旋提手法对椎动脉型颈椎病患者经颅多普勒相关指标的影响  

Impact of Rotation-traction Manipulation on Transcranial Doppler Related Indexes of Patients with Vertebral Artery Type of Cervical Spondylosis

作　　者：魏戌[1] 朱立国[1] 高景华[1] 杨克新[1] 于杰[1] 冯敏山[1] 银河[1] 高春雨[1] 谢利民[2] 李俊杰 

机构地区：[1]中国中医科学院望京医院 [2]中国中医科学院广安门医院 [3]国家电网有限公司北京电力医院

出　　处：《中医杂志》2017年第18期1573-1576,共4页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项(JD2X2012122);中国中医科学院科技创新优势团队建设项目(YS1304);中国中医科学院优势病种项目(CACMS05Y-1033)

摘　　要：目的观察旋提手法对椎动脉型颈椎病患者经颅多普勒(TCD)指标的影响,探讨TCD的临床价值。方法 195例椎动脉型颈椎病患者随机分为治疗组(96例)和对照组(99例)。治疗组采用旋提手法治疗,隔日1次;对照组采用牵引疗法,每日1次。于治疗前和治疗2周后进行TCD检查,观测双侧椎动脉和基底动脉血流量相关指标[包括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)、脉动指数(PI)]的变化。结果与正常组同侧比较,治疗前两组患者椎动脉双侧Vp、Vm、Vd水平及基底动脉Vp、Vm水平均明显升高(P<0.05或P<0.01)。与本组同侧治疗前比较,治疗组治疗后双侧椎动脉Vp、PI水平降低,基底动脉Vp、Vm水平明显降低(P<0.05或P<0.01);对照组治疗后双侧椎动脉Vp降低、左侧PI水平升高(P<0.05或P<0.01)。治疗组治疗后基底动脉Vm水平亦明显低于对照组治疗后(P<0.05)。两组治疗前后基底动脉Vd、PI水平差异均无统计学意义(P>0.05)。结论旋提手法可改善椎动脉型颈椎病患者TCD指标,从而改善椎-基底动脉血流速度,TCD可作为椎动脉型颈椎病的疗效评价指标之一。Objective To examine the impact of rotation-traction manipulation on transcranial doppler（ TCD）related indexes of patients with vertebral artery type of cervical spondylosis and to explore the clinical value of TCD.Methods One hundred and ninety-five patients with vertebral artery type of cervical spondylosis were randomized into a treatment group（ 96 cases） and a control group（ 99 cases）. The treatment group was given rotation-traction manipulation therapy once every other day. The control group was given traction treatment once every day. TCD test was conducted for the patients before treatment and after 2 weeks of treatment. Changes of bilateral vertebral artery and basilar artery blood flow related indexes [including systolic blood flow velocity peak（ Vp）,mean velocity（ Vm）,end diastolic velocity（ Vd） and pulsatility index（ PI） ]were examined. Results Compared with the normal group on the same side,the levels of Vp,Vm and Vd of patients＇ vertebral artery bilateral,as well as the levels of Vp and Vm of basilar artery increased in both treatment and control groups before treatment（ P 0. 05 or P 0. 01）.Compared with the same group on the same side before treatment,the levels of Vp and PI of bilateral vertebral artery decreased,and the levels of Vp and Vm of basilar artery decreased in the treatment group after treatment（ P 0. 05 or P 0. 01）. The level of Vp of bilateral vertebral artery decreased,and left PI level increased in the control group after treatment（ P 0. 05 or P 0. 01）. After treatment,basilar artery Vm level in the treatment group was lower than that in the control group（ P 0. 05）. There was no significant difference in levels of Vd and PI of basilar artery in both groups before and after treatment（ P 0. 05）. Conclusion Rotation-traction manipulation might improve TCD indexes of patients with vertebral artery type of cervical spondylosis,and then might improve the blood flow velocity of vertebral and basilar artery. TCD could be one of the effect eva

关 键 词：椎动脉型颈椎病 旋提手法 经颅多普勒 椎动脉 基底动脉 

分 类 号：R244.1[医药卫生—针灸推拿学]