手法整复治疗寰枢关节紊乱所致颈性眩晕的临床研究

Clinical observation on the treatment of cervical vertigo due to atlantoaxial joint disorder with manipulation

目的：观察手法整复治疗寰枢关节紊乱所致颈性眩晕的临床疗效。方法收集2010年7月－2014年7月广东潮州市潮州医院门诊患者86例，按随机数字表法将患者分为2组各43例，对照组静脉滴注倍他司汀氯化钠，治疗组在对照组基础上联合手法整复治疗。治疗1周后观察2组患者眩晕症状及体征的变化，以及左侧椎动脉（LVA）、右侧椎动脉（RVA）、基底动脉（BA）的平均血流速度（Vm），并比较寰齿前间隙（ADI）、双侧齿突侧块间距差（VBLADI）、齿突生长性偏移值（DO），判定眩晕患者临床疗效。结果治疗后，治疗组眩晕症状及体征的改善情况优于对照组（t＝12.655，P＜0.01），ADI、VBLADI关节间隙缩小情况优于对照组（t值分别为2.888、5.334，P＜0.05），RVA、LVA、BA的Vm 值升高情况优于对照组（t值分别为4.710、3.534、5.335，P＜0.01）。结论手法整复联合静脉滴注盐酸倍他司汀氯化钠注射液可有效改善患者眩晕症状，降低ADI、VBLADI、DO的CT值，缩小ADI、VBLADI，纠正寰枢关节紊乱。

Objective To study the clinical effect of manipulation in the treatment of cervical vertigo due to atlantoaxial joint disorder. Methods A total of 86 patients in our hospital from year of July, 2010 to 2014, with cervical vertigo due to atlantoaxial joint disorder were divided into a control group and a treatment group randomly, with 43 patients in each group. The control group was treated by intravenous dripping of betahistine hydrochloride sodium chloride injection, while the treatment group was additionally treated by manipulation on the basis of the control group. The efficacy and symptoms changes together with average blood flow rate of LVA, RVA, BA, and the value of ADI, VBLADI, and DO were compared between the two groups after one week of the treatment. Results After the treatment, the improvement of vertigo and symptoms of the treatment group was between than the control group（t=12.655, P〈0.05）; the value of ADI and VBLADI decreased lower in the treatment group than the control group （t were 2.888 and 5.334 respectively, P〈0.05）;Vm of RVA, LVA and BA increased higher in the treatment group than the control group （t were 4.710, 3.534 and 5.335 respectively, P〈0.01）. Conclusions Manipulation combined with intravenous dripping of betahistine hydrochloride sodium chloride injection is effective in improving vertigo, decreasing ADI and VBLADI, and correcting atlantoaxial joint disorder.