按痹症以中药结合超声引导下水针刀治疗颈源性眩晕的临床研究

Chinese Herbal Decoction Combined with Ultrasound-Guided Water Needle Knife According to Bi-Syndrome in Treatment of Cervical Vertigo

目的:探讨按痹症以中药结合超声引导下水针刀治疗颈源性眩晕的临床疗效。方法:项目分研究组及三个对照组,研究组为中药结合水针刀治疗,对照组分别为中药组、水针刀组及西药组。其中中药分两型用药,分别为虚实夹杂证(肝肾气血不足,夹痰湿瘀滞)及实证(痰热瘀结、风阳内动)两型。虚实夹杂证拟补肝肾、益气血、化痰瘀,半夏白术天麻汤、独活寄生汤化裁,实证组中药拟化痰祛瘀、息风清热,用天麻钩藤饮、大秦艽汤、宣痹汤化裁。结果:研究组总有效率为94.12%,中药组、水针刀组及西药组分别为88.24%、91.18%、72.73%,经Kurskal-Wallis检验提示研究组与中药组、针刀组及西药组相比均有显著性差异(P<0.05);症状与功能评分方面,研究组组内治疗前后及治疗后研究组与各对照组的比较,均为P<0.05。结论:按痹症以中药结合超声引导下水针刀治疗能够有效改善颈源性眩晕症状,椎-基动脉供血不足并非颈源性眩晕的主要病因,可能性最大为深感觉反射性眩晕或交感神经反射性眩晕。

Objective: To study the treatment of cervical vertigo by traditional Chinese medicine combined with ultrasound-guided needle knife. Methods: The project was divided into research group and control group. The research group was treated with traditional Chinese medicine combined with water needle knife, while the control group was treated with traditional Chinese medicine, water needle knife and Western medicine respectively. There are two types of traditional Chinese medicine: deficiency and excess syndrome (qi and blood insufficiency of liver and kidney, phlegm and dampness stagnation) and syndrome (phlegm-heat stagnation, wind-yang internal movement). Yingshi inclusion disease is intended to invigorate liver and kidney, replenish qi and blood, remove phlegm and blood stasis. Banxia Baizhu Tianma Decoction, Duhuo Jisheng Decoction, the empirical group of traditional Chinese medicine to remove phlegm and blood stasis, relieve wind and clear heat, with Tianma Gouteng Yin, Daqin Gentian, Xuanbi Decoction. Results: The total effective rate was 94.12% in the study group, and which was 88.24%, 91.18% and 72.73% in the traditional Chinese medicine group, the water needle knife group and the western medicine group. The Kurskal-Wallis test showed that there were significant differences between the study group and the traditional Chinese medicine group, the needle knife group and the western medicine group. In terms of symptoms and functional scores, the comparison between the study group before and after treatment and the comparison between the study group and the control group after treatment were all P<0.05. Conclusion: The treatment of arthralgia with traditional Chinese medicine combined with ultrasound- guided needle knife can effectively improve the symptoms of cervical vertigo. Vertebrobasilar insufficiency is not the main cause of cervical vertigo, and the most likely cause is deep sensory reflex vertigo or sympathetic reflex vertigo.