松肌正骨术治疗颈性眩晕的临床疗效及对脑动脉血流速度的影响  

Curative effect of muscle relaxation and bone-setting techniques for cervical vertigo and how it impacts on cerebral artery blood flow velocity

作　　者：夏振君[1] 车旭东[1] 李旭华 修文明[1] XIA Zhenjun;CHE Xudong;LI Xuhua;XIU Wenming(Department of Rehabilitation and Massage,Dalian Hospital of Traditional Chinese Medicine,Dalian,Liaoning 116013)

机构地区：[1]辽宁省大连市中医医院康复推拿科,辽宁大连116013

出　　处：《河北中医》2021年第11期1884-1887,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：大连市医学科学研究计划项目(中医药类)(编号:18z1013)。

摘　　要：目的观察松肌正骨术治疗颈性眩晕(CV)的临床疗效及对脑动脉血流速度的影响。方法将74例CV患者按照随机数字表法分为2组,对照组37例予注射用长春西汀治疗,治疗组37例在对照组治疗基础上应用松肌正骨术治疗,2组均治疗20 d。比较2组疗效;观察2组治疗前后症状评分、疼痛视觉模拟评分(VAS)变化;观察2组治疗前后大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)及椎动脉(VA)平均血流速度变化;观察2组治疗前后血浆神经肽Y(NPY)、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)水平变化。结果治疗组总有效率91.89%(34/37),对照组总有效率67.57%(25/37),治疗组疗效优于对照组(P<0.05)。2组治疗后眩晕、头痛、恶心呕吐、颈部僵硬症状评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后疼痛VAS均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后MCA、ACA、PCA及VA平均血流速度均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后NPY、ET-1水平均较本组治疗前降低(P<0.05),CGRP水平较本组治疗前升高(P<0.05);治疗后治疗组NPY、ET-1水平均低于对照组(P<0.05),CGRP高于对照组(P<0.05)。结论松肌正骨术治疗CV能提高脑动脉血流速度,改善患者眩晕、头痛、恶心呕吐、颈部僵硬症状,提高疗效。Objective To observe the curative effect of muscle relaxation and bone-setting techniques for cervical vertigo(CV)and how it impacts on cerebral blood flow velocity(BFV).Methods Totally 74 CV patients were assigned into equal group according to a random number table method,in addition to injection of vinpocetine,and treatment group received muscle relaxation and bone-setting techniques.Treated for 20 days,the key observation was symptom score,pain visual analogue score(VAS),mean blood velocity of anterior cerebral artery(ACA),middle cerebral artery(MCA),and posterior cerebral arteries(PCA),vertebral artery(VA);plasma neuropeptide Y(NPY),endothelin-1(ET-1),calcitonin gene-related peptide(CGRP),as well as curative effects between groups before and after treatment.Results The total effective rates were better in treatment group than in control group[91.89%(34/37)vs 67.57%(25/37),(P<0.05),respectively].After treatment,symptom(vertigo,headache,nausea and vomiting,stiff neck)scores in groups were decreased(P<0.05),which in treatment group were significantly decreased(P<0.05);VAS in groups was lower(P<0.05),which was lower notably in treatment group(P<0.05);mean blood velocity of MCA,ACA,PCA,VA in groups were increased(P<0.05),which were increased in treatment group than in control group(P<0.05);NPY and ET-1 in groups were decreased(P<0.05),which were decreased in treatment group than in control group(P<0.05);CGRP in groups was increased(P<0.05),which was increased in treatment group than in control group(P<0.05).Conclusion For CV patients,muscle relaxation and bone-setting techniques is capable of increasing cerebral artery BFV,improving the symptoms of vertigo,headache,nausea and vomiting,stiff neck and the curative effect.

关 键 词：颈椎 眩晕 正骨手法 

分 类 号：R255.3[医药卫生—中医内科学]