“小醒脑开窍”针刺法治疗后循环缺血性眩晕的疗效观察  

Clinical observation of the therapeutic effect on posterior circulation ischemic vertigo treated with“xiao xingnao kaiqiao”acupuncture

作　　者：董华 张建明 胡伟[2] 倪光夏[2] DONG Hua;ZHANG Jian-ming;HU Wei;NI Guang-xia(Department of Acupuncture and Moxibustion,Changzhou Hospital Affiliated to Nanjing University of Chinese Medicine,Changzhou 213000,Jiangsu Province,China;Department of Acupuncture and Moxibustion,The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029)

机构地区：[1]南京中医药大学常州附属医院,常州市中医医院针灸科,江苏常州213000 [2]南京中医药大学第二附属医院针灸科,南京210029

出　　处：《针刺研究》2020年第8期652-656,共5页Acupuncture Research

摘　　要：目的:观察"小醒脑开窍"针刺法治疗后循环缺血性眩晕(PCIV)的近、远期临床疗效,初步探讨其治疗机制。方法:90例PCIV患者随机分为治疗组和对照组,每组45例。在神经内科治疗基础下,对照组给予盐酸氟桂利嗪口服(5 mg,每日1次,共治疗21 d);治疗组给予"小醒脑开窍"针刺法,针刺印堂、内关(双)、三阴交(双)、百会、风池(双)、完骨(双)、天柱(双),留针30 min,每日1次,共治疗21 d。观察两组患者中医眩晕症状积分的变化;经颅多谱勒测定左椎动脉(LVA)、右椎动脉(RVA)、基底动脉(BA)的平均血流速度(Vm)及血管搏动指数(PI)的变化;3个月后随访,观察复发率,以评价其远期临床疗效。结果:治疗后,治疗组总有效率为91.11%(41/45),对照组总有效率为75.56%(34/45),治疗组高于对照组(P<0.05)。和本组治疗前比较,治疗组和对照组治疗后的中医眩晕症状积分均降低(P<0.05),治疗组低于对照组(P<0.05)。和本组治疗前比较,两组治疗后LVA、RVA及BA的Vm及PI均较治疗前改善(P<0.05),治疗组治疗后LVA、RVA及BA的Vm及PI改善均优于对照组(P<0.05)。3个月后随访,治疗组复发率为19.51%(8/41),对照组复发率为50.00%(17/34),治疗组低于对照组(P<0.05)。结论:"小醒脑开窍"针刺法能够明显改善PCIV的临床症状,其机制可能与针刺改善椎动脉及基底动脉的平均血流速度,提高脑组织血液供应有关,其治疗本病的近、远期疗效较好,复发率低。Objective To observe the short-term and long-term clinical effect on posterior circulation ischemic vertigo treated with"xiao xingnao kaiqiao"acupuncture(minor regaining consciousness and opening orifice)and explore its effect mechanism.Methods Ninety patients with posterior circulation ischemic vertigo were randomly divided into a treatment group and a control group,45 cases in each group.The patients of the two groups were all treated on the base of neurological medicine.In the control group,Flunarizine Hydrochloride was prescribed for oral administration(5 mg,once daily,for 21 days totally).In the treatment group,acupuncture of"xiao xingnao kaiqiao"was provided at Yintang(EX-HN3),bilateral Neiguan(PC6),bilateral Sanyinjiao(SP6),Baihui(GV20),bilateral Fengchi(GB20),bilateral Wangu(GB12)and bilateral Tianzhu(BL10).The needles were retained for 30 min,once daily for 21 days totally.The changes in vertigo score of traditional Chinese medicine(TCM)were observed,and the changes in the mean blood velocity(Vm)of the left vertebral artery(LVA),the right vertebral artery(RVA)and the basilar artery(BA)as well as the vascular pulsatility index(PI)were monitored and determined by transcranial Doppler(TCD).Additionally,the recurrence rate was followed up after 3 months to evaluate the long-term clinical effects.Results After treatment,the total effective rate of the treatment group was 91.11%(41/45)and 75.56%(34/45)in the control group.The total effective rate in the treatment group was higher than that in the control group(P<0.05).Compared with their own pre-treatment,the vertigo scores of TCM were reduced in either the treatment group or the control group after treatment(P<0.05)and the score in the treatment group was lower than that in the control group(P<0.05).Compared with their own pre-treatment,Vm and PI were all improved after treatment in either group(P<0.05).After treatment,the improvements in Vm and PI of LVA、RVA and BA in the treatment group were better than those in the control group(P<0.05).In the follow-up

关 键 词：小醒脑开窍针刺法 眩晕 后循环缺血 

分 类 号：R246.6[医药卫生—针灸推拿学]