平衡针刀联合温针灸治疗椎动脉型颈椎病的疗效观察

Effect of balance acupotomy combined with warm needling in treatment of cervical spondylosis of vertebral artery type

目的:观察平衡针刀联合温针灸治疗椎动脉型颈椎病(CSA)的临床疗效。方法:将90例CSA患者随机分为温针灸组、平衡针刀组及联合组,每组30例。温针灸组以温针灸风府、风池、完骨、天柱治疗,1次/d,连续5d后休息2d,1周为1个疗程,共治疗3个疗程;平衡针刀组使用平衡针刀治疗,每周治疗1次,连续治疗3周;联合组在温针灸组的基础上使用平衡针刀治疗,连续治疗3周。比较3组患者左椎动脉(LVA)、右椎动脉(RVA)、基底动脉(BA)的平均血流速度及搏动指数(PI)、阻力指数(RI)的变化情况,对比治疗前后3组患者眩晕症状与功能(ESCV)评分,观察3组患者临床疗效。结果:与本组治疗前比较,3组治疗后ESCV评分及BA、LVA、RVA平均血流速度均升高(P<0.05),PI、RI均下降(P<0.05)。与温针灸组、平衡针刀组比较,联合组ESCV评分及BA、LVA、RVA平均血流速度均升高(P<0.05),PI、RI均下降(P<0.05)。与平衡针刀组比较,温针灸组LVA、RVA、BA平均血流速度均升高(P<0.05),PI、RI均下降(P<0.05)。温针灸组总有效率为73.3%(22/30),平衡针刀组为70.0%(21/30),联合组为93.3%(28/30),联合组总有效率高于温针灸组和平衡针刀组(P<0.05)。结论:平衡针刀联合温针灸治疗CSA,可恢复颈部力学平衡状态,并有效改善椎-基底动脉血流状况,改善眩晕症状。

Objective To observe the clinical efficacy of balance acupotomy combined with warm needling in treatment of cervical spondylopathy of vertebral artery type(CSA).Methods Ninety patients were randomly divided into a warm needling group,a balance acupotomy group and a combined treatment group,30cases in each one.In the warm needling group,warm needling was given,once daily,for 5days consecutively,with the interval of 2days every week,and the treatment was conducted for 3weeks.In the combined treatment group,on the base of the treatment as the warm needling group,the balance acupotomy was exerted,for consecutive 3weeks.In the balance acupotomy group,the balance acupotomy was adopted,once a week,for 3weeks consecutively.Clinical efficacy,the mean blood flow velocity of left vertebral artery(LVA),right vertebral artery(RVA)and basilar artery(BA),the pulse index(PI)and the resistance index(RI)were observed in 3groups separately.The score of vertigo symptom and function was compared before and after treatment in 3groups.Results In comparison with before treatment,the score of evaluation scale for cervical vertigo(ESCV)and the mean blood flow velocity of LVA,RVA and BA were all increased(P<0.05).while PI and RI reduced(P<0.05)in each group after treatment.In comparison with those in the warm needling group and the balance acupotomy group,ESCV score and the mean blood flow velocity of LVA,RVA and BA were increased(P<0.05),while PI and RI decreased(P<0.05)in the combined treatment group after treatment.Compared with the balance acupotomy group,the mean blood flow velocity of LVA,RVA and BA was increased(P<0.05),and PI and RI reduced(P<0.05)in the warm needling group after treatment.The total effective rate was 73.3%(22/30)in the warm needling group,70.0%(21/30)in the balance acupotomy group and 93.3%(28/30)in the combined treatment group respectively.The total effective rate in the combined treatment group was higher than that either in the warm needling group or in the balance acupo-tomy group(P<0.05).Conclusion Balance acupotomy combined with warm needling may restore the mechanical equilibrium state of the neck,and effectively improve the change of vertebral-basilar artery blood flow and relieve vertigo symptoms in patient with of cervical spondylosis of vertebral artery type.