微针系统治疗椎动脉型颈椎病述评

Review of Cervical Spondylosis of the Vertebral Artery Type Treated with Minute-Needle System

微针系统治疗椎动脉型颈椎病优势明显,除了单纯应用腹针、腕踝针、头针、耳针等微针系统疗法,还与体针、推拿、艾灸、运动、康复操等疗法相结合,提高了疗效。但在临床微针系统应用中,仍然存在一定的问题。目前临床研究多数局限于临床总体疗效的比较和观察,缺乏有针对性、深入性、准确严谨性的实验探索。各种针法都有其优点和局限性,所以针刺操作很难得到统一规范,而且不同针灸大家都有其独特的针刺手法。再者临床观察疗效指标不同,很多采用一些主观的评定标准,比如临床症状好转程度、疼痛评分表,缺少客观性、特异性的理化指标,这样单纯得出来的痊愈率和有效率的对比会引起质疑。其次对于微针系统的相关作用机理研究的实验较少,治疗机理仍不确定,而且治疗后的跟踪随访报道很少,治疗后的远期效果不明确。在以后的临床试验中,微针系统治疗椎动脉型颈椎病的临床设计应当更加严格规范,操作方法也应统一制定,进一步加强按照随机、盲法、大规模、对照、多中心的开拓创新性研究,总结出临床值得推广的最佳治疗方案。此外微针系统要加强实验和研究机理,加入在尖端的科技元素,建立稳定和可重复的动物模型,随着这项研究的不断深入,使微针系统疗法在临床上更进一步的应用和推广。

In terms of treating cervical spondylosis of vertebral artery type,minute needle system has obvious advantages,besides simple application of abdominal acupuncture,wrist-ankle acupuncture,head acupuncture,ear acupuncture,it can be combined with body acupuncture,massage,moxibustion,exercise,recovering training. But in clinical applications,there are still some problems. At present,most clinical research is limited to clinical comparison and observation of general curative effect,lacks targeted,in-depth,accurate and rigorous experimental exploration. Each acupuncture has its advantages and limitations,so it is difficult to obtain standardized of acupuncture manipulation which has their unique acupuncture technique. Moreover,clinical observation of curative effect has different indexes,and there are many subjective criteria,such as improved level of clinical symptoms,pain score table,which lacks objectivity and specificity leading to doubts about the comparison of curing rate and effective rate. There are fewer experimental study on therapeutic mechanism of minute needle system; the treating mechanism remains uncertain; there are fewer reports on follow-up after treatment; and the long-term effect after treatment is not clear. Therefore in the following practice,the clinical design should be more strictly regulated; the operating methods should also be formulated; the innovation study including randomization,blinding,large-scale,controlled,multicenter methods should be further strengthened; and the best treatment programs should be summarized and popularized. Besides the above,minute needle system should strengthen experiments and research mechanisms,add advanced science and technology elements,establish stable and reproducible animal models in order to further apply and popularize minute needle system.