针刺椎枕肌与常规针刺法治疗椎动脉型颈椎病的临床效果比较

Comparison of Clinical Efficacy between Acupuncture at Vertebral Occipital Muscle and Conventional Acupuncture in Treatment of Patients with Vertebral Artery Type of Cervical Spondylosis

目的对比分析针刺椎枕肌与常规针刺法治疗椎动脉型颈椎病(CSA)的临床疗效。方法选取2017年1月-2018年12月就诊于我院的CSA患者100例,按治疗方法不同分为对照组和观察组,每组50例。对照组给予常规针刺治疗,观察组给予椎枕肌针刺治疗。比较2组治疗总有效率、症状与功能评分及患者左椎动脉(LVA)、右椎动脉(RVA)、基底动脉(BA)的平均血流速度变化;检测并比较2组血浆神经钛Y(NPY)、尾加压素Ⅱ(UⅡ)水平。结果观察组治疗总有效率高于对照组(P<0.05)。2组治疗后症状与功能评分及LVA、RVA、BA的平均血流速度改善程度均优于治疗前,且观察组优于对照组(P<0.05)。2组血浆NPY、UⅡ水平低于治疗前,且观察组低于对照组(P<0.05)。结论针刺椎枕肌治疗CSA能够更有效地缓解临床症状,改善脑供血,疗效明显优于常规针刺。

Objective To compare and analyze clinical efficacy between acupuncture at vertebral occipital muscle and conventional acupuncture in treatment of patients with vertebral artery type of cervical spondylosis. Methods A total of 100 patients with vertebral artery type of cervical spondylosis were randomly divided into control group and observation group(n=50 in each group). Control group was given conventional acupuncture, while observation group was given acupuncture at vertebral occipital muscle. The two groups were treated once a day for 6 times as a course of treatment and all patients received 2 courses of treatment. In two groups, the total effective rate, symptom and function score and changes of mean blood flow velocities in left vertebral artery(LVA), right vertebral artery(RVA) and basilar artery(BA) before and after treatment were compared, and levels of plasma neuropeptide Y(NPY) and urotensin II(U Ⅱ) were detected before and after treatment. Results The total effective rate in observation group was significantly higher than that in control group(P<0.05). After treatment in observation group, symptom and function score and improvement conditions of mean blood flow velocities of LVA, RVA and BA were significantly better(P<0.05), and levels of plasma NPY and U Ⅱ were significantly lower than those in control group(P<0.05). Conclusion Acupuncture at vertebral occipital muscle may effectively relieve clinical symptoms and improve blood supply of brain in treatment of patients with vertebral artery type of cervical spondylosis, and its efficacy is obviously better than that by conventional acupuncture.