针刀松解协同手法整复对椎动脉型颈椎病的疗效探讨

The clinical efficacy of acupotomy combined with manipulative reduction in treating cervical spondylosis of the vertebral artery type

目的观察针刀松解协同手法整复治疗椎动脉型颈椎病的临床疗效。方法将我院2014年5月—2016年6月收治的椎动脉型颈椎病患者120例随机分为研究组(n=60,采用针刀松解+手法整复治疗)、对照组(n=60,采用针刺+手法整复治疗),比较2组患者症状、体征改善情况,以及治疗前后的经颅多普勒超声(TCD)血流动力学变化。结果观察组治疗后眩晕、头痛、颈僵痛等症状、体征的改善程度显著优于对照组,差异有统计学意义(P<0.05)。2组治疗前双侧椎动脉及基底动脉的平均血流速度(Vm)、搏动指数(PI)、阻力指数(RI)无统计学差异(P>0.05);治疗后观察组Vm高于对照组,PI、RI低于对照组,差异均有显著统计学意义(P<0.01)。结论针刀松解协同手法整复可显著改善患者的症状、体征及椎-基底动脉血流动力学情况,为椎动脉型颈椎病一种良好的治疗方法。

Objective To investigate the clinical efficacy of acupotomy combined with manipulative reduction in treating cervical spondylosis of the vertebral artery type. Methods The vertebral artery type of cervical spondylosis patients of 120 cases in our hospital from January 2014 to June 2016,were randomly divided into observation group （n=60,with Acupotomy ＋ manipulative reduction in the treatment） and the control group （n=60,with acupuncture ＋ manipulative reduction in the treatment）.The chnical efficacy,symptoms and signs of the two groups were compared,as well as the transcranial Doppler ultrasound （TCD） hemodynamic changes. Results The total effective rate of the observation group was significantly higher than that of the control group,the symptoms and signs of vertigo,headache and neck pain after treatment were significantly better than the control group, the difference was statistically significant （P〈0.05）.The average blood flow velocity （Vm） ,pulse index （PI） and resistance index （RI） were not statistically different between the two groups before treatment （P〉0.05）;After treatment,the observation group Vm higher than the control group, RI,PI lower than the control group,the difference was statistically significant （P〈0.01 ）. Conclusion Acupotomy collaborative manipulation can significantly improve the symptoms and signs and vertebrobasilar hemodynamics,it is a good treatment method for cervical spondylosis of vertebral artery type.