桂枝葛根汤结合针刺治疗老年人颈性眩晕的临床疗效及对预后的影响

Clinical Effect of Guizhi Gegen Decoction Combined with Acupuncture in Treatment of Cervical Vertigo in The Aged and Its Effect on Prognosis

目的评价桂枝葛根汤结合针刺治疗老年人颈性眩晕的临床疗效及对预后的影响。方法选择2018年5月—2019年5月山东省医学科学院附属医院康复科收治的老年颈性眩晕患者120例,依据随机对照法将患者分为观察组和对照组,每组60例。对照组在西医治疗的基础上采用针刺治疗,观察组在对照组治疗的基础上辅助桂枝葛根汤治疗。治疗4周。随访6个月。观察两组患者治疗后治疗疗效、颈性眩晕症状与功能评估量表(ESCV)评分,治疗前后血浆黏度、全血低切黏度和全血高切黏度变化,治疗前后基底动脉、右侧椎动脉和左侧椎动脉平均血流水平,治疗前后生活质量评分,记录治疗过程中不良反应。结果观察组治疗总有效率为93.10%(54/58)高于对照组治疗总有效率的80.70%(46/57)(P<0.05);观察组患者经过4周的治疗,眩晕、头痛、颈肩痛、日常生活及工作和心理及社会适应评分高于对照组(P<0.05);血浆黏度、全血低切黏度和全血高切黏度较治疗前降低(P<0.05);治疗后椎-基底动脉、右侧椎动脉和左侧椎动脉平均血流水平高于对照组(P<0.05);患者的生活质量较对照组显著提高(P<0.05)。结论桂枝葛根汤结合针刺可有效降低老年人颈性眩晕患者的血液黏稠度,改善椎-基底动脉血流速度,提高颈性眩晕患者的生活质量和临床疗效,促进患者康复,提高预后效果。

Objective To evaluate the clinical effect of Guizhi Gegen Decoction combined with acupuncture on senile cervical vertigo and its influence on prognosis. Methods A total of 120 cases of elderly patients with cervical vertigo admitted to the rehabilitation department of Affiliated Hospital of Shandong Academy of Medical Sciences from May 2018 to May 2019 were selected, and the patients were divided into observation group and control group according to the randomized control method, with 60 cases in each group. The control group was treated with acupuncture on the basis of western medicine, and the observation group was treated with Guizhi Gegen Decoction on the basis of western medicine. The treatment lasted for 4 weeks. They were followed up for 6 months. The therapeutic effect and ESCV score of the two groupsafter treatment were observed, and the changes of plasma viscosity, whole blood low section-viscosity and whole blood high section-viscosity before and after treatment were observed. The mean blood flow levels of vertebrobasilar artery, right vertebral artery and left vertebral artery before and after treatment were observed. Results The total effective rate was 93.10%(54/58) in the observation group, higher than 80.70%(46/57) in the control group(P<0.05). After 4 weeks of treatment, the scores of vertigo, headache, neck and shoulder pain, daily life and workand psychological and social adjustment in the observation group were higher than those in the control group(P<0.05). Plasma viscosity, whole blood low viscosity and whole blood high viscosity were lower than those before treatment(P<0.05). After treatment, the mean blood flow level of vertebrobasilar artery, right vertebral artery and left vertebral artery was higher than that of the control group(P < 0.05). The quality of life of the patients was significantly improved compared with the control group(P<0.05). Conclusion Guizhi Gegen Decoction combined with acupuncture can effectively reduce the blood viscosity of elderly patients with cervical vertigo, improve the blood flow velocity of vertebrobasilar artery, improve the quality of life and clinical efficacy of patients with cervical vertigo, promote the rehabilitation of patients and improve the prognosis.