高压氧结合推拿治疗椎动脉型颈椎病患者的临床疗效及血液流变学变化  

Clinical effect and hemorheological changes of hyperbaric oxygen combined with Tuina therapy on patients with cervical spondylosis of vertebral artery type

作　　者：余贵斌 唐际存[2] 王梨明[2] 甘华杨 Yu Guibin;Tang Jicun;Wang Liming;Gan Huayang(Guilin Medical University,Guilin 541004,China)

机构地区：[1]桂林医学院 [2]桂林医学院附属医院,广西壮族自治区桂林541004

出　　处：《中华航海医学与高气压医学杂志》2020年第1期56-59,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：北京市白求恩公益基金支助项目(KX11OCS)。

摘　　要：目的:探讨高压氧(HBO)结合推拿治疗椎动脉型颈椎病(CSA)的临床疗效及血液流变学变化。方法:选取2018年1月至2019年1月桂林医学院附属医院收治的CSA患者110例,采用数字表法随机分为观察组和对照组,每组55例。对照组给予常规的中医推拿治疗,观察组在对照组治疗基础上给予HBO治疗,观察治疗前后2组患者的临床疗效、血液流变学、颈椎活动度及血浆神经肽Y(NPY)和尾加压素Ⅱ(UⅡ)水平的变化。结果:治疗后观察组总有效率(94.55%)显著高于对照组(81.82%)( P<0.05)。观察组治疗后血液流变学指标收缩期峰值血流速度、椎动脉-基底动脉平均血流速度均显著快于对照组( P<0.05)。观察组治疗后颈椎前、后、左、右移动的活动度均显著高于对照组( P<0.05)。2组治疗后血浆中NPY及UⅡ水平较治疗前均显著降低( P<0.01),并且治疗后观察组NPY及UⅡ水平显著低于对照组( P<0.05)。 结论:HBO结合推拿治疗CSA主要通过提高颈椎活动度、改善血液流变学及下调血浆NPY、UⅡ水平,提高患者的临床疗效。Objective To study the clinical effect and hemorheological changes of hyperbaric oxygen(HBO)combined with Tuina therapy on patients with cervical spondylosis of vertebral artery type(CSA).Methods One hundred and ten patients with CSA,admitted to the Affiliated Hospital of Guilin Medical University from January 2018 to January 2019,were randomly divided into observation group and control group according to the random number table,with 55 cases in each group.The control group was treated with Tuina therapy of traditional Chinese medicine,while the observation group was treated with HBO based on the treatment of the control group.The clinical effect,hemorheological changes,cervical vertebral movements,the levels of neuropeptide Y(NPY)and urotensinⅡ(UⅡ)in plasma were tested and recorded before and after treatment.Results After treatment,the total effective rate of the observation group(94.55%)was significantly higher than that of the control group(81.82%)(P<0.05).The peak systolic blood flow velocity and the mean blood flow velocity of vertebrobasilar artery in the observation group after treatment were significantly increased as compared with the control group(P<0.05).The angles to anterior,posterior,left,and right of cervical vertebral movement of the observation group after treatment were significantly larger than those of the control group(P<0.05).The levels NPY and UⅡin plasma of both groups after treatment were significantly lower than those before treatment(P<0.01),and the levels NPY and UⅡin the observation group were significantly lower than those in the control group after treatment(P<0.05).Conclusion HBO combined with Tuina therapy can improve the curative effect on CSA,by improving cervical vertebral movement and hemorheological characteristics,and lowering the levels of NPY and UⅡin plasma in CSA patients.

关 键 词：高压氧 推拿 椎动脉型颈椎病 疗效 血液流变学改变 

分 类 号：R6[医药卫生—外科学]