项指标组内治疗前后比较：①治疗后均具有显著性统计学差异(p<0.01),症状改善指数比较具有显著性统计学差异(p<0.01)表明两种治疗方法临床治疗效果显著；两组之间症状评分和曲度测定组内具有显著性统计学差异(p<0.01),血管阻力指数(RI)两组治疗后比较不具有统计学差异(p>0.05),表明治疗组比对照组对改善症状和曲度更具有显著治疗效果。②治疗组和对照组对椎动脉型颈椎病椎动脉血管阻力指数和治疗组均具有显著治疗意义,可能跟西比灵为钙离子拮抗剂,对解除椎动脉血管痉挛具有良好的治疗作用有关。
结论：宋贵杰教授治疗椎动脉型颈椎病方法临床效果显著,有一定的科学性和先进性,为进一步学习和研究宋贵杰教授中医骨伤科治疗经验提供一种先进的继承研究方法。
本文在全面总结宋贵杰教授中医骨伤科临床经验基础上,以椎动脉型颈椎病临床研究为中心,证实宋贵杰教授学术经验的科学性、独创性和先进性,凝练学术特色,揣摩学术脉络,提出学术思想,为形成学术流派提供初步的理论依据。
The paper consists of three parts.
The first part of the literature review were a systematic and in-depth review of the academic experience of Traditional Chinese Medicine research, the academic experience of treatment of vertebral artery cervical disease and the development of cervical vertebral artery disease research.
The second part is a summary of Professor Song Guijie's academic experience.
1. The basic ideas and methods of Professor Song Guijie's treatment of Cervical Spondylopathy of Vertebral Artery, which includes his understanding of the cervical spine, of the mechanism of vertebral artery type of cervical spondylosis, and dizziness caused by cervical spondylosis of vertebral artery type.
2. A summary of Professor Song Guijie's experience of treatment of protrasion of the lumbar intervertebral disci:the formation process of "three steps three postures and eight methods"is reviewed systematically, with the emphasis on analysis of the purpose of operation of the three methods and the mechanism of action, which provides a reliable theoretical basis for lumbar disc herniation dialectics.
3. The author summarizes Professor Song Guijie's drug experience of traumatology, focusing on the composition and role of the chest and abdomen injury diagnosis and pathogenesis, differential treatment, and specific prescriptions.
4. By introducing clinical experience of Professor Song Guijie's treatment of gallbladder removal, the author reveals his clinical thinking of new disease diagnosis and treatment.
5. A comprehensive summary of Professor Song Guijie's academic ideas of Chinese Orthopedics:①theory that man is an integral part of nature;②The overall concept and the idea of microcosmic syndrome;③idea of combining the manual therapy and drug treatment;④the idea of combining bone setting manipulation and tendon practices;⑤the idea of doctor-patient interaction.
The third part is about the clinical research of Professor Song Guijie's manipulation, combined with crane Cassia Decoction in the treatment of cervical spondylosis of vertebral artery type:
Purpose:To validate the scientific advantage professor Song GuiJie's experence treating vertebral artery cervical spondylosis.
Methods:Select120cases of vertebroarterial cervical spondylopathy vertigo patients from May2009to May2011.According to the clinical time sequence, randomly divide them into the treatment group and control group-60cases for each. In the treatment group, there were33male patients,27females, aged30to71, averagely55years old, Course1months to10year. In the control group, there were35male patients,25females, aged30to70, averagely57years old, course28d～11y. The age, sex, course, disease level distribution of there two groups showed no significant difference statistically (p>0.05), and they are comparable. In the treatment group, we applied professor Song Gui-Jie's method, in the treatment group, we used the cervical traction with occiput-jaw belt in sitting position and oral taking Xi Bi Lin capsule (flunarizine hydrochloride capsule, the Chinese medicine approved H37023094)10mg, qn,10times for a course of treatment. Before and after the treatments, we respectively collected datas with vertigo scale score method, cervical vertebra curvature measuring and vertebral artery resistance index in vertebral color dopplar ultrasound, and did the analysis with SPSS17.0.
Results:between these two groups, the comparision of symptom score, curvature measuring and resistance index showed no statistical differences before the treatment (p>0.05), which means the division o these two groups were reasonable. Comparision of these three themeters before and after the treatments in both groups:①After the treatment, all these three themeters showed significant statistical difference (p<0.01), the significant statistical difference of symptom improvement index comparison (p<0.01) means the clinical effects of both of these methods were prominant. Between these two groups of scale score and cervical vertebra curvature measuring after treatment showed significant statistical difference (p<0.01), resistance index showed no significant statistical difference (p>0.05), which means the method in the treatment group is more effective than the control group in improving symptoms and curvature.②Bothe of the groups showed therapeutic effects in improving symptoms and curvature. The reason might be the calcium antagonistic function of Flunarizine Hydrochloride Capsules, yet there were no therapeutic differences between thesee two groups.
conclusion:professor Song Gui-Jie's treatment method for vertebroarterial cervical spondylopathy has significant clinical effects, certain scientific advantage. Meanwhile, there could supply a scientific research method for further study and research of professor Song Gui-Jie's treatment experience for other orthopaedics diseases.
This paper, taking this example for the overall development of the research center of formulary clinical experience, professor of clinical experience that SongGuiJie scientific and originality, concise academic characteristic for academic context, put forward the academic thinking, and to form the academic schools provide preliminary theory basis.
On the bases of generally summarizing professor Song Gui-Jie's clinical experence in Chinese Medicine orthopaedics, by the clinical research of vertebroarterial cervical spondylopathy, we have proved the scientific mechanism and originality of his academic experience.it has provided preliminary theory basis for the formation of a new academic genre.
引文
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