不同针刺手法治疗后循环缺血性眩晕患者120例随机双盲对照试验  

Different Acupuncture Manipulations on 120 Patients with Posterior Circulation Ischemia Vertigo: A DoubleBlind Randomized Controlled Trial

作　　者：贺思[1] 赵晓峰[1] 文妍[1] 邓士哲 黄灵慧[1] 孟智宏[1] 

机构地区：[1]天津中医药大学第一附属医院

出　　处：《中医杂志》2015年第6期478-482,共5页Journal of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划("973"计划)(2010CB530506)

摘　　要：目的观察不同针刺手法治疗后循环缺血性眩晕(PCIV)患者的临床疗效并探讨其可能作用机制。方法将120例PCIV患者随机分为风池1组29例,风池2组31例,风池3组30例,风池4组30例。各组均以风池为主穴,风池1组:针刺方向为对侧外眼角,行手法捻转,频率为60 r/min;风池2组:针刺方向为喉结方向,频率为60 r/min;风池3组:针刺方向为对侧外眼角,频率为120 r/min;风池4组:针刺方向为喉结方向,频率为120 r/min。每周3或4次,共14次。治疗前后测定患者血浆5-羟色胺(5-HT)、去甲肾上腺素(NE)、γ-氨基丁酸(GABA)、谷氨酸(Glu)水平,评价眩晕程度,并观察各组临床疗效。结果各组患者临床疗效比较差异无统计学意义(P>0.05)。各组患者治疗后眩晕症状量表评分较治疗前均明显下降(P<0.05),且治疗后改善值组间比较,风池3组明显优于其他3组(P<0.05)。各组NE治疗后较治疗前均明显升高(P<0.05),风池4组GABA治疗后较治疗前明显下降(P<0.05)。结论针刺治疗能改善PCIV患者眩晕症状,不同针刺手法间有明显差异,风池3组效果最好,其机制可能与调节NE水平有关。Objective To observe the clinical efficacy of different acupuncture manipulations in the treatment of posterior circulation ischemia vertigo（ PCIV） and discuss the possible mechanisms. Methods Totally 120 PCIV patients were randomly divided into FC1 group of 29 cases,FC2 group of 31 cases,FC3 group of 30 cases,and FC4 group of 30 cases. Fengchi（ GB20） was the main acupoint for all groups with twirling manipulation,while the FC1 group was needled towards the outer corner of the contralateral eye,60 r / min; the FC2 group was needled towards the Adam＇s apple,60 r / min; the FC3 group was needled towards the outer corner of the contralateral eye,120 r / min;and the FC4 group was needled towards the Adam＇ s apple,120 r / min. The course was 14 times,3 or 4 times per week. The serum levels of 5-hydroxytryptamine（ 5-HT）,norepinephrine（ NE）,gamma aminobutyric acid（ GABA）,and glutamate（ Glu） were measured before and after treatments,the degree of vertigo was evaluated,and the clinical efficacy was observed. Result There was no significant difference in the clinical efficacy among the four groups（ P〉0. 05）. After the treatments,the symptom of vertigo improved significantly in each group（ P〈0. 05）,especially in the FC3 group（ P〈0. 05）,NE increased significantly in each group（ P〈0. 05）,and GABA decreased significantly in the FC4 group（ P〈0. 05）. Conclusions Conclusions Acupuncture could improve the symptom of vertigo in PCIV patients and different manipulations led to different results. The FC3 group showed the best results,which may be related to its regulation of NE.

关 键 词：后循环缺血 针刺 眩晕 神经递质 随机对照试验 风池穴 

分 类 号：R246.6[医药卫生—针灸推拿学]