针刺百会穴联合芪葛通络舒颈方治疗交感神经型颈椎病所致高血压疗效及对心率变异性与椎-基底动脉血流的影响

Curative effect of acupuncture at Baihui acupoint with Qige Tongluo Shujing Decoction on hypertension caused by sympathetic cervical spondylopathy and its effect on heart rate variability and vertebral-basilar artery blood flow

目的探讨针刺百会穴联合芪葛通络舒颈方治疗交感神经型颈椎病所致高血压患者疗效及对心率变异性(HRV)与椎-基底动脉血流的影响。方法将2018年1月—2019年6月在黑龙江省中医药科学院治疗的60例交感神经型颈椎病所致高血压患者随机分为2组,每组30例。对照组给予常规干预,观察组在常规干预基础上给予针刺百会穴联合芪葛通络舒颈方治疗,2组均治疗8周。比较2组治疗前后临床症状评分、血压、颈椎功能障碍指数(NDI)、NPQ颈痛量表评分、HRV参数、椎-基底动脉血流动力学参数,统计2组临床疗效。结果与治疗前比较,2组治疗后头晕、头痛、视力模糊、耳鸣、心悸、失眠评分及收缩压(SBP)、舒张压(DBP)、NDI、NPQ颈痛量表评分均明显降低(P均<0.05),且观察组治疗后各项评分、血压均明显低于对照组(P均<0.05)。与治疗前比较,观察组治疗后5 min节段R-R间期平均值的标准差(SDANN)、R-R间期标准差(SDNN)、相邻RR间期差>50 ms的个数占总心跳次数的百分比(PNN50)、相邻R-R间期差的均方根(rMMSD)、椎动脉和基底动脉收缩期血流速、舒张期血流速均明显增加(P均<0.05),血管阻力明显降低(P<0.05),且观察组治疗后以上指标改善情况均优于对照组(P均<0.05)。观察组治疗总有效率为90.0%(27/30),对照组为70.0%(21/30),观察组明显高于对照组(P<0.05)。结论针刺百会穴联合芪葛通络舒颈方治疗交感神经型颈椎病所致高血压不仅可明显减轻症状,降低血压,改善颈椎功能,还能调节自主神经功能与椎-基底动脉血流动力学。

Objective It is to investigate the curative effect of acupuncture at Baihui acupoint with Qige Tongluo Shujing Decoction on hypertension caused by sympathetic cervical spondylopathy and its effect on heart rate variability(HRV)and vertebral-basilar artery blood flow.Methods Sixty patients with hypertension caused by sympathetic cervical spondylosis treated at Heilongjiang Academy of Traditional Chinese Medicine from January 2018 to June 2019 were randomly divided into 2 groups with 30 cases in each group.The control group was given routine intervention,and the observation group was given acupuncture at Baihui acupoints combined with Qige Tongluo Shujing Decoction on the basis of routine intervention.Both groups were treated for 8 weeks.The clinical symptoms scores,blood pressure,cervical spine dysfunction index(NDI),NPQ neck pain scale scores,HRV parameters,and vertebrobasilar hemodynamic parameters were compared between the two groups before and after treatment,and the clinical efficacy of the two groups was calculated.Results Compared with before treatment,the scores of dizziness,headache,blurred vision,tinnitus,palpitations,insomnia,systolic blood pressure(SBP),diastolic blood pressure(DBP),NDI,and the scores of NPQ neck pain scale were significantly reduced after treatment in the two groups(P<0.05),and the scores and blood pressure of the observation group after treatment were significantly lower than those of the control group(P<0.05).Compared with before treatment,the standard deviation of the 5-minute mean cycle length(SDANN),standard deviation of normal to normal intervals(SDNN),and adjacent RR interval difference>50 ms at the 5 min segment RR interval averaged as a percentage of the total number of heartbeats(PNN50),the root mean square successive difference(rMMSD),the systolic blood flow velocity of the vertebral artery and basilar artery,and the diastolic blood velocity were increased significantly in the two groups after treatment(all P<0.05),and the vascular resistance was significantly reduced(P<0.05),and the improvement of the above indicators after treatment in the observation group was better than that of the control group(P<0.05).The total effective rate of treatment in the observation group was 90.0%(27/30),and that in the control group was 70.0%(21/30),the observation group was significantly higher than the control group(P<0.05).Conclusion Acupuncture at Baihui acupoints combined with Qige Tongluo Shujing Decoction can not only significantly reduce symptoms,lower blood pressure,improve cervical spine function,but also regulate autonomic nerve function and vertebral-basal artery blood flow dynamics in the treatment of hypertension caused by sympathetic cervical spondylosis.