推拿理筋点穴联合颈舒颗粒与倍他司汀治疗颈源性眩晕随机平行对照研究

Acupoint Massage and Tendon joint Jingshu Granule and Betahistine Treatment of Cervical Vertigo Randomized Controlled Study

[目的]观察推拿理筋点穴联合颈舒颗粒与倍他司汀治疗颈源性眩晕疗效。[方法]使用随机平行对照方法,将81例患者按就诊顺序编号方法简单随机分为两组。对照组41例颈舒颗粒,6g/次,3次/d,冲服;倍他司汀,6mg/次,3次/d,口服。治疗组40例推拿点穴,理筋通络:患者坐位,右肩关节向外舒展70°、肘关节屈曲至140°~160°,腕关节伸直;医生右手拇指随自身呼气加深加力按压患者颈部肌肉,左手拇指弹拨患者腕关节部位肌肉,带动腕关节作节律性前后、左右摇摆运动;然后加力按压患者颈部双侧横突、棘突旁指下有结节样或条索样改变部位,由上至下交替按摩10min;点穴通经:医生右手拇指随自身呼吸加深缓慢用力,斜向患者脊柱点并按住左侧C1、C2横突,向上按压左侧风池;医生右手中指在食指及无名指协助下随呼吸下沉按住右侧C1、C2横突,患者肩关节、肘部及腕关节均随之下沉,医生由下至上往患者颅骨底部方向随呼吸按压枕后隆突4~8min,至患者感觉头部发胀;推拿点穴均左右侧交替操作;颈舒颗粒与倍他司汀治疗同对照组。连续治疗20d为1疗程。观测临床症状、颈椎曲度、不良反应。治疗1疗程(20d),判定疗效。[结果]治疗组痊愈24例,有效13例,无效3例,总有效率96.32%;对照组痊愈14例,有效14例,无效13例,总有效率33.25%;治疗组疗效优于对照组(P<0.05)。颈椎曲度治疗组明显改善(P<0.01),对照组无明显变化(P>0.05)。[结论]推拿理筋点穴联合颈舒颗粒与倍他司汀治疗颈源性眩晕,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the acupuncture combined with massage and tendon Jingshu granule with betahistine treatment of cervicogenic vertigo. [Methods] 81 patients were randomly divided into two groups according to the random parallel control method. The control group of 41 cases of cervical Weisukeli, 6 g/times, 3 times/d, Chongbo; betahistine, 6 mg/times, 3 times/d, oral. The treatment group of 40 cases of acupuncture and massage, and tendons： patient seat, right shoulder extending outward 70 degrees, elbow flexion to 140 degrees to 160 degrees, wrist straight right hand thumb with its breath; the doctor pressed neck in patients with muscle force to enhance muscle, left thumb plucked patients with wrist position, driven by the wrist joint rhythm before and after and swinging movement; then after pressing bilateral neck in patients with transverse process and spinous process to nodular or cord like changes in the site, from top to bottom alternately massage 10 min; acupoint clearing： the doctor right thumb with slow deep breathing hard, oblique patients with spinal point and hold down the left C1, C2 transverse to. Press the left doctor Fengchi; right middle finger in the index finger and ring finger with the assistance of C1, press and hold the breath sinking C2 transverse, with shoulder, elbow and wrist are sinking, doctor from the bottom to the bottom of the direction of patients with skull press with breathing occipital carina 4~8 min, and the patients feel swollen head; acupuncture and massage were left and right side alternating operation; Jingshu granule and betahistine treatment with the control group. Continuous treatment for 1 courses of 20 d. Observation of clinical symptoms, cervical curvature, adverse reaction. Treatment of 1 courses of treatment（20 d）, determine the efficacy. [Results] 24 cases were cured, 13 cases were effective, 3 cases were ineffective, the total effective rate was 96.32%; thecontrol group was 14 cases, 14 cases were effective, 13 cases ineffective, the total effective rate was 33.25%. The treatment group was better than the control group （P0.05）. Cervical curvature of the treatment group was significantly improved （P0.01）, the control group had no significant change （P0.05）. [Conclusion] acupuncture combined with massage and tendon Jingshu granule with betahistine in treatment of cervical vertigo, satisfactory curative effect, no serious adverse reactions, worthy of promotion.