三维正骨推拿联合祛风通络温肾汤治疗椎动脉型颈椎病效果及对血清ET、NSE和椎基底动脉血流动力学的影响  

Effect of three-dimensional bone-setting manipulation combined with Qifeng Tongluo Wenshen Decoction on cervical spondylosis of vertebral artery type and its influence on serum ET,NSE and vertebrobasilar hemodynamics

作　　者：马军虎[1] 胡沛铎 牛相来[1] 周钰[1] MA Junhu;HU Peifeng;NIU Xianglai;ZHOU Yu(The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China;Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine,Urumqi 830000,Xinjiang,China)

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830054 [2]新疆维吾尔自治区中医医院,新疆乌鲁木齐830000

出　　处：《现代中西医结合杂志》2020年第28期3123-3127,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(2018D01C211)。

摘　　要：目的探究三维正骨推拿联合祛风通络温肾汤治疗椎动脉型颈椎病的效果及对血清内皮素(ET)、神经元特异性烯醇化酶(NSE)和椎基底动脉血流动力学的影响。方法选取2017年2月—2019年2月新疆医科大学第一附属医院诊治的椎动脉型颈椎病患者98例,按随机数字表法分为2组各49例。对照组给予祛风通络温肾汤加减治疗,研究组在对照组基础上加行三维正骨推拿治疗,均治疗14 d。比较2组治疗前及治疗14 d后的中医症状积分、椎基底动脉血流动力学[平均血流速度(MV)、阻力指数(RI)]、血清ET与NSE水平,评估2组临床疗效。结果治疗后2组中医症状积分均较治疗前明显降低(P均<0.05),且研究组中医症状积分明显低于对照组(P<0.05);治疗后2组左、右椎动脉及基底动脉的RI均较治疗前明显降低(P均<0.05),MV较治疗前明显升高(P均<0.05),且研究组左、右椎动脉及基底动脉的RI低于对照组(P均<0.05),MV高于对照组(P<0.05);治疗后2组血清ET、NSE水平均较治疗前明显降低(P均<0.05),且研究组血清ET、NSE水平明显低于对照组(P均<0.05)。研究组治疗总有效率为98.0%(48/49),明显高于对照组的77.6%(38/49)(P<0.05)。结论三维正骨推拿联合祛风通络温肾汤加减治疗椎动脉型颈椎病可显著缓解症状,下调血清ET、NSE水平,改善椎基底动脉血流动力学,提高治疗效果。Objective It is to explore the effect of three-dimensional bone-setting manipulation combined with Qifeng Tongluo Wenshen Decoction on cervical spondylosis of vertebral artery type and its influence on serum endothelin(ET),neuron-specific enolase(NSE)and vertebrobasilar hemodynamics.Methods A total of 98 patients with vertebral artery type cervical spondylosis diagnosed and treated in the First Affiliated Hospital of Xinjiang Medical University from February 2017 to February 2019 were selected and divided into two groups according to the random number table,49 cases in each group.The control group was treated with Qufeng Tongluo Wenshen Decoction,and the study group was treated with three-dimensional bone-setting manipulation on the basis of the control group.Both groups were treated for 14 days.The TCM symptom scores,vertebrobasilar hemodynamics[mean blood flow velocity(MV),resistance index(RI)],levels of serum ET and NSE before treatment and after 14 days of treatment were compared between the two groups,and the clinical efficacy of the two groups was evaluated.Results After treatment,the TCM symptom scores of the two groups were significantly lower than those before treatment(P<0.05),and the TCM symptom scores of the study group were significantly lower than those of the control group(P<0.05).The RI of the left and right vertebral arteries and vertebrobasilar artery were significantly lower than those before treatment(P<0.05),and the MV was significantly higher than those before treatment(P<0.05),and the RI of the left and right vertebral artery and vertebrobasilar artery of the study group were lower than those of the control group(P<0.05),MV was higher than that of the control group(P<0.05).After treatment,the serum ET and NSE levels in the two groups were significantly lower than those before treatment(P<0.05),and the serum ET and NSE levels in the study group were significantly lower than those in the control group(P<0.05).The total effective rate of treatment in the study group was 98.0%(48/49),which was

关 键 词：椎动脉型颈椎病 三维正骨推拿 祛风通络温肾汤 内皮素 神经元特异性烯醇化酶 椎基底动脉血流动力学 

分 类 号：R681.55[医药卫生—骨科学]