动静结合针刺法配合手法复位治疗后半规管良性阵发性位置性眩晕的临床观察  

Clinical observation on treatment of PC-BPPV by dynamic and static acupuncture method com-bined with manual reduction

作　　者：叶海敏[1] 陈壮志 张鹏[1] YE Hai-min;CHEN Zhuang-zhi;ZHANG Peng(Department of Acupuncture-Moxibustion and Tuina Rehabilitation,The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410005,China)

机构地区：[1]湖南中医药大学第二附属医院针灸推拿康复科,长沙410005

出　　处：《针刺研究》2023年第5期494-499,共6页Acupuncture Research

基　　金：湖南中医药大学校级科研基金项目(No.2020XJJJ061);湖南省临床医疗技术创新引导项目(No.2021SK51307)。

摘　　要：目的:观察动静结合针刺法配合手法复位对后半规管良性阵发性位置性眩晕(PC-BPPV)的临床疗效。方法:将90例符合纳入标准的PC-BPPV患者随机分为手法对照组、针刺对照组、试验组,每组各30例。手法对照组采用Epley复位法进行手法复位治疗,针刺对照组在手法复位治疗基础上给予普通针刺治疗,试验组在手法复位治疗基础上给予动静结合针刺治疗,两针刺组均选取百会、印堂,健侧的三间、中渚、后溪、外关,患侧的晕听区、风池,针刺每日1次,留针30 min,每6次为1个疗程,1疗程后休息1 d, 3组均治疗2个疗程。采用眩晕障碍量表(DHI)、视觉模拟评分(VAS)分别评价各组患者在治疗前、治疗1个疗程、治疗2个疗程后的眩晕程度并比较临床疗效。结果:与治疗前比较,各组治疗1个疗程及2个疗效后的DHI评分、VAS评分显著降低(P<0.05)。治疗1个疗程及2个疗程后,与针刺对照组、手法对照组比较,试验组DHI评分显著降低(P<0.05);与手法对照组比较,试验组VAS评分显著降低(P<0.05)。手法对照组、针刺对照组与试验组的总有效率分别为66.67%、83.33%、86.67%,试验组的总有效高于其他两组(P<0.05)。结论:动静结合针刺法配合手法复位对于PC-BPPV具有明确的治疗作用,且在眩晕症状的改善速度及疗效持久度方面有一定的优势,值得临床进一步推广使用。Objective To observe the clinical effect and advantages of dynamic and static acupuncture method com-bined with manual reduction on posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV).Methods Ninety patients with PC-BPPV who met the inclusion criteria were randomly divided into manual reduction control group,acupuncture con-trol group and experimental group,with 30cases in each group.Epley reduction method was used for manual reduction control treatment of patients in the manual reduction control group,until there was no obvious vertigo of patients.Patients in the acupunc-ture control group received ordinary acupuncture treatment,while patients in the experiment group received dynamic and static acupuncture treatment,both on the basis of manual reduction control treatment.Baihui(GV20)and Yintang(GV24+),Sanyinjiao(SP6),Zhongzhu(TE3),Houxi(SI3)and Waiguan(TE5)on the healthy side,and the vertigo-auditory area and Fengchi(GB20)on the affected side were selected for acupuncture intervention,which was performed once a day,with needles retained for 30mi-nutes in two acupuncture groups.Every six times was taken as a session and two sessions were required.Dizziness handicap in-ventory(DHI)scale and visual analogue score(VAS)were used to evaluate the degree of vertigo before,after 1and 2sessions of treatment respectively.Results Compared with those before treatment,the DHI score and VAS score of each group after 1 and 2sessions of treatment were both significantly decreased(P<0.05).Compared with the acupuncture control group and the manual reduction control group,the DHI score of the experiment group was significantly decreased(P<0.05)after 1and 2ses-sions of treatment.VAS score of the experiment group was significantly decreased compared with that of the manual reduction control group(P<0.05)after 1and 2sessions of treatment.The total effective rate of the experiment group was 86.67%,better than those of the acupuncture control group(83.33%,P<0.05)and the manual reduction control group(66.67%,P<0.05

关 键 词：良性阵发性位置性眩晕 后半规管 动静结合针刺法 临床观察 

分 类 号：R245.31[医药卫生—针灸推拿学]