针刀枕下三角松解治疗对椎动脉型颈椎病症状功能评分及椎动脉血流的影响

Effects of suboccipital triangle release with acupotomy on symptom and functional score and vertebral artery blood flow of vertebral artery type of cervical spondylosis

目的观察针刀枕下三角松解治疗对椎动脉型颈椎病症状与功能评分及椎动脉血流的影响。方法选择2017年3月~2018年3月西安交通大学医学院附属红会医院中医骨科神经脊柱病区收治的57例颈性眩晕患者,按随机数字表法将其分为观察组和对照组。观察组29例,采用小针刀松解枕下三角的治疗方法;对照组28例,采用针灸和干扰电治疗。治疗结束后均给予颈部功能康复锻炼。分别于首次治疗后、治疗2周及3个月后比较两组患者椎动脉型颈椎病症状与功能评分和脑血流图中椎动脉血流峰值的变化,评价两组临床疗效。结果治疗结束后,两组患者症状与功能评分和椎动脉血流峰值均较治疗前提高,差异有统计学意义(P <0.05),其中首次治疗后和治疗2周后,治疗组症状与功能评分和椎动脉血流峰值明显高于对照组,差异有统计学意义(P <0.05),而治疗3个月后,两组椎动脉型颈椎病症状与功能评分和椎动脉血流峰值均较治疗前提高(P <0.05),但两组间比较差异无统计学意义(P> 0.05)。结论针刀松解颈部枕下三角区软组织可快速有效改善椎动脉型颈椎病症状、颈部功能和椎动脉血流,近期疗效优于针灸和理疗,远期疗效类似。针刀治疗见效快,简便廉价,值得推广应用。

Objective To observe the effects of suboccipital triangle release with acupotomy on symptom and functional score and vertebral artery blood flow of vertebral artery type of cervical spondylosis.Methods Fifty-seven patients with cervical vertigo admitted to Neurospinal Ward of Chinese Medicine Orthopaedic Department of Honghui Hospital Affiliated to Medical School of Xi'an Jiaotong University from March 2017 to March 2018 were selected,and they were divided into observation group and control group by random number table method.29 cases in observation group were treated with needle-knife to loosen the suboccipital triangle.28 cases in control group were treated with acupuncture and interference electrical therapy.Both groups were given neck function rehabilitation exercise at the end of treatment.The changes of symptom and functional score and peak values of vertebral artery blood flow in the cerebral hemodynamics of vertebral artery type of cervical spondylosis were respectively observed after the first treatment and after treatment for 2 weeks and 3 months.The clinical efficacy of the two groups was evaluated.Results At the end of treatment,the symptom and functional score and peak values of vertebral artery blood flow in the two groups were all higher than those before treatment,the differences were statistically significant(P<0.05).After the first treatment and 2 weeks after treatment,the symptom and functional score and peak values of vertebral artery blood flow in the treatment group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).After treatment for 3 months,the symptom and functional score and peak values of vertebral artery blood flow in the two groups were all higher than those before treatment(P<0.05),but there were no significant differences between the two groups(P>0.05).Conclusion The soft tissue of suboccipital triangle released by acupotomy can rapidly and effectively improve the symptom,cervical function and vertebral artery blood flow of vertebral artery type of cervical spondylosis.The short-term effect is better than acupuncture and physiotherapy.The long-term efficacy is similar.Needle-knife treatment has quick returns,and it is simple,cheap and worthy of promotion and application.