针药配合龙氏手法治疗椎动脉型颈椎病的多中心疗效观察

Multicenter Observation on Curative Effect of Pi-Zhen Combined with Massage Ointment and Long shi Manipulation

目的探讨铍针、温通膏配合龙氏手法综合方案治疗椎动脉型颈椎病(CSA)的临床价值。方法采用三中心、单盲、随机、对照研究方法,将168例合格受试者随机纳入铍针、温通膏配合龙氏手法综合治疗组56例、针刺组56例、龙氏手法组56例进行治疗,对多项评价指标及安全性进行评价。结果(1)综合治疗组总有效率96.4%,针刺组85.8%,龙氏手法组89.3%,综合组疗效优于其余两组的疗效(P<0.05);(2)治疗后3组颈性眩晕症状及功能总积分均升高(均P<0.01),综合组积分升高程度优于其余两组(均P<0.01);(3)综合组在纠正颈椎失稳方面优于两对照组(均P<0.05);(4)治疗后3组椎动脉血流速度(Vp、Vm、Vd)均较治疗前明显改善,综合组比其他两组改善更明显,均P<0.05;(5)在本研究中未发现所采用治疗方法的不良反应。结论铍针、温通膏配合龙氏手法综合疗法可有效治疗CSA,综合疗法较之单纯采用针刺疗法或龙氏手法具有优势。

Objective To investigate clinical value of pi-zhen combined with massage ointment and Long shi manipulation comprehensive program for treatment of cervical spondylosis of arterial type（CSA）. Methods By using three-center, single-blind, randomized, controlled method, 186 eligible subjects were randomly divided into a pi-zhen combined with massage ointment and Long shi manipulation comprehensive program group, an acupuncture group, a Long shi manipulation group with 56 cases in each group and were treated. Multiple-dimensional indexes were estab- lished to evaluate the therapeutic effect and safety. Results （ 1 ） The effective rate were 96.4% in the comprehensive program group,85.8% in the acupuncture group,89.3% in the Long shi manipulation group, respectively. The comprehensive program group being better than the other groups （ P 〈 0.05 ）. （ 2 ） After treatment the total cumulative scores for symptoms of dizziness and the functions in the three groups significantly increased（ P 〈 0.01 ）, the comprehensive program group being superior to the other groups （P 〈 0.01 ）. （3）The comprehensive program group was more effective than the other groups in rectifying the instability of the cervical vertebrae（P 〈0.05 ）. （4）The systolic peak velocity（Vp）, mean velocity（Vm） and end diastolic peak velocity（Vd） in vertebral artery of three groups were obviously improved as compared with those before treatment, comprehensive program group being superior to the other groups （P 〈 0.05 ）. （5） NO adverse effects were found in the three groups. Conclusions The pi-zhen combined with massage ointment and Long shi manipulation comprehensive therapy has a definite therapeutic effect on CSA with good safety, It is of superiority as compared with the simple acupuncture or the simple Long shi manipulation treatment.