Acupuncture-based treatments on cervical spondylosis of vertebral artery type

Cervical spondylosis of vertebral artery type is one of the chief patterns of cervical spondylosis.It is often described as neck pain accompanied with radiating pain and neurologic symptoms,such as sudden dizziness,blurred vision,tinnitus,nausea,vomiting,memory loss,and sudden fainting.The incidence of cervical spondylosis increases and patients with cervical spondylosis become progressively younger.Acupuncture in the cervical spondylosis of vertebral artery type treatment has a local positive reaction“Liuhe point”,in order to dredge the local Qi and blood.More and more evidences into the effectiveness and safety of cervical spine acupuncture for cervical spondylosis,specific neck pain,cervical radiculopathy,etc.This article summarizes the recent literature on acupuncture and acupuncture combined with other therapies for cervical spondylosis of vertebral artery type treatment and provides a comprehensive review from the perspectives of acupuncture therapy,warm needle moxibustion therapy,electroacupuncture,and acupuncture combined with other therapies,in order to provide reference and reference for clinical treatment.

MULTI-CENTER RANDOMIZED CONTROLLED TRIALS OF COMBINED TREATMENT OF VERTEBRAL ARTERY TYPE CERVICAL SPONDYLOSIS WITH ACUPUNCTURE AND MASSAGE

Objective:To evaluate the clinical value of synthetical therapy of acupuncture and massage for treating vertebral artery type cervical spondylosis (VACS). Methods: In the present study, triple-center, single-blind, randomized and control methods were adopted. Qualified subjects were randomly assigned to three groups: acupuncture-massage (acu-mas) group, acupuncture group, and massage group (60 subjects in each group). Bilateral Fengchi (风池GB 20), Jiaji (夹脊EX-B 2, C_ 4-7) and Baihui (百会GV 20) were punctured in combination with massage at the neck-shoulder and back region. The treatment was conducted once daily, 14 times altogether. Results: After treatment, of the 60 cases in each of acu-mas, acupuncture and massage groups, 28, 11 and 13 were cured, 13, 20 and 17 markedly effective, 12, 14 and 16 effective, and 7, 15 and 14 ineffective, with the total effective rates being 88.3%, 75.0% and 76.7% respectively. The therapeutic effect of acu-mas group was significantly superior to that of simple acupuncture and massage groups (P<0.05). The scores of clinical symptoms and signs in 3 groups all declined significantly after treatment (P<0.01), and the score of symptoms of acu-mas was markedly lower than those of acupuncture and massage groups (P<0.05). No significant differences were found among 3 groups in the score of clinical signs and between acupuncture and massage groups in the score of clinical symptoms (P>0.05). The time for producing therapeutic effects in acu-mas group was significantly shorter than those of acupuncture and massage groups (P<0.01, 0.05), meaning a faster of acu-mas group in producing clinical effect. No adverse events were found in all the 3 groups. Conclusion: Acupuncture and massage are effective and safe in the treatment of VACS, and the therapeutic effect of acupuncture combined with massage is superior to that of simple acupuncture and simple massage therapy.

Clinical Efficacy of Acupuncture Combined with Massage on Cervical Spondylopathy of Vertebral Artery Type and Its Effect on Hemodynamics of Patients

Objective:To investigate the clinical efficacy of acupuncture combined with massage on cervical spondylopathy of vertebral artery type and its effect on hemodynamics of patients.Methods:Sixty patients with vertebral artery type cervical spondylosis treated in our hospital from July 2017 to October 2019 were selected as the research subjects and randomly divided into 2 groups of 30 cases each.The control group was treated with acupuncture,and the observation group was treated with acupuncture combined with massage,and the clinical efficacy and hemodynamic index of the two groups were compared after 1 month of treatment[peak systolic blood velocity(PSV),pulsatile index(PI),time mean flow velocity(TMFV)].Results:There was no statistical difference in the PSV,PI,and TMFV between the two groups before treatment(P>0.05).After treatment,the observation group had a higher treatment efficacy than the control group with PSV and TMFV increasing and PI decreasing in both groups,and the change in the observation group was greater than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Acupuncture combined with massage on cervical spondylopathy of vertebral artery type can improve the clinical efficacy and improve the hemodynamic index of patients,which is worthy of clinical application.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACPUNCTURE COMBINED WITH MASSAGE FOR CERVICAL SPONDYLOSIS OF VERTEBRAL ARTERIAL TYPE BY USING TRANCRANIAL DOPPLYER ULTRASONOGRAPHY

Objective: To observe the effect of acupuncture combined with massage on blood flow velocity of the vertebro-basilar artery in cervical spondylosis of vertebral arterial type (CSVAT) patients. Methods: In the present study, methods of evidence-based medicine, triple-centers, single-blindness, randomization and control were used. A total of 100 cases of CSVAT patients were randomized into acupuncture plus massage (acu-massage) group (n=38), acupuncture group (n=32) and massage group (n=30). Acupoints used were Fengchi (风池GB 20), cervical Jiaji (颈夹脊EX-B 2), Baihui (百会GV 20), and the methods of massage used were kneading-rolling, adhesion-separating and acupoint-digital pressing, topical digital pressing and rubbing, traction-extending and mild palm-rubbing. The treatment was conducted once daily, with 7 sessions being a therapeutic course and continuously for 2 courses. Changes of peak velocity (Vp), end-diastolic velocity (Vd), mean velocity (Vm) of blood flow of the vertebral artery (VA) and basilar artery (BA), etc were detected before and after the treatment by using transcranial Doppler (TCD) ultrasonography. Results: After the treatment, the abnormally low Vp of both VA and BA in acu-massage, acupuncture and massage groups, Vm of VA in acu-massage and acupuncture groups, Vm of BA in acu-massage and massage groups, and Vd of VA and BA in the 3 groups all increased significantly in comparison with their own pretreatment (P<0.05, 0.01), and the therapeutic effects of acu-massage group in the 3 indexes were significantly superior to those of acupuncture group and/or massage group (P<0.05, 0.01). The abnormally increased Vp of VA in acu-massage and acupuncture groups, Vm of VA in the 3 groups, and Vd of VA in acu-massage and massage groups decreased obviously after the treatment in comparison with their own pretreatment (P<0.05, 0.01), and the therapeutic effects of acu-massage group were significantly superior to those of acupuncture and/or massage group in the 3 indexes of VA (P<0.05, 0.01). In addition, the abnormally increased Vp, Vm and Vd of BA in the 3 groups showed a similar tendency. No significant differences between acupuncture and massage groups in 3 indexes (P>0.05). Conclusion: The therapeutic effects of acupuncture plus massage is significantly superior to those of simple acupuncture and simple massage therapies in improving abnormal blood dynamics of vertebral and basilar arteries in CSVAT patients.

TREATMENT OF VERTEBRAL－ARTERY TYPE CERVICAL SPONDYLOPATHY WITH NEEDLE－KNIFE THERAPY

In the present paper, 62 cases of vertebral-artery type cervical spondylopathy were treated with needie-knife therapy (acupotomy). After 2- 6 sessions of treatment, 23 cases (37. 1%) were cured, 19 (30. 7%)showed marked improvement, 15 (24.2%) had some improvement and 5 (8.1 % ) failed in the treatment. The total effective rate was 91.9 %. It indicates that acupotomy therapy is a highly effective remedy for treating vertebral-artery type cervical spndylopathy.

THE CHANGE AND SIGNIFICANCE OF ENDOTHELIN IN SERUM OF VERTEBRAL ARTERIAL INSUFFICIENCY TYPE ERVICAL SPONDYLOSIS

we studied 30 vertebral arterial insufficiency type cervical spondylosis patients and 30sex and age matched healthy controls by detecting their serum endothelin (ET) levels with radioimmuuoassay (RIA).At the same time, we selected 20 severe patients for operation therapy,and compared their serum ET levels before and after operation.The results showed that 30 patients had higher ET levels [(119. 46±58.65)ng/L] than those of the controls [(38. 43±14.33)ng/L], and the 20 patients had higher ET levels before operation [(139. 34±52. 56)ng/L] than after operation [(50.84±21. 67)ng/L)].Both have statistical significance (P<0.001 ).Therefore, we think that serum ET is one or important humoral factors contributing to vertebral arterial insufficiency type cervical spondylosis.It may be useful in treating verteibral arterial insufficiency type cervical spondylosis with effective ET-antibody, inhibitor or ET converting enzyme and special ET receptor blocker.

Clinical Efficacy of Modified Erchen Decoction on Cervical Spondylotic Vertebral Arteriopathy with Stagnation and Blockade of Phlegm-dampness Syndrome and Effects on Cerebral Blood Flow Parameters

OBJECTIVE: To observe the effect of Modified Erchen Decoction on cervical spondylotic vertebral arteriopathy with stagnation and blockade of phlegm-dampness syndrome and effects on cerebral blood flow parameters. METHODS: A total of 80 cervical spondylotic vertebral arteriopathy(CSA) patients with stagnation and blockade of phlegmdampness syndrome admitted to our hospital from October 2016 to April 2017 were selected and randomly divided into observation group and control group, with 40 cases in each group. The observation group was treated with Modified Erchen Decoction and the control group was given conventional treatment with Western medicine. After 4 weeks of treatment, the main clinical symptoms and signs(vertigo, neck and shoulder pain, headache, psychological and social adjustment, daily life and work) and cerebral blood flow parameters [the peak values of intracranial vertebral-basal artery diastolic blood flow velocity(Vd) and systolic blood flow velocity(Vp)] were compared between the 2 groups. The total clinical effective rate and adverse reactions during treatment were also compared. RESULTS: After treatment, the total effective rate of the observation group was 90.0%, which was significantly higher than that of the control group(77.5%). The difference between the two groups was statistically significant(P < 0.05). After treatment, The scores of vertigo, neck and shoulder pain, headache, psychology and society adaptation, daily life and work were significantly increased(P < 0.05), and the above scores of the observation group were increased more obviously. The difference between the groups was statistically significant(P < 0.05). After treatment, the levels of Vd and Vp were significantly increased(P < 0.05), and the increase of the above indexes was more obvious in the observation group. The difference between the 2 groups was statistically significant(P < 0.05). There were no significant abnormalities in blood routine, urine routine, liver function and renal function. There was no significant difference in the incidence of adverse reactions between the 2 groups.(P > 0.05). CONCLUSION: The treatment of vertebral artery type cervical spondylopathy with stagnation and blockade of phlegm-dampness syndrome by Modified Erchen Decoction can effectively relieve the main clinical symptoms and signs, improve cerebral blood flow parameters, and improve the peak values of vertebral-basal artery diastolic blood flow velocity(Vd) and systolic blood flow velocity(Vp), which is safe and effective, and helps to promote the recovery of cervical function.

Clinical effects of innovative tuina manipulations on treating cervical spondylosis of vertebral artery type and changes in cerebral blood flow

OBJECTIVE:To determine the clinical effect,treatment times,and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations.METHODS:One hundred and twenty six cervical spondylosis patients(vertebral artery type) were randomly divided into test and control groups.Patients in the test group were treated with innovative Tuina manipulations,while those in the control group were treated with the routine Tuina manipulations according to the textbook of Chinese Massage for Acupuncture and Moxibustion majors.The clinical effects,treatment times,clinical symptoms,and cerebral blood flow were measured.RESULTS:The response to the treatment was 100% in the test group and 88.71% in the control group.Patients in the test group required(7 ± 4) treatments before recovery,while those in the control group required(15 ± 7) treatments before recovery(P<0.05).The clinical symptoms exhibited greater improvement in the test group compared to the control group(P<0.05).There were no differences in cerebral blood flow between the two groups.CONCLUSION:Both innovative Tuina manipulations and routine Tuina manipulations produced satisfactory therapeutic results in vertebral artery type cervical spondylosis patients.However,the innovative manipulation was more effective in improving the functional symptoms,although there were no changes in the cerebral blood flow.

基于“筋骨平衡”理论针刺推拿疗法治疗椎动脉型颈椎病的临床观察

目的浅析椎动脉型颈椎病(cervical spondylotic vertebral arteriopathy,CSA)患者实施基于“筋骨平衡”理论针刺推拿疗法对其中医症状积分、颈性眩晕症状与功能评估量表(cervical vertigo symptom and function assessment scale,ESCV)评分、颈椎曲度及脑血流参数的影响。方法选择该院2019年12月—2021年12月就诊的CSA患者86例实施研究,随机数字表法分作观察组与对照组,各43例;其中对照组脱落2例,剔除1例,共完成40例;观察组脱落1例,剔除1例,共完成41例;对照组予以常规牵引疗法,观察组予以基于“筋骨平衡”理论针刺推拿疗法;比较两组治疗前与治疗后中医症状积分、ESCV评分、颈椎曲度及脑血流参数的变化,并对比两组疗效。结果治疗后,观察组中医症状积分皆显著低于对照组(P<0.05)。治疗后,观察组ESCV评分和颈椎曲度皆明显高于对照组(P<0.05)。治疗后,观察组椎底动脉及左、右椎动脉的Vs与Vd水平均显著高于对照组(P<0.05)。观察组总有效率显著高于对照组[95.12%(39/41)vs 80.00%(32/40),P<0.05]。结论基于“筋骨平衡”理论针刺推拿疗法对CSA患者疗效显著,有效改善中医症状积分、ESCV评分以及颈椎曲度,增强脑血流参数。

腹部摩法结合颈椎旋转定位扳法治疗痰湿阻络型椎动脉型颈椎病患者的疗效观察

目的探讨腹部摩法结合颈椎旋转定位扳法治疗椎动脉型颈椎病痰湿阻络证的效果。方法选取2022年1月—2022年12月期间黑龙江中医药大学附属第二医院收治的90例椎动脉型痰湿阻络证患者,采用随机数字表法分为腹摩组、扳法组、联合组,每组各30例。3组患者均给予西药与常规推拿治疗,在此基础上,腹摩组施以腹部摩法,扳法组施以颈椎旋转定位扳法,联合组给予腹部摩法+颈椎旋转定位扳法,3组患者均治疗2周。观察比较3组患者临床疗效、安全性以及治疗前后中医证候积分、眩晕症状评分(Evaluation scale for cervical vertigo,ESCV评分)、颈椎功能评分[颈椎功能障碍指数(Neck disability index,NDI)及日本骨科协会(Japanese orthopaedic association scores,JOA)]、椎-基底动脉血流动力学[平均血流速度(Velocitymean,Vm)、收缩期峰值血流速度(Velocity systolic,Vs)、舒张期末血流速度(Vend of diastolic velocity,Vd)、阻力指数(Resistance index,RI)、搏动指数(Pulsation index,PI)值]。结果治疗后联合组临床总有效率96.67%(29/30)高于腹摩组70.00%(21/30)与扳法组80.00%(24/30),差异有统计学意义(P<0.05)。治疗后3组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且联合组中医证候积分明显低于腹摩组与扳法组,差异有统计学意义(P<0.05)。治疗后3组患者ESCV评分均较治疗前降低,差异有统计学意义(P<0.05);且联合组ESCV评分明显低于腹摩组与扳法组,差异有统计学意义(P<0.05)。治疗后3组患者NDI评分较治疗前降低,JOA评分较治疗前升高,差异有统计学意义(P<0.05);且联合组NDI评分明显低于腹摩组与扳法组,JOA评分明显高于腹摩组与扳法组(P<0.05)。治疗后3组患者椎-基底动脉Vm、Vs、Vd参数均较治疗前升高,RI、PI参数均较治疗前降低,差异有统计学意义(P<0.05);且联合组Vm、Vs、Vd参数明显高于腹摩组与扳法组,RI、PI参数明显低于腹摩组与扳法组,差异有统计学意义(P<0.05)。治疗期间,3组患者安全性分级与不良反应发生率比较,差异无统计学意义(P>0.05)。结论腹部摩法结合颈椎旋转定位扳法治疗椎动脉型颈椎病痰湿阻络证安全、有效,有利于改善颈椎功能,调节椎-基底动脉血流动力学,进而缓解眩晕症状。

灸刺放血联合治疗椎动脉型颈椎病急性发作期临床观察

目的 观察灸刺放血联合治疗椎动脉型颈椎病急性发作期的临床效果。方法 将70例椎动脉型颈椎病急性发作期患者随机分成观察组(灸刺放血结合组)和对照组(灸刺结合组),各35例。观察组予电子灸、普通针刺及刺络放血拔罐疗法,对照组给予电子灸及普通针刺法联合治疗;于首次治疗前后行椎-基底动脉血流动力学[脑血管彩色多普勒超声(TCD)]测定及对眩晕程度进行评估对比。结果 治疗后,TCD显示2组患者收缩峰期血流速度(Vs)、平均血流速度(Vm)均降低(P<0.01),且2组比较,差异有统计学意义(P<0.05)。但2组血管搏动指数(PI)、血管阻力指数(RI)无改善(P>0.05)。治疗后,2组眩晕程度均好转(P<0.01),且2组比较,差异有统计学意义(P<0.05)。结论 灸刺放血结合疗法能够有效减慢椎动脉型颈椎病急性发作期患者的椎-基底动脉高血流速度、缓解眩晕程度,即时效果明显优于针刺艾灸结合组,可在各级医疗机构推广应用。

通窍活血汤加减联合甘露醇治疗椎动脉型颈椎病的临床疗效观察

目的探讨通窍活血汤加减联合甘露醇治疗椎动脉型颈椎病的临床疗效。方法50例椎动脉型颈椎病患者,选择随机数字表法分成对照组及观察组,各25例。对照组接受甘露醇注射液联合氟桂利嗪胶囊治疗,观察组在对照组基础上加用通窍活血汤加减治疗。比较两组治疗效果、治疗前后症状和体征积分与椎动脉血流指标[左侧椎动脉平均血流速(LVA-Vm)、右侧椎动脉平均血流速(RVA-Vm)、左侧椎动脉血流阻力指数(LVA-RI)、右侧椎动脉血流阻力指数(RVA-RI)]水平,安全性。结果观察组治疗总有效率96.00%高于对照组的76.00%(P<0.05)。两组治疗后症状和体征积分均高于同组治疗前,且观察组治疗后症状和体征积分(21.06±2.12)分高于对照组的(13.47±1.95)分(P<0.05)。两组治疗后LVA-Vm、RVA-Vm水平均高于同组治疗前,LVA-RI、RVA-RI水平均低于同组治疗前,且观察组治疗后LVA-Vm(31.20±3.32)cm/s、RVA-Vm(32.06±2.97)cm/s均高于对照组的(27.65±2.87)、(28.11±2.44)cm/s,LVA-RI(0.54±0.06)、RVA-RI(0.46±0.10)均低于对照组的(0.62±0.07)、(0.64±0.09)(P<0.05)。两组治疗期间均未出现三大常规异常或肝肾功能异常情况,也无其他不良反应,安全性良好。结论通窍活血汤加减联合甘露醇治疗椎动脉型颈椎病疗效显著,能够有效改善患者的椎动脉血流状况,且安全性良好。

椎动脉型颈椎病发病机制及中医治疗的研究进展

椎动脉型颈椎病是临床常见的颈椎病类型之一,以发作性眩晕、颈痛、恶心、耳鸣、耳聋等为临床症状,严重影响患者生活质量。本病发病机制复杂,目前尚未形成统一的认识,治疗上多以保守治疗为主。中医学具有简便验廉的特点,安全有效,常作为本病的主要治疗选择。本文结合同领域的前沿热点,就椎动脉型颈椎病发病机制、中医治疗椎动脉型颈椎病的潜在作用机制及研究现状进行总结,为中医治疗椎动脉型颈椎病的研究及应用提供依据。

基于疼痛、椎动脉-基底动脉血流及颈椎活动度观察针刺联合Mulligan手法治疗椎动脉型颈椎病的疗效

目的:观察针刺联合Mulligan手法治疗椎动脉型颈椎病患者的疗效及对疼痛、椎动脉-基底动脉血流、颈椎活动度的影响。方法:2020年1月—2023年1月秦皇岛市中医医院收治的186例椎动脉型颈椎病患者随机分为Mulligan手法组和联合针刺组,每组93例。Mulligan手法组采用Mulligan手法进行治疗,联合针刺组在Mulligan手法治疗的基础上联合针刺治疗,治疗2周。观察两组治疗2周后的临床疗效,比较两组治疗前和治疗2周后血清细胞因子水平、椎动脉-基底动脉血流情况、颈椎活动度及疼痛情况。结果:治疗2周后,联合针刺组总有效率为92.47%(86/93),高于Mulligan手法组81.72%(76/93),差异有统计学意义(P<0.05)。两组治疗2周后血清C反应蛋白(CRP)、白细胞介素6(IL-6)、神经元特异性烯醇酶(NSE)水平及椎动脉、基底动脉阻力指数(RI)、现有疼痛强度(PPI)、视觉模拟评分(VAS)、疼痛分数指数(PRI)评分低于治疗前(P<0.05),联合针刺组低于Mulligan手法组(P<0.05);椎动脉、基底动脉平均峰流速(Vm)、颈椎右侧屈、右旋转、左侧屈、左旋转度数高于治疗前(P<0.05),联合针刺组高于Mulligan手法组(P<0.05)。结论:针刺联合Mulligan手法治疗椎动脉型颈椎病,可有助于调节患者机体血清细胞因子水平,改善其椎动脉-基底动脉血流情况、颈椎活动度,降低疼痛,具有较好的治疗效果。

颈椎病不同证候椎动脉PSV特点及相关性研究

目的研究颈椎病(cervical spondylosis,CS)不同证候患者椎动脉(vertebral artey,VA)收缩期峰值血流速度(peak systolic velocity,PSV)特点及与证候程度的相关性。方法采用流行病学横断面调查研究的方法,测定68例颈椎病不同证候患者的双侧椎动脉超声PSV数值与中医证候评分,分析不同证候患者双侧椎动脉超声PSV数值特点,并对双侧椎动脉超声PSV数值与中医证候积分的相关性进行分析。结果(1)颈椎病气滞血瘀证组患者双侧椎动脉超声PSV数值均低于颈椎病气血不足证组患者(左侧:P<0.01;右侧:P<0.05)。(2)颈椎病气滞血瘀证组患者中医证候积分与双侧椎动脉超声PSV数值相比较呈负相关(左侧:r=-0.355,P=0.034;右侧:r=-0.390,P=0.019);颈椎病气血不足证组患者中医证候积分与双侧椎动脉超声PSV数值相比较呈负相关(左侧:r=-0.641,P<0.01;右侧:r=-0.768,P<0.01)。结论颈椎病患者不同证候患者双侧椎动脉PSV数值特点不同,与中医证候评分之间存在相关性,椎动脉超声PSV能够在一定程度上反映中医证候的差异与程度。

谢林教授从“痰瘀滞络”学说论治椎动脉型颈椎病的临床疗效

目的:观察葛泽定眩汤治疗椎动脉型颈椎病的临床疗效。方法:将符合纳入标准的100例患者,随机分成对照组和治疗组,分别给予盐酸氟桂利嗪胶囊及葛泽定眩汤治疗,并通过观察颈性眩晕症状与采集功能评估量表(ESCV)头晕问卷调查表(DHI)疼痛视觉模拟评分(VAS评分)及中药新药临床疗效评定标准加以评判。结果:与治疗前相比,治疗2周后及治疗后3月,两组ESVC、DHI、VAS数值均明显优于治疗前。两组对比发现,在治疗2周后及治疗后3月,葛泽定眩汤组疗效均明显优于盐酸氟桂利嗪胶囊组。葛泽定眩汤组临床治疗有效率达97.83%(45/46),高于盐酸氟桂利嗪胶囊的临床治疗有效率83.67%(41/49)。结论:从“痰瘀滞络”学说拟定的葛泽定眩汤治疗椎动脉型颈椎病有较好的临床疗效,特色突出,值得推广。

通脉化瘀胶囊治疗椎动脉型颈椎病患者的疗效及对其椎基底动脉超声参数的影响

目的 探究通脉化瘀胶囊治疗椎动脉型颈椎病患者的疗效及对其椎基底动脉超声参数的影响。方法 选取2021年5月—2022年12月期间衡水市中医医院收治的椎动脉型颈椎病患者114例,按简单随机数字表法分为对照组和研究组,每组各57例。对照组在常规干预基础上给予盐酸氟桂利嗪胶囊,研究组在对照组基础上采取通脉化瘀胶囊。治疗4周后,观察比较两组患者临床疗效及治疗前后椎基底动脉超声参数[椎-基底动脉平均血流速度(Vertebrobasilar mean blood flow velocity, Vm)、收缩期峰值血流速度(Peak systolic blood flow velocity, Vs)、舒张期末血流速度(End-diastolic blood flow velocity, Vd)、搏动指数(Pulsation index, PI)、阻力指数(Resistance index, RI)]、中医证候积分、眩晕症状相关评分、颈椎关节活动度(颈部左旋、右旋、左侧屈、右侧屈、前屈、后伸)。结果 治疗后两组患者椎-基底动脉Vm、Vs、Vd超声参数均较治疗前升高,RI、PI超声参数均较治疗前降低,差异有统计学意义(P<0.05);且研究组椎-基底动脉Vm、Vs、Vd超声参数均明显高于对照组,RI、PI超声参数均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者中医证候头晕目眩、耳聋耳鸣、颈肩处疼痛及急躁易怒、入睡困难、手指麻木、记忆力下降积分均较治疗前降低,差异有统计学意义(P<0.05);且研究组中医证候头晕目眩、耳聋耳鸣、颈肩处疼痛及急躁易怒、入睡困难、手指麻木、记忆力下降积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者眩晕症状肩颈痛、眩晕、头痛、日常生活及工作、心理及社会适应评分均较治疗前降低,差异有统计学意义(P<0.05);且研究组眩晕症状肩颈痛、眩晕、头痛、日常生活及工作、心理及社会适应评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者颈椎关节活动度颈部左旋、右旋、左侧屈、右侧屈、前屈、后伸度数均较治疗前增大,差异有统计学意义(P<0.05);且研究组颈椎关节活动度颈部左旋、右旋、左侧屈、右侧屈、前屈、后伸度数均明显优于对照组,差异有统计学意义(P<0.05)。治疗后研究组临床总有效率94.74%(54/57)明显高于对照组82.46%(47/57),差异有统计学意义(P<0.05)。结论 常规西药联合通脉化瘀胶囊治疗椎动脉型颈椎病可调节椎基底动脉超声参数,增大颈椎关节活动度,缓解临床症状及眩晕程度。

推拿结合热奄包治疗椎动脉型颈椎病(风寒湿型)的临床研究

目的:探究推拿结合热奄包治疗椎动脉型颈椎病(风寒湿型)的临床效果。方法:选取2022年1-10月在赣州市中医院治疗的105例椎动脉型颈椎病(风寒湿型)患者作为研究对象,按照患者的治疗意愿,将以上患者分为A组、B组、C组,A组采取推拿治疗,B组采取热奄包治疗,C组采取推拿结合热奄包治疗,三组均治疗3个月。比较三组治疗效果、中医症状评分、眩晕残障程度、双侧椎动脉的血流情况。结果:相比A组(65.71%)及B组(80.00%),C组总有效率(91.43%)显著升高(χ^(2)=7.021,P=0.030)。治疗后,三组中医症状评分较治疗前均显著改善,且C组患者的眩晕、心悸、耳鸣、头痛、畏寒肢冷及肢体麻木评分均显著低于A组、B组(P<0.05);三组眩晕残障程度评分较治疗前均显著改善,且C组躯体亚表、情绪亚表、功能亚表评分与总分均显著低于A组、B组(P<0.05);三组双侧椎动脉的血流情况较治疗前均显著改善,且C组收缩期血流速度峰值(Vp)、平均血流速度(Vm)、舒张末期血流速度(Vd)均显著低于A组、B组(P<0.05)。结论:推拿结合热奄包治疗椎动脉型颈椎病(风寒湿型)患者,其椎动脉血流显著改善,临床症状降低,治疗效果较好。

从气虚血瘀探讨铁死亡与椎动脉型颈椎病的关系

从气虚血瘀探讨铁死亡与椎动脉型颈椎病(CSA)的关系。椎动脉遭受刺激、压迫后的缺血、缺氧状态是CSA发生的病理基础。中医认为CSA的关键病机是气虚血瘀,气虚推动无力,瘀血内停,血液流变学指标改变,病理产物积聚,容易触发血管内皮细胞铁死亡,加重病情进展。从气虚血瘀病机与铁死亡理论探讨CSA的中医药防治,为CSA的临床诊治提供新思路。

温针灸夹脊穴在寒湿痹阻型椎动脉型颈椎病中的应用效果及对颈椎功能的影响

目的探讨针对寒湿痹阻型椎动脉型颈椎病患者通过温针灸夹脊穴治疗的疗效以及给患者颈椎功能恢复产生的影响。方法选择我院2022年1月至2022年12月收治的120例寒湿痹阻型椎动脉型颈椎病患者,以患者治疗方案的不同将其分为观察组与对照组各60例。对照组患者以常规牵引、普通针刺等治疗方法为主,观察组患者加以温针灸夹脊穴治疗,比较两组患者临床治疗效果、颈椎功能、中医证候积分、血流动力学指标改善效果。结果治疗后,观察组临床疗效(96.67%)高于对照组(71.67%)(P<0.05);治疗前,两组中医证候积分和颈椎功能障碍指数(NDI)比较无统计学意义(P>0.05);治疗后与治疗前比,两组中医证候积分和颈椎功能障碍指数均降低,且观察组低于对照组(P<0.05);治疗后,观察组的血流动力学指标改善效果高于对照组(P<0.05)。结论采用温针灸夹脊穴治疗椎动脉型颈椎病患者,可改善患者颈椎功能障碍,提高疗效,降低中医证候积分,提高患者血流动力学指标。