调和气血法为主配合热敏灸治疗椎动脉型颈椎病随机对照临床研究

A Randomized Controlled Clinical Study of Harmonizing Qi and Blood Therapy combined with Moxibustion on Temperature-sensitive Points for Treatment of Cervical Spondylosis of Vertebral Artery Type

目的:通过随机对照试验,探讨以调和气血法为主配合热敏灸治疗椎动脉型颈椎病的临床疗效及安全性。方法:68例椎动脉型颈椎病患者随机分为治疗组(n=34)和对照组(n=34),治疗组给予中药内服配合热敏灸治疗,对照组口服西药西比灵胶囊和敏使朗。记录并统计分析患者治疗前、治疗后第1周、第2周的颈性眩晕症状与功能评分及颈椎病症状分级量化表评分评价临床疗效;同时观察并记录患者的不良反应,评价综合治疗的安全性。结果:①经治疗后,2组患者颈性眩晕症状与功能评分与治疗前比相明显提高,颈椎病症状分级量化表评分与治疗前相比明显降低;其差异均有统计学意义(P<0.001)。②治疗组第1周的颈性眩晕症状与功能评分高于对照组,其差异有统计学意义(P<0.05),而2组治疗第2周的评分比较差异无统计学意义(P>0.05);治疗组第1周、第2周的颈椎病症状分级量化表评分较对照组明显降低,其差异有统计学意义(P<0.001)。③治疗组临床显效率为62.50%;对照组临床显效率为53.33%。2组显效率比较差异无统计学意义(P>0.05)。④观察期间,治疗组2例经热敏灸治疗后出现颈部局部皮肤红疹;对照组有3例在服药后出现恶心欲吐副反应。结论:调和气血法为主配合热敏灸治疗能显著改善椎动脉型颈椎病患者临床症状和提高生活能力,具有良好的临床疗效。

Objective： A randomized controlled trial was performed to evaluate the effectiveness and side-effect of treatment with harmonizing Qi and blood combined with moxibustion on temperature-sensitive points for cervical spondylosis of vertebralartery type. Methods：A total of 68 patients were divided into treatment group （n= 34） and control group （n= 34）. The patients in treatment group were treated with harmonizing Qi and blood therapy combined with moxibustion on temperature-sensitive points. Sibelien and Betahistine were used in control group. The cervical vertigo symptoms and functional score as well as quantitative grading scores of symptoms were recorded respectively after one week and two weeks. The side effect was also observed and recorded. Resuits： （1）Cervical vertigo symptoms and functional score increased markedly and quantitative grading scores of symptoms decreased markedly in both groups after 7and 14 days treatment, and the difference was statistically significant （P〈0. 001）; （2）There was better effect in treatment group than in control group in the improvement of cervical vertigo symptoms and functional score after 7days therapy （P〈0.05）, but no significant differences was found after 14 day therapy （P〉0.05） ; while treatment group had better effects than control group in the improvement of cervical vertebra disease symptoms quantitative grading score after 7 and 14 days therapy （P〈0. 001）; 3The total remarkably effective rate was 62.50% in the treatment group, higher than 53. 33% in the control group （P〉0.05） ; 4Two cases underwent skin stimulus in the treatment group; 3 cases underwent nausea and vomiting in the control group. Conclusion： Harmonizing Qi and blood therapy combined with moxibustion on temperature-sensitive points can improve the clinical symptoms and the ability of living, which is effective and safe in the treatment of cervical spondylosis of verte-bral artery type.