益气补肾、活血通络方联合牵引治疗椎动脉型颈椎病临床研究

Clinical Study on Qi-Boosting and Kidney-Nourishing and Blood-Activating and Meridian-Dredging Decoction Combined with Cervical Traction in the Treatment of Cervical Spondylosis of Vertebral Artery Type

目的:观察益气补肾、活血通络方联合颈椎牵引治疗椎动脉型颈椎病的临床疗效。方法:将90例椎动脉型颈椎病患者按照随机数字表法分为观察组和对照组A、对照组B,每组各30例。对照组A给予常规治疗,对照组B在对照组A治疗的基础上给予颈椎牵引疗法,观察组在对照组B治疗的基础上予以益气补肾、活血通络方口服。比较3组患者治疗前后中医证候积分、颈源性眩晕症状与功能评估量表(evaluation scale for cervical vertigo,ESCV)评分、超氧化物歧化酶(serum superoxide dismutase,SOD)、神经元特异性烯醇酶(neuron specific enolase,NSE)水平及椎-基底动脉平均血流速度。结果:3组患者治疗后ESCV评分及SOD水平高于本组治疗前,且治疗后观察组高于对照组A和对照组B,差异具有统计学意义(P<0.05)。3组患者治疗后中医证候积分及NSE水平低于本组治疗前,且治疗后观察组低于对照组A和对照组B,差异具有统计学意义(P<0.05)。3组患者治疗后椎-基底动脉平均血流速度高于本组治疗前,且治疗后观察组高于对照组A和对照组B,差异具有统计学意义(P<0.05)。结论:益气补肾、活血通络方联合颈椎牵引治疗椎动脉型颈椎病,可改善患者临床症状和颈椎功能,增加椎-基底动脉血流速度,其作用机制可能与抑制周围血中炎症反应和神经保护有关。

Objective:To observe the clinical efficacy of Qi-Boosting and Kidney-Nourishing and Blood-Activating and Meridian-Dredging Decoction combined with cervical traction on cervical spondylosis of vertebral artery type.Methods:A total of 90 patients with cervical spondylosis of vertebral artery type were randomly divided into the observation group,the control group A and the control group B,with 30 cases in each group.The control group A was given routine treatment,the control group B was given cervical traction therapy on the basis of the treatment of the control group A,and the observation group was given Qi-Boosting and Kidney-Nourishing and Blood-Activating and Meridian-Dredging Decoction on the basis of the treatment of the control group B.The TCM syndrome score,evaluation scale for cervical vertigo(ESCV)score,serum superoxide dismutase(SOD),neuron specific enolase(NSE)and average blood flow velocity of vertebral basilar artery were compared before and after treatment between the three groups.Results:After treatment,the ESCV score and SOD level of the three groups were higher than those of the same group before treatment,and the above indexes in the observation group were higher than those in the control group A and the control group B.All the differences were statistically significant(P<0.05).After treatment,the TCM syndrome score and NSE level of the three groups were lower than those of the same group before treatment,and the above indexes in the observation group were lower than those in control group A and the control group B.All the differences were statistically significant(P<0.05).The average blood flow velocity of vertebral basilar artery in the three groups after treatment was higher than that before treatment,and the index in the observation group after treatment was higher than that in the control group A and the control group B.All the differences were statistically significant(P<0.05).Conclusion:Qi-Boosting and Kidney-Nourishing and Blood-Activating and Meridian-Dredging Decoction combined with cervical traction in the treatment of cervical spondylosis of vertebral artery type can improve the clinical symptoms and cervical function,and increase the blood flow velocity of vertebral basilar artery.Its mechanism may be related to the inhibition of inflammatory reaction in peripheral blood and neuroprotection.