项六针电针联合三步推拿法治疗椎动脉型颈椎病临床研究

Clinical Study on Nape Needling at Six Points with Electroacupuncture Combined with Three-Step Tuina Manipulation for Vertebral Artery Cervical Spondylosis

目的:观察项六针电针联合三步推拿法治疗椎动脉型颈椎病的临床疗效及对患者颈动脉血流状态的影响。方法:选取76例椎动脉型颈椎病患者为研究对象,按照入院先后顺序分为对照组与观察组,每组38例。对照组给予常规针刺与推拿治疗,观察组给予项六针电针联合三步推拿法治疗,1周为1个疗程,治疗2个疗程,疗程间休息2 d。比较2组临床疗效及治疗前后的临床症状积分、椎动脉血流动力学指标。结果:治疗后,2组眩晕、颈肩痛积分均较治疗前下降(P<0.05),观察组眩晕、颈肩痛积分均比对照组下降更明显(P<0.05)。治疗后,2组收缩期峰值血流(PSV)、血管搏动指数(PI)、平均血流速度(TMFV)、血管阻力指数(RI)均有所改善,观察组上述4项椎动脉血流动力学指标均比对照组改善更明显,差异均有统计学意义(P<0.05)。观察组治愈率50.00%,高于对照组的23.68%(P<0.05)。结论:项六针电针联合三步推拿法治疗椎动脉型颈椎病疗效显著,可改善患者的局部血流状况,预后效果较佳。

Objective:To observe the clinical effect of the therapy of nape needling at six points with electroacupuncture combined with three-step tuina manipulation for vertebral artery cervical spondylosis and its effect on the carotid artery blood flow of patients.Methods:A total of 76 patients with vertebral artery cervical spondylosis were selected as the study subjects,and were divided into the control group and the observation group according to the sequence of admission,38 cases in each group.The control group was given conventional acupuncture and tuina for treatment,and the observation group was treated with nape needling at six points with electroacupuncture combined with three-step tuina manipulation.Both groups were treated for two courses,one week being one course,with two-day rest between each course.The clinical effect,the symptom scores and the hemodynamics of vertebral artery in the two groups were compared before and after treatment.Results:After treatment,the scores of vertigo and neck-shoulder pain in the two groups were decreased when compared with those before treatment(P<0.05),and the decrease of the above two scores in the observation group was more significant than that in the control group(P<0.05).After treatment,the Peak Systolic Velocity(PSV),vascular Pulsatility Index(PI),Time-Mean Flow Velocity(TMFV)and vascular Resistance Index(RI)were improved in both groups,and the improvement of the above four hemodynamics of vertebral artery in the observation group was more significant than that in the control group,differences being significant(P<0.05).The cure rate was 50.00%in the observation group,higher than that of 23.68%in the control group,the difference being significant(P<0.05).Conclusion:The therapy of nape needling at six points with electroacupuncture combined with three-step tuina manipulation has significant therapeutic effect in treating patients with vertebral artery cervical spondylosis,which can improve the local blood flow velocity with a good prognosis.