电针治疗椎动脉型颈椎病疗效观察

Observations on the Efficacies of Electroacupuncture for Cervical Spondylotic Vertebral Arteriopathy

目的观察电针和益气聪明汤治疗椎动脉型颈椎病(CSA)的临床疗效并探讨其可能的机制。方法将100例CSA患者随机分为治疗组和对照组,每组50例。治疗组采用电针治疗,对照组采用口服益气聪明汤治疗。观察两组治疗前后疼痛视觉模拟评分、TCD检查结果及治疗后6个月复发情况和不良反应,比较两组临床疗效。结果治疗组总有效率为84.0%,对照组为88.0%,两组临床疗效比较,差异无统计学意义(P>0.05)。两组治疗后VAS评分与同组治疗前比较,差异均有统计学意义(P<0.01)。治疗组治疗前后VAS评分差值与对照组比较,差异有统计学意义(P<0.05)。两组治疗后前各椎基动脉(左椎动脉、右椎动脉、基底动脉)收缩期最大流速与同组治疗前比较,差异有统计学意义(P<0.01)。治疗组治疗后各椎基动脉收缩期最大流速与对照组比较,差异均无统计学意义(P>0.05)。治疗组有效患者复发率为9.5%,对照组为11.4%,两组比较差异无统计学意义(P>0.05)。结论电针和益气聪明汤均能有效治疗CSA,电针在镇痛效果和避免不良反应方面优于中药治疗。

Objective To investigate the clinical efficacies of electroacupuncture versus Yiqi Congming Tang in treating cervical spondylotic vertebral arteriopathy （CSA） and explore the possible mechanisms. Methods One hundred CSA patients were randomly allocated to treatment and control groups, 50 cases each. The treatment group received electroacupuncture and the control group, oral administration of Yiqi Congming Tang. Methods In the two groups, the Visual Analog Pain Scale score was counted and the outcome of TCD examination was evaluated before and after treatment and the recurrence and adverse reactions were examined at six months after the end of treatment. The clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 84.0% in the treatment group and 88.0% in the control group. There was no statistically significant difference in therapeutic effect between the two groups （P〉0.05）. There was a statistically significant pre-/post-treatment difference in the VAS score in both groups （P〈0.01）. There was a statistically significant difference in pre-/post-treatment VAS score difference value between the treatment and control groups （P〈0.05）. There were statistically significant pre-/post-treatment differences in the maximum systolic flow velocities in vertebrobasilar arteries （left vertebral artery, right vertebral artery and basilar artery） in the two groups （P〈0.01）. There were no statistically significant post-treatment differences in the maximum systolic flow velocities in vertebrobasilar arteries between the two groups （P〉0.05）. The recurrent rate in effectively treated patients was 9.5% in the treatment group and 11.4% in the control group; there were no statistically significant differences between the two groups （P〉 0.05）. Conclusions Both electroacuptmcture and Yiqi Congming Tang can effectively treat CSA. Electroacupuncture is superior to Yiqi Congming Tang in analgesic effect and avoiding adverse reactions.