针挑与牵旋手法对椎动脉型颈椎病血流的影响及机制研究  

Influence of Needle-pricking Bleeding Combined with Pulling-rotating Manipulation on Blood Rheology in Patients with Vertebral Artery Type Cervical Spondylosis

作　　者：陈栋[1] 钟键[1] 洪衍波[2] 陈大典[2] 邓列华[1] 蔡明雪[1] 章岳娟[1] 林秀华[1] 郑富仕[1] 

机构地区：[1]暨南大学附属第一医院新医针挑科,广州510630 [2]中山大学附属第二医院中医正骨科,广州510000

出　　处：《针刺研究》2009年第5期344-348,共5页Acupuncture Research

基　　金：暨南大学自然科学研究基金资助(99046)

摘　　要：目的:比较针挑合牵旋手法与单纯手法对椎动脉型颈椎病(VATCS)椎基底动脉血液流变学、血管舒缩弹性、血液黏度的影响及其作用机制。方法:将198例患者随机分成治疗组101例与对照组97例,治疗组采用牵旋手法结合针挑进行治疗,对照组采用牵旋手法治疗,治疗前后经颅多普勒超声检测左右双侧椎动脉(VA)、基底动脉(BA)的收缩峰期血流速度(Vpeak)、舒张末期血流速度(Vmin)、搏动指数(PI)、阻力指数(RI)值及治疗组治疗前后全血表观黏度和血浆黏度值。结果:治疗组双侧VA、BA的Vpeak、Vmin值经治疗后明显加快,接近或已经恢复至正常值范围,而VA、BA的PI及RI值有显著下降,与对照组比较差异有统计学意义(P<0.05)。治疗组治疗前与治疗后比较,全血表观黏度和血浆黏度值有明显改善(P<0.05,P<0.01)。结论:针挑与牵旋手法可明显改善椎基底动脉血流,促进血管舒缩弹性的恢复,增加脑部血供,降低血流黏稠度。Objective To observe the effect of needle-pricking bleeding combined with pulling-rotating manipulation and simple manipulation on blood rheology in vertebral artery type cervical spondylosis （VATCS） patients, so as to analyze their mechanisms in relieving VATCS. Methods A total of 198 VATCS patients were randomly divided into treatment group （ n = 101 ） which was treated with needle-pricking plus pulling-rotating manipulation, and control group （ n = 97） which was treated with simple pulling-rotating manipulation, according to the random number table. The treatment was given once every 7 days, 9 times altogether. The peak systolic blood flow velocity （Vpeak） , end-diastolic blood velocity （Vmin） , pulsatility index （PI） and resistent index （RI） of bilateral vertebral arteries （VA） and basilar artery （BA） were detected by transcranial doppler sonography （TCD）. Whole blood apparent viscosity and the plasma viscosity in the treatment group were determined by using a blood viscosimeter. Results Of the 101 and 97 VATCS cases in the treatment and control groups, 62（61.38%） and 12（12.37%） were cured basically, 23（22.77% ） and 26 （26.80%） experienced marked improvement, 14 （ 13.86% ） and 41 （42.27%） were improved, 2（ 1.98% ） and 18（ 18.55% ） failed in the treatment, with the total effective rates being 98.01% and 81.44% separately. The effective rate of the treatment group was significantly higher than that of control group （ P〈0.05）. Compared with pretreatment, Vpeak and Vmin of the bilateral VA and BA in the treatment group, and Vpeak of the right VA in the control group increased significantly （ P〈0.01, P〈0.05）, PI and RI of the bilateral VA and BA in the treatment group, and PI and RI of the right VA in the control group decreased significantly （P〈0.01, P〈0.05）, suggesting a marked reduction of the vascular resistance and an apparent increase of the cerebral blood supply after the treatment. The therapeutic effects of the a

关 键 词：椎动脉型颈椎病 针挑 扳法 经颅多普勒超声 

分 类 号：R681.55[医药卫生—骨科学]