针刺颈夹脊穴配推拿治疗椎动脉型颈椎病的临床研究

Clinical research of the cervical spondylosis of vertebral artery type mainly treated with needling EX-B2 point ＆ Tui na

目的观察针刺颈夹脊穴为主配合按摩治疗椎动脉型颈椎病的疗效。方法收集2006年1月至2006年12月东直门医院针灸科门诊60例椎动脉型颈椎病患者，按就诊顺序随机分为两组各30例，治疗组以针刺颈夹脊穴配合推拿治疗；对照组采用推拿治疗，治疗2周为1个疗程。观察两组患者治疗前、后的总体疗效、症状评分、单一症状疗效及椎动脉、基底动脉血流速度平均值的变化情况。结果①临床疗效比较：治疗组总体疗效构成（Z=2．594）、痊愈率（X^2=5．963）与对照组比较，差异有统计学意义（P〈0．05）；总有效率比较，差异无统计学意义（X^2=2．308，P〉0．05）；②症状积分比较：两组治疗后临床症状积分均较同组治疗前明显改善（t治疗组=8．680，t对照组=8．266，P均〈0．01），其中治疗组症状积分的改善情况优于对照组（P=0．039〈0．05）。③单一症状疗效比较：治疗组眩晕、恶心呕吐症状的改善情况与对照组比较，差异有统计学意义（Z值分别为：2．598、2．984，P〈0．05）；椎动脉、基底动脉血流速度平均值比较各组疗前、疗后及组间比较差异均无统计学意义（P〉0．05）。结论针刺颈夹脊穴为主配合推拿治疗椎动脉型颈椎病疗效较单用推拿治疗明显提高，且对缓解患者主症眩晕有明显优势。

Objective To observe the therapeutic effect of treating cervical spondylosis of vertebral artery type （CSA） mainly by needling EX-B2 point ＆ Tui ha, and to investigate the advantage of needling EX-B2 point to treat CSA. Methods 60 patients with CSA were divided into a trial group （30cases） and a control group （30cases） by the sequence of visit. Patients in the trial group were treated by needling EX-B2 point combined with electro-acupuncture and Tui na, other patients in the control group were treated by Tui na, with 2 weeks as a therapeutic course. Then, the change of therapeutic effect, symptoms index, mono-symptomatic therapeutic effect and average blood flow velocities of vertebral artery and basilar artery were observed in both groups before and after the treatment. Results The therapeutic effect constitution ＆ cure rate showed significant differences between the two groups （P〈0.05） , but there was no difference in total efficacy. Significant differences were found in both groups in symptoms index before and after treatment, and after the treatment the symptoms index was lower. There was significant difference between the two groups in symptoms index difference （P〈0.05）, and the trial group was better. The mono-symptomatic therapeutic effect of vertigo, nausea and vomiting showed significant difference between the two groups （P〈 0.05 ） , and the trial group was better. No marked differences were observed in average blood flow velocities of vertebral artery and basilar artery between groups and in each group. Conclusion The therapeutic effect of CSA mainly treated by needling EX-B2 point ＆ Tui na was much better than just treated by Tui ha, and this method showed obvious advantage in relieving vertigo.