针刺推拿结合治疗椎-基底动脉供血不足的临床及机理研究

Clinical observation and mechanism study on acupuncture combined with massage for treatment of vertebrobasilar insufficiency

目的 :优选提高治疗椎 基底动脉供血不足综合征 (VBI)临床疗效的最佳方案 ,并探讨其治疗VBI的作用机理。方法 :将患者随机分为针推治疗组 (A组 )、针刺治疗组 (B组 )、推拿治疗组 (C组 )进行治疗对比观察 ,并采用经颅多普勒 (TCD)检测治疗前后收缩期峰流速 (Vs)、舒张期末峰流速 (Vd)、平均峰流速 (Vm )以及血管搏动指数 (PI)。结果 :A组痊愈率和总有效率均明显高于B组与C组 ,经统计学处理 ,差异有显著性意义 (P <0 0 5 )。此外 ,A组左椎动脉 (LVA)、右椎动脉(RVA)及基底动脉 (BA)的Vm、PI和血管弹性指数 (DI)治疗前后差异有非常显著性意义 (P <0 0 1)。结论 :针推结合疗法对改善椎 基底动脉的Vm、PI、DI以及VBI患者的临床症状均有显著作用 ,且优于单纯针刺和推拿疗法 ,是目前治疗VBI的最佳方法之一。

Objective To search for the best program increasing clinical therapeutic effect on vertebrobasilar insufficiency (VBI) and to study the mechanism. Methods The patients were randomly divided into an acupuncture plus massage group, an acupuncture group and a massage group. Their therapeutic effects were observed and compared. And transcranial doppler (TCD) was used for detection of systolic flow velocity (Vs), enddiastolic peak flow velocity (Vd), mean peak flow (Vm) and pulsatility index (PI) before and after treatment. Results The cured rate and the total effective rate in the acupuncture plus massage group were significantly higher than the acupuncture group and the massage group ( P <0 05). And there were significant differences in Vm, PI and DI in the left vertebral artery (LVA), the right vertebral artery (RVA) and the basilar artery (BA) before and after treatment ( P <0 01). Conclusion Acupuncture combined with massage can improve Vm, PI, DI of VA BA and the clinical therapeutic effect on VBI as well. It is superior to the simple acupuncture therapy and simple massage therapy. At present, it is one of the best therapy for VBI.