摘要
Objective To compare the differences in the efficacy on cervical spondylosis of the vertebral artery type （CSA） treated with the warm needling therapy combined with the rehabilitation physiotherapy, the simple warm needling therapy and the simple rehabilitation physiotherapy separately and observe the impacts of them on the vertebral basilar artery （VBA） in hemodynamics. Methods Ninety cases of CSA patients were randomized divided into an acupuncture plus rehabilitation group, a warm needling group and a rehabilitation group, 30 cases in each. In the acupuncture ＋ rehabilitation group, the warm needling therapy was used at Jiájǐ （夹脊 EX-B 2） from C3 to C7 in combination with the rehabilitation physiotherapy such as traction and magnetic therapy. In the warm needling group, the simple warm needling therapy was applied. In the rehabilitation group, the simple rehabilitation physiotherapy was adopted. The VBA hemodynamic parameters, Vp, Vd, Vm and PI values were detected under the transcranial Doppler and taken as the indexes for the efficacy assessment of the groups. The efficacy of each group was assessed in association with the clinical curative rate. Results After treatment, the VBA hemodynamic parameters, Vp, Vd, Vm and PI values were all remarkably improved as compared with those before treatment in the three groups （P〈0.01, P〈0.05）. The improvement of the indexes in the acupuncture plus rehabilitation group were more significant as compared with either of the other two groups （all P〈0.01）. The clinical curative rate was 70.0% （21/30） in the acupuncture plus rehabilitation group, which was superior to 53.3% （16/30） in the warm needling group and 53.3% （16/30） in the rehabilitation group （all P〈0.01）. Conclusion The warm needling in combination with the rehabilitation physiotherapy significantly improves in VBA hemodynamic parameters for CSA and its clinical efficacy is superior to either the simple warm needling or the rehabilitation physiotherapy. Hence, this combined therapy was highly deserved to be promoted in clinical practice.
目的:比较温针灸结合康复理疗、单纯温针灸与康复理疗治疗椎动脉型颈椎病(CSA)的疗效差异,及对椎-基底动脉(VBA)血流动力学的影响。方法:将90例CSA患者随机分为针康组、温针灸组、康复组,每组30例。其中针康组穴取C 3—C 7夹脊穴行温针灸结合牵引、磁疗等康复理疗;温针灸组予单纯温针灸治疗,康复组行单纯康复理疗。采用经颅多普勒血流分析仪(TCD)所测定的患者VBA血流动力学参数Vp、Vd、Vm、PI值为疗效评定指标,结合临床治愈率评价各组疗效。结果:治疗后3组VBA血流动力学观察指标Vp、Vd、Vm值均较治疗前明显改善(P﹤0.01,P﹤0.05),针康组各观察指标均较其他两组改善更显著(均P﹤0.01);针康组临床治愈率为70.0%(21/30),优于温针灸组53.4%(16/30)和康复组53.3%(16/30)(均P﹤0.01)。结论:温针灸配合康复理疗治疗椎动脉型颈椎病能显著改善椎-基底动脉血流动力学,临床疗效优于单纯温针灸和康复理疗治疗,有较高的临床推广意义。
