穴位手法推拿对颈性眩晕患者脑组织血流灌注的影响

Effect of Acupoint Manipulation on Cerebral Blood Flow Perfusion in Patients with Cervical Vertigo

【目的】探讨穴位手法推拿对颈性眩晕患者脑组织血流灌注的影响。【方法】将120例颈性眩晕患者随机分为观察组和对照组,每组各60例。对照组患者给予西比灵加能量合剂治疗,观察组患者给予穴位手法推拿治疗,连续治疗3周后,比较2组患者治疗前后脑灌注状态指标[相对脑血流量(rCBF)、相对脑血容量(r CBV)、平均通过时间(MTT)和达峰时间(TTP)]、血液D-二聚体(DDi)含量、临床症状(头痛、颈肩痛和眩晕)的改善情况。【结果】(1)治疗后,2组患者rCBV、rCBF均明显提高(P<0.05),MTT、TTP均明显缩短(P<0.05),且观察组对r CBV、r CBF的提高作用和对MTT、TTP的缩短作用均明显优于对照组(P<0.05)。(2)治疗后,对照组DDi含量较治疗前略升高,但差异无统计学意义(P>0.05),观察组DDi含量较治疗前明显下降(P<0.05),观察组在降低DDi含量方面明显优于对照组(P<0.05)。(3)治疗后,2组患者头痛、颈肩痛和眩晕等症状积分均较治疗前改善(P<0.05),且观察组对头痛、颈肩痛和眩晕等症状积分的改善作用明显优于对照组(P<0.05)。【结论】穴位手法推拿能显著改善颈性眩晕患者临床症状和脑组织血流灌注状态,缓解患者病情,改善预后。

Objective To investigate the effect of acupoint manipulation on cerebral blood flow perfusion in patientswith cervical vertigo. Methods A total of 120 patients with cervical vertigo were randomly divided into 2 groups,60 cases in each group. Patients in the control group were treated with Sibelium plus energy mixture,and patients in the observation group were given acupoint manipulation. The treatment lasted for 3 weeks. Before and aftertreatment,we observed the cerebral perfusion parameters of relative cerebral blood flow（r CBF）,relative cerebralblood volume（r CBV）,mean transit time（MTT）,time to peak（TTP）, blood D-dimer（DDi）level,and the reliefof clinical symptoms of headache,neck and shoulder pain,and vertigo. Results（1）After treatment,r CBV andr CBF of the two groups were markedly increased,and MTT and TTP were shortened（P〈0.05 compared with thosebefore treatment）. The treatment group has stronger effect on increasing r CBV and r CBF and on shortening MTTand TTP than the control group（P〈0.05）.（2）After treatment, DDi level of the control group was mildlyincreased,but the difference was insignificant compared with that before treatment（P〈0.05）;DDi level of thetreatment group was markedly increased,and the difference was significant compared with that before treatment（P〈0.05）;the treatment group had stronger effect on decreasing DDi level than the control group（P〈0.05）.（3）After treatment,the scores of headache,neck and shoulder pain,and vertigo in the two groups were improved（P〈0.05 compared with those before treatment）,and the improvement in the treatment group was superior to thatin the control group（P〈0.05）. Conclusion Acupoint manipulation can significantly improve the clinical symptomsand cerebral blood flow perfusion of cervical vertigo patients, which results into the alleviation of the illnesscondition and the improvement of prognosis.