针刀联合清艾条压灸治疗颈性眩晕:随机对照研究

Needle-knife therapy combined with moxa stick pressure moxibustion for cervical vertigo:a randomized controlled trial

目的:比较针刀联合清艾条压灸与口服西药治疗颈性眩晕(CV)的疗效差异。方法:将60例颈性眩晕患者随机分为观察组和对照组,各30例。观察组予以针刀联合清艾条压灸百会、神庭、天柱、玉枕、头维等穴治疗,针刀每周1次,最多行3次治疗,压灸每日1次,每周治疗6次;对照组予以甲磺酸倍他司汀,每次12 mg,每天2次,双氯芬酸钠双释放胶囊每次75 mg,每天1次,口服治疗。两组均连续治疗3周。观察两组治疗前后及治疗后3个月随访时颈性眩晕的症状与功能评价量表评分,治疗结束3个月后随访患者的远期疗效。结果:观察组总有效率为93.3%(28/30),显著优于对照组的63.3%(19/30,P<0.05)。与治疗前相比,两组患者治疗后眩晕症状与功能评价量表总评分及眩晕、颈肩痛、头痛、日常工作和生活、心理和社会适应能力5个单项积分均有不同程度升高(P<0.05,P<0.01);与本组治疗后相比,观察组随访时除头痛及总评分略有下降外,余4个单项评分较治疗后均有提高(均P<0.05),对照组随访时总评分及5个单项评分较治疗后均降低(P<0.05,P<0.01);与对照组治疗后及随访时同时间点比较,观察组眩晕症状与功能评价量表总评分及5个单项评分均明显提高(P<0.05,P<0.01)。结论:针刀联合清艾条压灸可明显减轻CV患者头晕、头痛、颈肩痛,并能提高患者的生活质量,疗效较西药为优,并有较好的远期疗效。

Objective To compare the effect difference between needle-knife therapy combined with moxa stick pressure moxibustion and western medicine for cervical vertigo. Methods A total of 60 cervical vertigo patients were randomized into an observation group and a control group, 30 cases in each group. The patients in the observation group were treated with needle-knife therapy combined with moxa stick pressure moxibustion at Baihui（GV 20）, Shenting（GV 24）,Tianzhu（BL 10）, Yuzhen（BL 9）, Touwei（ST 8）, etc. The needle-knife therapy was given once a week, 1-3 times. The pressure moxibustion was given once a day, 6 times a week. The patients in the control group were received 12 mg of betahistine mesylate, twice a day, and 75 mg of diclofenac sodium double release capsule, once daily for oral treatment. The treatment was given for 3 weeks in both groups. The symptom and functional evaluation scale of cervical vertigo were observed before and after treatment and 3 months after treatment. The long-term effect was observed 3 months after treatment.Results The total effective rate in the observation group was 93.3%（28/30）, which was significantly higher than 63.3%（19/30） in the control group（P〈0.05）. Compared with those before treatment, the scores of vertigo symptom and functional evaluation scale, dizziness, neck and shoulder pain, headache, daily life, psychological and social adaptability were increased in the two groups（P〈0.05, P〈0.01）. Except for a slight decrease in headache and total score at the follow-up period in the observation group, the remaining 4 individual scores were higher than those after treatment（all P〈0.05）. At follow-up, the total score and five individual scores were lower than those after treatment in the control group（P〈0.05, P〈0.01）. Compared with those in the control group, the vertigo scale scores and the five individual scores in the observation group were increased significantly after treatment and at follow-up（P〈0.05, P〈0.01）. Conclusion Needle-knife therapy combined with moxa stick pressure moxibustion can significantly relieve dizziness, headache, neck and shoulder pain in patients with CV, and can improve the quality of life. The combination therapy are better than western medicine, and have a better long-term effect.