定眩汤联合清宫正骨手法治疗痰浊上蒙型颈性眩晕的临床研究

Clinical Study of Dingxuan Decoction Combined with Qing's Palace Bone Setting Manipulation on the Treatment of Cervical Vertigo with Phlegm-Turbidity

目的:探讨定眩汤联合清宫正骨手法治疗痰浊上蒙型颈性眩晕患者疗效改善情况,评价联合治疗对血流动力学及颈椎矢状面参数的影响。方法:采用随机、双盲、安慰剂对照的设计方法,将80例患者随机分为观察组和对照组各40例,两组患者在均接受清宫正骨手法治疗的基础上(2次/周,30 min/次,治疗2周),观察组口服定眩汤颗粒,对照组口服定眩汤颗粒安慰剂,1袋/次,2次/d,治疗2周,比较两组患者血流动力学指标(左侧椎动脉流速、右侧椎动脉流速、血管收缩期最大流速)、颈性眩晕症状(颈性眩晕评价量表(ESCV)评分)、生存质量(生理健康总分、心理健康总分)、影像学检查指标(T1倾斜角、C2~7Cobb角、C2~7矢状面轴向距离)四类指标治疗前后变化并进行统计学分析。结果:治疗后观察组的血流动力学指标(左侧椎动脉流速、右侧椎动脉流速、血管收缩期最大流速)和颈性眩晕评价量表评分、生理健康评分、心理健康评分均优于对照组,组间比较差异有统计学意义(P<0.05),影像学检查指标治疗前后差异均无统计学意义(P>0.05),两组患者在治疗期间均未发生不良反应。结论:定眩汤联合清宫正骨手法治疗痰浊上蒙型颈性眩晕在改善脑部供血状况方面发挥协同作用,在清宫正骨手法治疗基础上加用定眩汤对患者的眩晕症状恢复具有明显增效作用,且安全性较好。

Objective:To explore the efficacy of Dingxuan decoction combined with Qing's Palace bone setting manipulation on the treatment of cervical vertigo patients with phlegm and cloudiness,and to evaluate the effect of the combination treatment on hemodynamics and cervical spine sagittal plane parameters.Methods:80 patients were randomly divided into the observation group(40 patients)and the control group(40 patients)according to a randomized,double-blind,placebo-controlled design method.Based on both groups receiving Qing's Palace bone setting manipulation(2 times a week,30 min each time,2 weeks of treatment),the observation group orally took Dingxuan decoction granules,and the control group took Dingxuan decoction granules placebo,one sachet each time,2 times a day for 2 weeks of treatment.The hemodynamics of the two groups(left vertebral artery(LVA),right vertebral artery(RVA),peak systolic velocity(PSV)),cervical vertigo symptoms(evaluation scale for cervical vertigo(ESCV)score),quality of life(total physical health score,total mental health score),imaging(T1 tilt angle,C2-7 Cobb angle,C2-7 sagittal axial distance)before and after the treatment of the four types of indexes changes were compared and statistical analyzed.Results:The hemodynamic indexes(LVA,RVA,PSV),ESCV scores,physical health scores,and mental health scores of the observation group were better than those of the control group after treatment,and had statistically significant(P<0.05).There was no statistical difference in the imaging indexes before and after the treatment(P>0.05),and no adverse reactions occurred on the treatment period of the patients in both groups.Conclusion:The treatment of cervical vertigo of phlegm and cloudy cervical dizziness with Qing's Palace bone setting manipulation plays a synergistic role in improving the blood supply of the brain.The addition of Dingxuan decoction based on Qing's Palace bone setting manipulation has a significant synergistic effect on the recovery of vertigo symptoms of the patients,and the safety is good.