针刺治疗椎动脉型颈椎病即时效应评价:正交试验设计

Evaluation of the immediate effect of acupuncture on cervical spondylosis of vertebral artery type based on orthogonal design

目的:分析方法、选穴、留针时间3因素对针刺治疗椎动脉型颈椎病即时效应影响的差异,优选最佳治疗方案。方法:观察临床病例32例,随机区组分为8组,每组4例,运用正交试验设计的方法,采用方法(电针、补泻手法)、选穴[C4—C7夹脊穴、颈三针(天柱、颈百劳、大杼)]、留针时间(5 min、15 min)3因素2水平,以L8(27)正交表安排试验,观察针刺前后椎动脉(VA)及基底动脉(BA)平均血流速度(Vm)变化。结果:采用电针连续波、C4—C7夹脊穴针刺后5 min对椎动脉型颈椎病椎-基底动脉血流即时变化影响最显著,且方法及选穴两因素对结果影响大(均P<0.05)。结论:针刺治疗椎动脉型颈椎病优化即时效应为电针+C4—C7夹脊穴+5 min。不同因素对针刺治疗椎动脉型颈椎病的即时效应影响,从大到小排列为:选穴>方法>时间。

Objective To analyze the differences in the immediate effect of acupuncture on cervical spondylosis of vertebral artery type among three factors： needling technique, acupoint selection and time of needle retaining so as to option the best therapeutic program. Methods Thirty-two cases were observed and randomly divided into 8 groups, 4 cases in each one. The orthogonal design of three factors and two levels was adopted. There were nee-dling technique （electroacupuncture, reinforcing and reducing method）, aeupoint selection [C4--C7 Jiaji （EX-B 2） and three needles of neck：Tianzhu（BI. 10）, Jingbailao（EX-HN 15）, Dazhu（BL 11）] and time of needle retaining （5 min, 15 min）. L8 （27 ） orthogonal design table was arranged in the trial. The changes in mean velocity （Vm） of vertebral artery （VA） and basilar artery （BA） were observed before and after acupuncture. Results The imme-diate effect of VA-BA blood flow was the most significant after electroacupuneture at C4--C7 Jiaji （EX-B 2）, with continuous wave for 5 min. This method and acupoint selection greatly influenced the therapeutic results （both P〈0.05）. Conclusion The optimized therapeutic program of the immediate effect of acupuncture for cervical spondylosis of vertebral artery type is electroacupuncture＋C4-C7 Jiaji （EXB 2）＋5 min. The importance of different factors for the immediate effect in acupuncture treatment of cervical spondylosis of vertebral artery type is： acupoint selection〉needling technique〉time of needle retaining.