辨证论治与变量颈椎牵引及手法联合西药治疗颈性眩晕随机平行对照研究

Syndrome Differentiation and Treatment of Cervical Vertebra,Variable Traction and Manipulation Combined with Western Medicine in Treating Cervical Vertigo Randomized Parallel Controlled Study

[目的]观察辨证论治与变量颈椎牵引及手法联合西药治疗颈性眩晕疗效。[方法]使用随机平行对照方法,将60例门诊患者按抽签法分为两组。对照组30例①5%葡萄糖氯化钠注射250mL加脉络宁20mL静滴,1次/d;尼莫地平40mg,3次/d,口服。②枕颌带坐位变量牵引,牵引质量2～10kg,(按患者体位和自我感觉有所增减)先由轻至重牵引,逐渐增至患者最大耐受限度,10～14d牵引质量再由重减轻,至病程完成。牵引时间每次10～30min,以患者能耐受为限,1次/d,14d为1疗程。③手法点、按、揉风池、百会、天柱、合谷、内关、大椎、肩贞、肩井等穴位。治疗组30例辨证论治。①肝阳上亢型,方以天麻沟藤饮加减。②气血亏虚型,方以归脾汤加减。③痰浊中阻型,方以半夏白术天麻汤加减。④肾精不足型,方以偏阳虚用右归丸加减,偏肾阴虚用左归丸加减。西医、牵引、手法治疗同对照组。连续治疗14d为1疗程。观测临床症状、不良反应。连续治疗疗程,判定疗效。[结果]治疗组临床治愈6例,显效14例,有效7例,无效3例,总有效率90.00%。对照组临床治愈2例,显效13例,有效7例,无效8例,总有效率73.33%。临床疗效治疗组优于对照组(P<0.05)。[结论]辨证论治、变量颈椎牵引及手法联合西药治疗颈性眩晕疗效满意,值得临床应用。

[ Objective ] Observation of treatment based on syndrome differentiation, variable cervical trac- tion and manipulation combined with western medicine in treatment of cervical vertigo. [ Methods ] Using randomized controlled methods, 60 cases of patients were divided into two groups according to the draw. 30 cases of the control group of 5% glucose and sodium chloride injection 250mL plus Mailuoning 20mL intravenous drip, 1 times/d ; nimodipine 40mg, 3/d, oral. The pillow jaw belt seat variable traction, traction weight 2 - 10kg, （ according to patient positioning and feel increased or decreased ） by the light to heavy traction, grad- ually increased to maximum tolerance of patients, 10 - 14d traction quality again by weight, until the comple- tion of. Traction time every time 10 -30rain, the patients can tolerance limit, 1/d, 14d 1 treatment. The method, according to knead, Baibui, Fengchi, Hegu, Tianzhu, Neiguan, Dazhui, Jianzhen, Jianjing acu- points. The treatment group of 30 cases of treatment based on syndrome differentiation. The liver yang hyper- activity type, with rattan Decoction of Gastrodia clara ditch. The deficiency of Qi and blood type, with Guipi decoction. Resistance type, phlegm, by banxiabaizhutianma decoction. The kidney essence deficiency type, with partial deficiency of kidney deficiency of Yin with modified Yougui Pill, offset by Zuogui pill addition and subtraction. Western medicine, traction, massage therapy and control group. Continuous treatment of 7 - 14d, observation of clinical symptoms, curative effect. [ Results ] Treatment of 6 cases of clinical cure, 14 cases markedly effective, effective 7 cases, invalid 3 cases, the total efficiency of 90%. The control group cured 2 cases, effective in 13 cases, effective 7 cases, invalid 8 cases, the total efficiency of 73.33%. The clinical effect of the treatment group than in control group （ P 〈 0. 05 ）. [ Conclusion ] Syndrome differentiation, variable cervical traction and manipulation combined with western medicine in treatment of cervical vertigo satisfaction, worthy of clinical application.