三联疗法治疗寰枢关节半脱位所致眩晕  

Curative effect and safety of triple therapy in the treatment of vertigo caused by subluxation of atlanto-axial joint

作　　者：金斌[1] 鲍铁周[1] 宋永伟[1] 

机构地区：[1]河南省洛阳正骨医院,河南洛阳471002

出　　处：《中医正骨》2013年第3期44-46,共3页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:观察三联疗法即颈椎牵引+盐酸川芎嗪静脉滴注+理筋整脊手法治疗寰枢关节半脱位所致眩晕的临床疗效及安全性。方法:将符合要求的96例寰枢关节半脱位所致眩晕患者随机分为治疗组和对照组,每组48例。治疗组采用颈椎牵引+盐酸川芎嗪静脉滴注+理筋整脊手法治疗,对照组采用颈椎牵引+盐酸川芎嗪静脉滴注治疗。治疗1个疗程后参照《临床疾病诊断依据治愈好转标准》和《中医病证诊断疗效标准》制定疗效评定标准评定2组患者的临床疗效,并于治疗结束后比较2组患者寰枢关节半脱位的改善情况。结果:①治疗组治愈40例,好转7例,无效1例;对照组治愈30例,好转14例,无效4例;治疗组临床疗效优于对照组(Z=-2.333,P=0.020);②治疗组寰枢轴线与齿状突轴线距离的改善及齿状突与两侧块间距差值的改善均优于对照组(t=0.734,P=0.003;t=0.433,P=0.005);③2组患者不良反应发生率比较,差异无统计学意义(P=1.000)。结论:采用颈椎牵引+盐酸川芎嗪静脉滴注+理筋整脊手法的三联疗法治疗寰枢关节半脱位所致眩晕,能够调整寰椎与枢椎的位置关系,明显改善患者的眩晕症状,疗效确切,且不良反应轻微,值得临床推广应用。Objective：To observe the clinical curative effect and safety of triple therapy in the treatment of vertigo caused by subluxation of atlanto-axial joint.Methods：Ninety-six patients with vertigo caused by subluxation of atlanto-axial joint who met the requirements were randomly divided into treatment group and control group,48 cases in each group.Patients in the treatment group were administrated with cervical traction combined with intravenous drip of ligustrazine hydrochloride and tendon-regulation and orthopaedic-spinal manipulations,while the others in the control group were administrated with cervical traction combined with intravenous drip of ligustrazine hydrochloride.After one course of treatment,the clinical curative effects were evaluated according to the evaluation criteria in accordance with Standard for Diagnosis basis and Cure Improvement of Clinical Disease and Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes,and the improvements of subluxation of atlanto-axial joint were compared between the 2 groups after the treatment.Results：Forty patients got an excellent result,7 good,and 1 poor in the treatment group;while 30 patients got an excellent result,14 good,and 4 poor in the control group;therefore,the clinical curative effect of treatment group was better than that of control group（Z=-2.333,P=0.020）.The treatment group was better than the control group in the improvement of distance between atlantoaxial axis and odontoid process axis,and the improvement of differences of distance between odontoid process and both lateral mass（t=0.734,P=0.003;t=0.433,P=0.005）.There was no statistical difference in adverse effects rate between the 2 groups（P=1.000）.Conclusion：The triple therapy,composed of cervical traction,intravenous drip of ligustrazine hydrochloride and tendon-regulation and orthopaedic-spinal manipulations,can not only adjust the positional relationship between atlas and axis,but also significantly improve the vertigo sym

关 键 词：眩晕 寰枢关节 脱位 骨牵引复位法 舒筋整复手法 川芎嗪 治疗 临床研究性 

分 类 号：R274[医药卫生—中医骨伤科学]