化痰通络汤联合项七针治疗椎动脉型颈椎病的疗效及对血清SOD、NSE和椎-基底动脉血流动力学的影响
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摘要
目的:探讨化痰通络汤联合"项七针"治疗椎动脉型颈椎病的疗效及对患者血清超氧化物歧化酶(SOD)、神经元特异性烯醇酶(NSE)和椎-基底动脉血流动力学的影响。方法:纳入112例椎动脉型颈椎病患者,随机分为观察组(n=56)和对照组(n=56)。两组患者均采用项七针治疗,观察组患者加用化痰通络汤口服,治疗周期为4周。比较两组患者的临床疗效和主要临床症状改善情况,检测两组患者的血清SOD、NSE水平及椎-基底动脉血流动力学指标。结果:(1)治疗后,观察组和对照组的临床总有效率分别为92.86%、78.57%,两组临床疗效比较,差异有统计学意义(P<0.05),观察组疗效优于对照组。(2)治疗后,两组患者的眩晕、头痛、恶心、颈肩痛症状评分较治疗前均明显降低(P<0.05),且观察组患者的上述症状评分低于对照组(P<0.05)。(3)治疗后,两组患者的SOD水平较治疗前明显升高(P<0.05),NSE水平较治疗前明显降低(P<0.05),且观察组患者的血清SOD水平高于对照组(P<0.05),NSE水平低于对照组(P<0.05)。(4)治疗后,两组患者的左椎动脉(LVA)、右椎动脉(RVA)和基底动脉(BA)的血管收缩期、舒张期和平均血流速度均明显升高(P<0.05),且观察组患者的LVA、RVA及BA的血管收缩期、舒张期和平均血流速度高于对照组(P<0.05)。结论:化痰通络汤联合项七针治疗椎动脉型颈椎病具有较好的疗效,值得临床推广应用。
Objective: To explore the clinical efficacy of Huatan Tongluo Decoction combined with Nape Seven Needles in the treatment of cervical spondylosis of vertebral artery type and its influence on the serum superoxide dismutase( SOD),neuron-specific enolase( NSE) and vertebrobasilar artery hemodynamics. Methods: One hundred and twelve patients with cervical spondylosis of vertebral artery type were selected and randomly divided into the observation group and the control group,56 cases in each group. The patients in both groups were treated with Nape Seven Needles and the patients in the observation group were additionally treated with Huatan Tongluo Decoction,with a course of 4 weeks. The clinical efficacy and the improvement on main clinical symptoms were compared between the two groups,and the levels of serum SOD and NSE and the indexes of vertebrobasilar artery hemodynamics were measured.Results:(1)After treatment,the clinical total effective rates of the observation group and the control group were 92. 86% and 78. 57%respectively. There was statistically significant difference on the clinical efficacy between the two groups( P<0.05),and the efficacy of the observation group was superior to the control group.(2)After treatment,the symptom scores of vertigo,headache,nausea and pain of neck and shoulder in the two groups were obviously decreased compared with treatment before( P<0.05),and the above scores of the observation group were lower than those of the control group( P<0.05).(3)After treatment,the level of SOD in both groups was significantly increased compared with treatment before( P<0.05),and the level of NSE in both groups was significantly decreased( P<0.05). The serum level of SOD in the observation group was higher than that in the control group( P<0.05) and the level of NSE in the observation group was lower than that in the control group( P<0.05).(4)After treatment,the systolic,diastolic and mean blood flow velocities of left vertebral artery( LVA),right vertebral artery( RVA) and basilar artery( BA) in both groups were obviously increased( P<0.05),and the systolic,diastolic and mean blood flow velocities of LVA,RVA and BA in the observation group were higher than those in the control group( P<0.05). Conclusion: Huatan Tongluo Decoction combined with Nape Seven Needles shows good efficacy in the treatment of cervical spondylosis of vertebral artery type,which is worth popularizing in clinic.
Objective: To explore the clinical efficacy of Huatan Tongluo Decoction combined with Nape Seven Needles in the treatment of cervical spondylosis of vertebral artery type and its influence on the serum superoxide dismutase( SOD),neuron-specific enolase( NSE) and vertebrobasilar artery hemodynamics. Methods: One hundred and twelve patients with cervical spondylosis of vertebral artery type were selected and randomly divided into the observation group and the control group,56 cases in each group. The patients in both groups were treated with Nape Seven Needles and the patients in the observation group were additionally treated with Huatan Tongluo Decoction,with a course of 4 weeks. The clinical efficacy and the improvement on main clinical symptoms were compared between the two groups,and the levels of serum SOD and NSE and the indexes of vertebrobasilar artery hemodynamics were measured.Results:(1)After treatment,the clinical total effective rates of the observation group and the control group were 92. 86% and 78. 57%respectively. There was statistically significant difference on the clinical efficacy between the two groups( P<0.05),and the efficacy of the observation group was superior to the control group.(2)After treatment,the symptom scores of vertigo,headache,nausea and pain of neck and shoulder in the two groups were obviously decreased compared with treatment before( P<0.05),and the above scores of the observation group were lower than those of the control group( P<0.05).(3)After treatment,the level of SOD in both groups was significantly increased compared with treatment before( P<0.05),and the level of NSE in both groups was significantly decreased( P<0.05). The serum level of SOD in the observation group was higher than that in the control group( P<0.05) and the level of NSE in the observation group was lower than that in the control group( P<0.05).(4)After treatment,the systolic,diastolic and mean blood flow velocities of left vertebral artery( LVA),right vertebral artery( RVA) and basilar artery( BA) in both groups were obviously increased( P<0.05),and the systolic,diastolic and mean blood flow velocities of LVA,RVA and BA in the observation group were higher than those in the control group( P<0.05). Conclusion: Huatan Tongluo Decoction combined with Nape Seven Needles shows good efficacy in the treatment of cervical spondylosis of vertebral artery type,which is worth popularizing in clinic.
引文
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[14]刁虹,李伟,王东,等.颈椎病4号方配合小针刀治疗椎动脉型颈椎病[J].中国实验方剂学杂志,2014,20(14):185-187.
[15]刘睿.化痰通络汤联合针灸治疗对脑卒中后遗症期患者神经功能修复的影响[J].辽宁中医杂志,2016,43(7):1472-1475.
[16]史栋梁,史桂荣,孟庆良,等.中药内服联合穴位注射治疗神经根型颈椎病临床研究[J].中国中医基础医学杂志,2014,20(4):522-524.
[17]于秀鹏.手法配合中药治疗脊髓型颈椎病疗效观察[J].中国中医药信息杂志,2014,21(12):102-103.
[2]冷安明,杨静,赵焰.祛痰活血汤治疗气虚血瘀型轻症椎动脉型颈椎病对于颅内动脉血流速度的影响[J].中华中医药学刊,2016,34(7):1717-1719.
[3]魏楠.针灸推拿与中药联合应用对椎动脉型颈椎病患者血流动力学的影响[J].中国老年学杂志,2016,36(3):693-694.
[4]李增春,陈德玉,吴德升,等.第三届全国颈椎病专题座谈会纪要[J].中华外科杂志,2008,46(23):1796-1799.
[5]孙宇,李贵存.第二届颈椎病专题座谈会纪要[J].解放军医学杂志,1994,19(2):156-158.
[6]桂星花,马朝阳,唐雷,等.人迎穴改良针刺法对椎动脉型颈椎病患者颈部血流速度的影响及疗效观察[J].针刺研究,2017,42(2):163-167.
[7]王长月,王浩然,闫明,等.针刺加中药治疗椎动脉型颈椎病70例临床观察[J].辽宁中医杂志,2016,43(1):138-140.
[8]潘明柱,荣兵.镇肝息风汤加减配合项七针治疗椎动脉型颈椎病的临床研究[J].中国中医基础医学杂志,2018,24(5):658-661.
[9]梁德,崔健超,张华健,等.舒筋通络颗粒治疗神经根型和椎动脉型颈椎病2170例临床观察[J].中医杂志,2016,57(14):1226-1230.
[10]张洁文,黄增彬.正气理筋液配合正骨手法治疗椎动脉型颈椎病的疗效观察[J].广东医学,2017,38(5):791-792,796.
[11]NARENDRA S,DAS U K,TRIPATHY S K,et al. Superoxide Dismutase, Uric Acid, Total Antioxidant Status, and Lipid Peroxidation Assay in Chronic and Aggressive Periodontitis Patients[J]. J Contemp Dent Pract,2018,19(7):874-880.
[12]CATLI G,ANIK A,ACAR S,et al. Brain injury markers:S100calcium-binding protein B, neuron-specific enolase and glial fibrillary acidic protein in children with diabetic ketoacidosis[J].Pediatr Diabetes,2018,19(5):1000-1006.
[13]陈金篆,林财朱.电针刺激星状神经节治疗椎动脉型颈椎病的效果[J].中国老年学杂志,2014,34(19):5467-5468.
[14]刁虹,李伟,王东,等.颈椎病4号方配合小针刀治疗椎动脉型颈椎病[J].中国实验方剂学杂志,2014,20(14):185-187.
[15]刘睿.化痰通络汤联合针灸治疗对脑卒中后遗症期患者神经功能修复的影响[J].辽宁中医杂志,2016,43(7):1472-1475.
[16]史栋梁,史桂荣,孟庆良,等.中药内服联合穴位注射治疗神经根型颈椎病临床研究[J].中国中医基础医学杂志,2014,20(4):522-524.
[17]于秀鹏.手法配合中药治疗脊髓型颈椎病疗效观察[J].中国中医药信息杂志,2014,21(12):102-103.