颈性眩晕的椎枕肌损伤机制与针灸推拿治疗研究进展

The Research Progress of the Mechanism of Cervical Vertigo and Acupuncture and Moxibustion and Tuina Therapy

颈性眩晕致病因素繁多,发病机制复杂,椎动脉供血不足、交感神经受刺激兴奋、本体感受器异常、脑脊液循环受阻都与椎枕肌损伤关系密切。颈性眩晕的椎枕肌损伤机制主要有:椎动脉机械压迫机制、颈部本体感受器机制、脑脊液循环障碍机制、交感神经刺激机制。针灸推拿治疗颈性眩晕常用方法有:针刀疗法、刃针疗法、针刺疗法、手法治疗等。鉴于该肌群特殊的解剖位置,以及复杂的比邻关系,要求医者必须熟悉椎枕肌的局部解剖,同时具备较深的揣穴功底。目前,此类研究仍然缺乏一个规范的、重复性及操作性均佳的标准。如何量化椎枕肌的功能状态,成为评估病情及疗效的关键,也是今后临床及科研的侧重点。

The etiological factors of cervical vertigo are numerous and the pathogenesis is complex.The insufficiency of vertebral artery blood supply,stimulation and excitation of sympathetic nerves,abnormalities of proprioceptors,and obstruction of cerebrospinal fluid circulation are closely related to the injury of cervical occipital muscles.The cervical occipital muscle injury mechanisms of cervical vertigo mainly include:mechanical compression of vertebral artery mechanism,proprioceptor mechanism of cervical spine,mechanism of obstruction of cerebrospinal fluid circulation,and sympathetic nerve stimulation mechanism.The commonly used methods for acupuncture and massage treatment of cervical vertigo include:acupuncture and moxibustion therapy,blade needle therapy,acupuncture therapy,and manual therapy.Considering the special anatomical location and complex adjacent relationships of the muscle group,it requires doctors to be familiar with the local anatomy of the cervical occipital muscle and have a deep understanding of acupuncture points.Currently,the related studies still lack a standardized,reproducible,and operable criterion.How to quantify the functional state of the cervical occipital muscles has become a key factor in evaluating the condition and assessing the effectiveness of treatment,and is also the focus of clinical and research efforts in the future.