电针联合推拿对气滞血瘀型椎动脉型颈椎病脑血流参数的影响

Effect of Electroacupuncture plus Manipulative Massage on Cerebral Blood Flow Parameters in Cervical Spondylotic Arteriopathy of Qi Stagnation and Blood Stasis Type

目的观察电针联合推拿对气滞血瘀型椎动脉型颈椎病(CSA)脑血流参数的影响。方法将90例气滞血瘀型椎动脉型颈椎病患者随机分为观察组和对照组,每组45例。对照组给予常规药物治疗,观察组在对照组治疗基础上给予电针联合推拿治疗。观察两组治疗前后主要临床症状积分(眩晕、颈肩痛、头痛、恶心呕吐、视力障碍)、脑血流参数[左椎动脉(LVA)、右椎动脉(RVA)及基底动脉(BA)的平均血流速度(Vm)]、血液流变学(全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、血沉)的变化,并比较临床疗效。结果观察组总有效率为91.1%,对照组总有效率为71.1%,观察组高于对照组(P<0.05)。两组治疗后主要临床症状积分均明显改善(P<0.05),且观察组优于对照组(P<0.05);两组治疗后LVA、RVA和BA的Vm均较同组治疗前升高(P<0.05),观察组高于对照组(P<0.05);两组治疗后全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、血沉均较同组治疗前降低(P<0.05),观察组低于对照组(P<0.05)。结论电针联合推拿和药物治疗能够有效改善气滞血瘀型CSA患者的脑血流参数及椎-基底动脉血液流变学,快速缓解或消除CSA临床症状,疗效确切。

Objective To observe the effect of electroacupuncture plus manipulative massage on cerebral blood flow parameters in cervical spondylotic arteriopathy(CSA)of qi stagnation and blood stasis type.Methods Ninety patients with cervical spondylotic arteriopathy of qi stagnation and blood stasis type were randomized to observation and control groups,with 45 cases in each group.The control group received conventional medication and the observation group,electroacupuncture plus manipulative massage in addition.The main clinical symptom(vertigo,neck and shoulder pain,headache,nausea and vomiting,and visual disorder)scores were recorded and cerebral blood flow parameters(mean blood flow velocity(Vm)in the left vertebral artery(LVA),right vertebral artery(RVA)and basilar artery(BA))and hemorheological indicators(high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity,hematocrit and erythrocyte sedimentation rate)were measured in the two groups before and after treatment.The clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 91.1% in the observation group and 71.1% in the control group and was higher in the observation group than in the control group(P<0.05).After treatment,the main clinical symptom scores decreased significantly in both groups(P<0.05)and were significantly lower in the observation group than in the control group(P<0.05).After treatment,LVA,RVA and BA Vm increased in both groups compare with before(P<0.05)and were higher in the observation group than in the control group(P<0.05).After treatment,high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity,hematocrit and erythrocyte sedimentation rate decreased in both groups compare with before(P<0.05)and were significantly lower in the observation group than in the control group(P<0.05).Conclusions Electroacupuncture plus manipulative massage and medication can effectively improve cerebral blood flow parameters and vertebrobasilar hemorheological indicators in patients with CSA of qi stagnation and blood stasis type.It can rapidly relieve or eliminate the clinical symptoms of CSA with a definite therapeutic effect.