改良浮针松解枕下肌群治疗椎动脉型颈椎病临床观察及对血流动力学的影响

Clinical Observation and Hemodynamic Effect of Modified Superficial Needling Releasing Suboccipital Muscle for Cervical Spondylosis of Vertebral Artery Type

目的:观察运用改良浮针松解枕下肌群治疗椎动脉型颈椎病的临床疗效及其对血流动力学影响。方法:将临床诊断椎动脉型颈椎病患者120例,随机分为治疗组及对照组,每组60例。对照组运用传统针刺治疗,治疗组采用改良浮针治疗。分别记录2组在治疗前、治疗后2周及治疗后4周的眩晕障碍评分(DHI),采用经颅多普勒(TCD)评估血流动力学变化,并分析其疗效。结果:2组治疗后DHI评分较治疗前改善,2组治疗后2周及治疗后4周眩晕程度均有不同程度减轻,与对照组同时间点比较,治疗组眩晕减缓程度更为显著(P<0.05)。2组治疗后2周及治疗后4周左侧椎动脉(LVA)、右侧椎动脉(RVA)、基底动脉(BA)的平均血流速度(Vm)均有不同程度提高。治疗后2周及治疗4周后,2组评分比较,差异有统计学意义(P<0.05)。治疗后2周,2组分别与治疗前比较,差异有统计学意义(P<0.05),治疗后4周,治疗组与治疗前比较,差异有统计学意义(P<0.05),但对照组与治疗前比较,差异无统计学意义(P>0.05)。2组未发现严重不良反应。结论:运用改良浮针松解枕下肌群治疗椎动脉型颈椎病可获得肯定临床疗效,且能有效改善血流动力学指标。

Objective: To observe the clinical effect of modified superficial needling releasing suboccipital muscle for cervical spondylosis of vertebral artery type and its effect on hemodynamics. Methods: A total of 120 cases of patients diagnosed with cervical spondylosis of vertebral artery type were randomly divided into the treatment group and the control group,60 cases in each group. The control group was treated with conventional acupuncture,and the treatment group was treated with modified superficial needling. The scores of Dizziness Handicap Inventory(DHI) before treatment, after twoweek treatment and four-week treatment in the two groups were recorded. The hemodynamic changes were evaluated by transcranial doppler(TCD). The curative effect was analyzed. Results:The DHI scores after treatment in the two groups were improved when compared with those before treatment;the degree of dizziness after two-week treatment and four-week treatment in the two groups were reduced in different degrees;the decrease of the degree of dizziness in the treatment group was more significant when compared with that in the control group at the same time point(P<0.05). The mean velocity(Vm) of left vertebral artery(LVA),right vertebral artery(RVA) and basilar artery(BA) after two-week treatment and four-week treatment in the two groups were increased in different degrees. After two-week treatment and four-week treatment,there was significant difference being found in the comparison of hemodynamic indexes between the two groups(P<0.05). In the two groups, there was significant difference being found in the comparison of hemodynamic indexes after two-week treatment and before treatment(P<0.05). After four-week treatment, when compared the hemodynamic indexes in the treatment group with those before treatment,there was significance in the difference(P<0.05),but there was no significant difference being found in the control group when compared with those before treatment(P>0.05). No significant adverse reaction occurred in the two groups. Conclusion: The application of modified superficial needling releasing suboccipital muscle can obtain defined clinical effect in treating cervical spondylosis of vertebral artery type, and effectively improve hemodynamic indexes.