手法结合牵引治疗中老年颈性眩晕的临床研究

A Randomized Controlled Trial of Manipulation combining with Traction in the Treatment of Middle and Old-aged Patients with Cervical Vertigo

目的:观察中老年颈性眩晕患者的血流动力学变化并分析其变化特征,探讨旋转扳法结合牵引和穴位推拿对中老年颈性眩晕患者椎基底动脉流速的影响和两种手法的疗效差异。方法:64例中老年颈性眩晕患者随机分为旋转扳法结合牵引组(A组,32例)和穴位推拿组(B组,32例),分别施加相应的治疗手法。应用经颅超声多普勒检测手法前后椎基底动脉流速并观察流速改变和临床疗效。结果:治疗1疗程后:两组的左侧椎动脉、右侧椎动脉、基底动脉平均血流速度均较治疗前明显增高(P<0.01),治疗后两组的左侧椎动脉、右侧椎动脉、基底动脉流速改变之间的差异有统计学意义(P<0.01)。A组的疗效优于B组(P<0.05)。结论:中老年颈性眩晕患者血流动力学改变主要表现为低流速状态,在手法治疗中旋转扳法结合牵引对椎基底动脉的影响较穴位推拿明显,并可能具有比穴位推拿更好的临床疗效。

Objective;To investigate the characteristics of hemodynamic changes in vertebral artery （VA） and basal artery （BA） in middle and old--aged patients with cervical vertigo （CV）, and to compare the effects of rotatory reduction combi- ning with traction and acupoint massage in treating CV. Methods Sixty--four patients of CV were randomly divided into rotatory reduction combining with traction group （group A, 32 cases） and acupoint massage group （group B, 32 cases）. The changes of VA velocity and therapeutic effect were observed via transcranial Doppler （TCD） before and after treatment. Results： Three weeks after treatment, the mean velocity in left VA, right VA and BA were significantly increased compared with those before treatment （P〈0. 01）. Also, there was significant difference in the change of mean velocity between the two groups （P〈0.01）. Moreover, the therapeutic effects of group A was superior to that of group B （P〈0. 05）. Conclusion： The hemodynamics may be characterized by low slow rate. The effect of rotatory reduction combining with traction on CV was superior to that of acupoint massage.