针刺联合川芎清脑颗粒对椎动脉型颈椎病疗效及椎动脉血流的影响

Curative Effect of Acupuncture Combined with Chuanxiong Qingnao Granules on Cervical Spondylosis of Vertebral Artery Type and Its Effect on Blood Flow of Vertebral Artery

目的:观察针刺联合川芎清脑颗粒对椎动脉型颈椎病(CSA)疗效及椎动脉血流的影响。方法:纳入80例CSA患者,按治疗方法不同分为治疗组和对照组各40例。治疗组给予针刺联合川芎清脑颗粒治疗,对照组给予盐酸氟桂利嗪片联合前列地尔注射液治疗,2组均治疗3周。比较2组临床疗效、颈性眩晕症状与功能评估量表(ESCV)、颈椎退变程度及颈椎病临床评价量表(CASCS)评分。采用彩色多普勒超声检测2组椎动脉内径、收缩期血流速峰值(Vs)、阻力指数(RI)及搏动指数(PI)。结果:治疗组总有效率为95.0%,高于对照组的72.5%,差异有统计学意义(P<0.05)。治疗后,2组ESCV中眩晕(程度、频度、持续时间)、颈肩痛、头痛、日常生活及工作、心理及社会适应评分均较治疗前上升,治疗组ESCV各项细则评分均高于对照组,差异均有统计学意义(P<0.01)。治疗后,2组CASCS评分均较治疗前升高(P<0.05);治疗组CASCS评分高于对照组(P<0.05)。椎退变程度评分治疗后组间比较,差异无统计学意义(P>0.05)。治疗后,2组椎动脉内径、Vs均较治疗前增大(P<0.05),RI、PI均较治疗前减小(P<0.05);治疗组椎动脉内径、Vs均大于对照组(P<0.05),RI、PI均小于对照组(P<0.05)。结论:针刺联合川芎清脑颗粒能有效缓解CSA患者眩晕及伴随症状,改善颈椎功能及椎动脉供血情况。

Objective:To observe the curative effect of acupuncture combined with Chuanxiong Qingnao granules on cervical spondylosis of vertebral artery type(CSA)and its effect on blood flow of vertebral artery.Methods:A total of 80 cases of CSA patients were enrolled and divided into the treatment group and the control group according to different treatment methods,40 cases in each group.The treatment group was treated with acupuncture combined with Chuanxiong Qingnao granules,and the control group was treated with flunarizine hydrochloride capsules combined with alprostadil injection.Both groups were treated for three weeks.The clinical effect as well as the scores of Evaluation Scale for Cervical Vertigo(ESCV)and Clinical Assessment Scale for Cervical Spondylosis(CASCS)were compared between the two groups.The diameter,the peak systolic velocity(Vs),resistance index(RI)and pulsatility index(PI)of vertebral artery in the two groups were detected by color doppler ultrasound.Results:The total effective rate was 95.0% in the treatment group,higher than that of 72.5% in the control group,the difference being significant(P<0.05).After treatment,the scores of vertigo(degree,frequency and duration),neck and shoulder pain,headache,daily living and work,mentality and social adaptation in ESCV in the two groups were increased when compared with those before treatment,and each score in the treatment group was higher than that in the control group,differences being significant(P<0.01).After treatment,the scores of CASCS in the two groups were increased when compared with those before treatment(P<0.01);the score of CASCS in the treatment groups was higher than that in the control group(P<0.01).After treatment,there was no significant difference in the comparison of the score of cervical degeneration between the two groups(P>0.05).After treatment,the values of diameter and Vs of vertebral artery in the two groups were increased(P<0.05),and the values of RI and PI of vertebral artery were decreased(P<0.05);the values of diameter and Vs in the treatment group were larger than those in the control group(P<0.05),and the values of RI and PI were lower(P<0.05).Conclusion:The therapy of acupuncture combined with Chuanxiong Qingnao granules can effectively relieve vertigo and complications in CSA patients,and improve cervical function and the blood supply of vertebral artery.