激痛点推拿配合针刺治疗椎动脉型颈椎病临床研究

Clinical Study on Massage on Trigger Points Combined with Acupuncture for Cervical Spondylosis of Vertebral Artery Type

目的:探讨激痛点推拿配合针刺治疗椎动脉型颈椎病(CSA)的临床疗效。方法:选取76例CSA患者,按随机数字表法分为研究组和对照组各38例。对照组行颌枕牵引疗法治疗,研究组行激痛点推拿配合针刺治疗。观察2组症状改善情况,检测血清一氧化氮(NO)及内皮源性超极化因子(EDHF)水平。结果:治疗前,2组血液流变学指标比较,差异均无统计学意义(P>0.05)。治疗后,2组血液流变学指标均较治疗前降低,且研究组各项指标均低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组血清NO及EDHF水平比较,差异无统计学意义(P>0.05)。治疗2、4周,2组NO水平均明显升高,且研究组高于对照组;2组EDHF水平先升高后降低,且研究组均显著高于对照组;差异均有统计学意义(P<0.05)。治疗前,2组症状及体征评分比较,差异无统计学意义(P>0.05)。治疗后,2组症状及体征评分较治疗前降低,且研究组症状及体征评分低于对照组,差异均有统计学意义(P<0.05)。研究组总有效率为94.74%,高于对照组78.95%,差异有统计学意义(P<0.05)。结论:激痛点推拿配合针刺治疗CSA患者,可改善患者血液流变学指标,提高血清NO、EDHF水平,临床疗效较好。

Objective:To discuss the clinical effect of massage on trigger points combined with acupuncture for cervical spondylosis of vertebral artery type(CSA).Methods:A total of 76 cases of CSA patients were divided into the study group and the control group according the random number table method,38 cases in each group.The control group was treated with jaw-occipital belt traction,and the study group was treated with massage on trigger points combined with acupuncture.The improvement of symptoms in the two groups was observed.The levels of nitric oxide(NO)and endothelium derived hyperpolarizing factor(EDHF)in serum were detected.Results:Before treatment,there was no significant difference being found in the comparison of hemorheological indexes between the two groups(P>0.05).After treatment,the hemorheological indexes in the two groups were decreased when compared with those before treatment,and each index in the study group was lower than that in the control group,differences being significant(P<0.05).Before treatment,compared the levels of NO and EDHF in serum between the two groups,there was no significance in the difference(P>0.05).In the 2th and 4th week after treatment,the levels of NO in the two groups were significantly increased,and the level in the study group was higher than that in the control group;the levels of EDHF in the two groups were first increased then decreased,and the changes in the study group were more significant than those in the control group,differences being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of the scores of symptoms and signs between the two groups(P>0.05).After treatment,the scores of symptoms and signs in the two groups were decreased when compared with those before treatment,and the scores in the study group were lower than those in the control group,differences being significant(P<0.05).The total effective rate was 94.74%in the study group,higher than that of 78.95%in the control group,the difference being significant(P<0.05).Conclusion:The therapy of massage on trigger points combined with acupuncture in treating CSA patients can improve the hemorheological indexes and the levels of NO and EDHF in serum,with good clinical effect.