针刺风池、“供血”穴治疗椎-基底动脉供血不足临床疗效及机制探讨

Investigation on therapeutic effect and mechanism of acupuncture at Fengchi (GB 20) and "Gong-xue" for treatment of patients with vertebral-basilar insufficiency

目的:观察针刺、药物两种治疗方法对椎-基底动脉供血不足(VBI)患者的效应差异及针刺作用机制。方法:将60例VBI患者按经颅多普勒(TCD)提示的血流速度不同分为针刺组(31例)、药物组(29例)。针刺组针刺风池和"供血"穴,药物组口服盐酸氟桂利嗪胶囊(西比灵),2周后对其治疗前后的临床症状、TCD相关数据进行比较、分析及评价。结果:针刺能明显改善患者的临床症状,与药物组相比差异有统计学意义(P<0.05)。针刺能使椎-基底动脉血流速度减慢的收缩期峰值速度(Vs)、舒张末血流速度(Vd)、平均血流速度(Vm)回升,亦能使血流速度增快的Vs、Vd、Vm下降,且与治疗前相比差异有统计学意义(均P<0.05),但改善幅度与药物组相比无统计学意义(均P>0.05)。针刺及药物治疗前后,血管搏动指数(PI)、阻力指数(RI)、Vs/Vd差异均无统计学意义(均P>0.05)。结论:针刺风池及"供血"穴对VBI患者椎-基底动脉血流速度具有双相、良性调节作用,对椎-基底动脉血管顺应性尚无明显作用。

Objective To compare the difference of the therapeutic effect of acupuncture and western medicine on the patients with vertebral-basilar insufficiency （VBI）, and investigate its mechanism. Methods According to the different velocity of blood flow recorded by Transcranial Doppler （TCD）, sixty patients with VBI were divided into an acupunture group （31 cases） and a western medicine group （29 cases）. In the acupuncture group, the patients were punctured at Fengchi （GB 20） and ＂Gongxue＂ （Extra）. In the western medicine group, the patients were orally given the Flunarizine hydrochlorid capsules. Before and after two-week treatment, the clinical symptoms and related data of TCD were compared, analyzed and evaluated. Results The clinical symptoms were obviously improved in the acupuncture group, which was better than the western medicine group （P〈0.05）. Acupuncture not only could up-regulate the velocity of vertebral-basilar blood flow （VBF） on the patients with slower VBF of peaksystolic phase （Vs）, end-diastolic phase （Vd） and mean value （Vm）, but also reduced the VBF on the patients with faster Vs, Vd and Vm. In comparison of the data before and after treatment, there were significantly differences in two groups （P〈0.05）, however, there were no difference between the two groups （all P〉0.05）. On the index of vascular pulsation （PI）, resistance index （RI） and Vs/Vd, there were no difference in both groups before and after treatment （all P〉0.05）. Conclusion Acupuncturing at Fengchi （GB 20） and ＂Gongxue＂ has bidirectional and beneficial function of regulation on the VBF, but no active role on the compatibility of vertebral-basilar blood vessel.