机构地区:[1]四川省医学科学院·四川省人民医院,成都610100 [2]成都市温江区中医医院,成都611100 [3]成都市新都区妇幼保健院,成都610500
出 处:《上海针灸杂志》2023年第11期1177-1183,共7页Shanghai Journal of Acupuncture and Moxibustion
基 金:成都市卫生健康委员会科研项目(2021405)。
摘 要:目的观察浮针联合Mulligan手法治疗瘀血阻络型椎动脉型颈椎病的临床疗效及对血清血栓素B2(B2 of thromboxane,TXB2)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、神经元特异性烯醇酶(neuron specific enolase,NSE)水平及血流动力学的影响。方法将124例瘀血阻络型椎动脉型颈椎病患者随机分为观察组和对照组,每组62例。对照组患者采用Mulligan手法治疗,观察组采用浮针联合Mulligan手法治疗。观察两组治疗前后血清TXB2、TNF-α、前列腺素E2(prostaglandin E2,PGE2)、NSE、一氧化氮(nitric oxide,NO)和白介素-6(interleukin-6,IL-6)水平,观察两组治疗前后椎动脉阻力指数(resistance index,RI)、椎动脉和椎基底动脉平均峰流速、椎动脉型颈椎病功能评定量表(vertebral artery type cervical spondylosis functional assessment scale,FS-CSA)、改良颈性眩晕症状与功能评估量表(modified evaluation scale for cervical vertigo,ESCV)评分、中医证候积分、颈椎椎体水平位移、椎体角度位移和椎体屈伸活动范围情况,并比较两组临床疗效。结果两组治疗后血清TNF-α、TXB2和PGE2水平降低(P<0.05),且观察组低于对照组(P<0.05)。两组治疗后血清NSE和IL-6水平降低,NO水平升高(P<0.05);且观察组血清NSE、IL-6低于对照组(P<0.05),NO高于对照组(P<0.05)。两组治疗后椎动脉和椎基底动脉平均峰流速提高(P<0.05),椎动脉RI降低(P<0.05);且观察组椎动脉和椎基底动脉平均峰流速高于对照组(P<0.05),椎动脉RI低于对照组(P<0.05)。两组治疗后ESCV评分、FS-CSA和中医证候积分降低(P<0.05);且观察组低于对照组(P<0.05)。两组治疗后椎体角度位移和椎体水平位移降低(P<0.05),椎体屈伸活动范围增大(P<0.05);观察组椎体角度位移、椎体水平位移低于对照组(P<0.05),椎体屈伸活动范围大于对照组(P<0.05)。对照组总有效率为85.5%,观察组为96.8%,两组比较差异有统计学意义(P<0.05)。结论浮针联合MulligObjective To observe the clinical efficacy of superficial needling combined with Mulligan manipulation in treating vertebral artery type cervical spondylosis with stagnant blood obstructing the meridians pattern,and the effects on serum thromboxane B2(B2 of thromboxane,TXB2),tumour necrosis factor-α(TNF-α),neuron specific enolase(NSE)levels and haemodynamics.Method A total of 124 patients with vertebral artery type cervical spondylosis due to stagnant blood obstructing the meridians pattern were randomly divided into the observation group and the control group,with 62 cases in each group.Patients in the control group were treated with Mulligan manipulation,and patients in the observation group were treated with superficial needling combined with Mulligan manipulation.The serum levels of TXB2,TNF-α,prostaglandin E2(PGE2),NSE,nitric oxide(NO)and interleukin-6(IL-6),the resistance index(RI)of vertebral artery,mean peak velocity of vertebral artery and vertebrobasilar artery,vertebral artery type cervical spondylosis functional assessment scale(FS-CSA),modified evaluation scale for cervical vertigo(ESCV)score,traditional Chinese medicine(TCM)syndrome score,horizontal displacement of cervical vertebral body,angular displacement of cervical vertebral body and flexion and extension range of motion of vertebral body before and after treatment were compared between the two groups,and the clinical efficacy was compared between the two groups..Result The levels of TNF-α,TXB2 and PGE2 in the two groups were decreased after treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of serum NSE and IL-6 were decreased in the two groups(P<0.05),and the level of NO was increased.The serum NSE and IL-6 in the observation group were lower than those in the control group(P<0.05),and NO was higher than that in the control group(P<0.05).After treatment,the mean peak velocity of vertebral artery and vertebrobasilar artery in the two groups increased(P<0.05),a
关 键 词:浮针 瘀血阻络 Mulligan手法 颈椎病 椎动脉 炎性因子 内皮功能 血流动力学
分 类 号:R246.2[医药卫生—针灸推拿学]
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