针刺配合推拿治疗椎动脉型颈椎病临床观察

Clinical Study of Treatment of Cervical Spondylotic Vertebral Arteriopathy by Acupuncture plus Massotherapy

目的优选提高治疗椎动脉型颈椎病(CSA)临床疗效的最佳方案,并探讨其治疗CSA的作用机制。方法将患者随机分为针刺配合龙氏手法治疗组(A组)、针刺治疗组(B组)、龙氏手法治疗组(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,差异有统计学意义(P<0.05)。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)治疗前后比较差异有统计学意义(P<0.01)。结论针刺配合龙氏手法治疗对椎动脉型颈椎病Vm、PI、DI以及CSA患者的临床症状均有显著作用,且优于单纯针刺和龙氏手法疗法,是目前治疗CSA的最佳方法之一。

Objective To select the optimal method for improving the clinical therapeutic effect on cervical spondylotic vertebral arteriopathy （CSA） and explore the mechanism of its therapeutic action on CSA. Methods Patients were randomly allocated to an acupuncture plus Long＇ s manipulation group （group A）, an acupuncture group （group B） and a Long＇ s manipulation group （group C） for comparative observation. Systolic peak velocity （Vs）, end-diastolic peak velocity （Vd）, mean peak velocity （Vm） and vascular pulsation index （PI） were measured by transcranial Doppler （TCD） before and after treatment. Results The cure rate and the total efficacy rate were significant higher in group A than in group B and C ; there was a statistically significant difference （ P 〈 0.05 ）. Besides, there were statistically significant differences in Vm, PI and vascular dilation index （DI） of the left vertebral artery （LVA）, the right vertebral artery （RVA） and the basilar artery （BA） between pretreatment and posttreatment in group A （P 〈 0.01 ）. Conclusion Acupuncture plus Long＇ s manipulation has a marked effect on Vm, PI and DI and the clinical symptoms in .CSA patients and is superior to simple acupuncture or Long＇ s manipulation. It is now one of the best methods for treating CSA.