定位摇头推拿疗法治疗颈源性头晕316例临床研究

Clinical Reseach of Treating 316 Cases of Cervical Vertigo

目的:探讨颈椎定位摇头推拿法治疗颈源性头晕的治疗作用及对视觉模拟评分、寰枢关节位移指数、椎-基底动脉TCD检测结果的影响。方法:取2011年1月-2013年1月登记正骨治疗颈源性头晕病例的连续316例资料随机分成治疗组和对照组,治疗组采用定位摇头推拿方法,对照组使用《软组织损伤治疗学》中常规推拿治疗,观察治疗前后两组症状体积评分、视觉模拟评分、椎-基底动脉TCD检测结果、寰枢关节位移指数、临床疗效,并对其进行比较。结果:治疗后治疗组患者临床症状、体征积分有了明显下降,其中眩晕(2.74±1.03)分,颈肩痛(1.56±0.35)分,头痛(0.38±0.07)分,恶心、呕吐(1.59±1.32)分,耳鸣(0.45±0.31)分,旋颈试验阳性(0.58±0.20)分;对照组眩晕(5.67±2.01)分,颈肩痛(3.13±1.83)分,头痛(1.87±0.63)分,恶心、呕吐(3.27±0.68)分,耳鸣(1.65±0.63)分,旋颈试验阳性(1.78±0.65)分。视觉模拟评分、寰枢关节位移指数、椎-基底动脉TCD检测结果均有明显好转,其中治疗组视觉模拟评分为(2.52±1.34)分,对照组视觉模拟评分为(3.24±1.29)分,治疗组寰枢关节位移指数为(2.92±0.82)分,对照组寰枢关节位移指数为(4.50±1.32)分,治疗组LVA(44.63±5.69)、RVA(42.16±5.18)、BA(52.64±4.46),对照组LVA(39.25±5.48)、RVA(38.58±4.53)、BA(45.34±5.12)。结论:绝大部分颈源性头晕病例经颈椎定位摇头推拿法保守治疗,可减少和消除其对椎动脉的压迫和刺激,缓解前庭神经核或迷路缺血,解除头晕症状,获得满意疗效。

Objective：To detect the clinical effects of cervical mapping massage manipulation for cervical vertigo, and influ- ence the outcome of visual analogue scales, atlantoaxial joint displacement index, and TCD of vertebral--basilar arterial system. Methods：All 316 patients, who were treated with traumatic and orthopedic manipulation for cervical vertigo, were randomly divided into treatment group and control group between January 2011 and January 2013. Treatment group were used mapping massage manipulation, and control group were used routine massage manipulation to therapeutics of soft tis- sue injury. The symptom volume scales, visual analogue scales, outcome TCD of vertebral--basilar arterial system, atlan- toaxial joint displacement index, and clinical effect were observed and compared between the two groups. Results：The clini- cal symptoms, volume scales in the treatment group were significantly dropped compared to the control group. In treatment group, the scores of vertigo was 2.74±1.03, neck and shoulder pain was 1.56±0.35, headache was 0.38±0.07, nausea and vomiting was 1. 594±1.32, tinnitus was 1.65±0.63, and the spin neck test positive was 1.78±0.65. Compared to the control group, the visual analogue scales, atlantoaxial joint displacement index, and outcome TCD of vertebral--hasilar ar- terial system in treatment group were significantly improved. In treatment group, visual analogue scales was 2.52-4-1.34, atlantoaxial joint displacement index was 2.92±0.82, the outcome TCD of vertebral--basilar arterial system： LVA was 44.63±5.69, RVA was 42. 164±5.18, and BA was 52.64±4.46. In the control group, the visual analogue scales was 3. 24 ±1.29, atlantoaxial joint displacement index was 4.50 ±1.32, test TCD outcome of vertebral-basilar arterial system= LVA was 39.25±5.48, RVA was 38.58±4.53, and BA was 45.34±5.12. Conclusion：The treatment effect of cervical vertigo mainly lies in the accurate diagnosis. Cervical vertigo, which is induced by insufficient blood supply due to vascular compression of atlantoaxial, can be conservative treated by cervical mapping massage manipulation. The manipulation can reduce and relieve the compression and stimulation to vertebral artery, alleviate ischemia in the vestibular nucleus or laby- rinth, remove the symptoms of dizziness, and obtain the satisfactory curative effects.