颈椎横突旁针刺联合循经推拿对后循环缺血性眩晕患者眩晕症状及脑血流量影响  

Effect of Cervical Vertebra Transverse Process Acupuncture Combined with Tuina on Vertigo Symptoms and Cerebral Blood Flow in Patients with Posterior Circulation Ischemic Vertigo

作　　者：汪生志 柳刚[2] 欧小燕 李娜[1] 朱玉侠 WANG Shengzhi;LIU Gang;OU Xiaoyan;LI Na;ZHU Yuxia(Anhui University of Traditional Chinese Medicine,Hefei 230031,Anhui,China;The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230061,Anhui,China)

机构地区：[1]安徽中医药大学,安徽合肥230031 [2]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《辽宁中医药大学学报》2023年第12期150-154,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：安徽省自然科学基金项目(1608085MH184);安徽省重大疑难疾病中西医协同攻关项目(皖中医药发展秘〔2021〕70号);全国中医药创新骨干人才培养项目(皖卫中医药发〔2019〕12号)。

摘　　要：目的观察颈椎横突旁针刺联合循经推拿法治疗后循环缺血性眩晕(posterior circulation ischemia vertigo,PCIV)的临床疗效,初步探讨其治疗机制。方法选取2021年10月—2022年10月安徽中医药大学第二附属医院脑病三科门诊及住院60例PCIV患者,随机分为治疗组和对照组,每组30例。在常规治疗如控制血压、血糖、血脂等的基础上,对照组采取口服盐酸氟桂利嗪胶囊治疗,每日5 mg,每晚1次,服用4周;治疗组采取颈椎横突旁针刺联合头颈部循经推拿法治疗,针刺得气后留针30 min,推拿每次20 min,以上治疗各1次/d,6次/周,12次为1个疗程,共治疗2个疗程。观察两组患者治疗前后中医眩晕症状积分的变化;经颅多谱勒(TCD)测定左侧颅内外椎动脉(LVA)、右侧颅内外椎动脉(RVA)以及基底动脉(BA)的血管搏动指数(PI),收缩期峰值血流速度(Vs),舒张末期血流速度(Vd)参数的变化;并进行临床疗效评价。结果治疗后,治疗组总有效率90%,高于对照组76.67%(P<0.05)。治疗后两组BA、LVA、RVA的Vs均较治疗前升高(P<0.05),且治疗组明显高于对照组(P<0.05)。治疗后两组的Vd较治疗前均升高(P<0.05),治疗组亦明显高于对照组(P<0.05)。两组治疗后PI值均较治疗前降低(P<0.05),治疗组明显低于对照组(P<0.05)。治疗后两组中医眩晕症状积分均较治疗前降低(P<0.05),且治疗组的积分明显低于对照组(P<0.05)。结论颈椎横突旁针刺联合循经推拿法对PCIV患者的临床症状有明显的改善作用,其机制可能与针刺改善椎动脉及基底动脉的血流速度,提高脑组织血液供应有关,其治疗本病的疗效较好。Objective To observe the clinical efficacy of cervical vertebra transverse process acupuncture combined with Tuina in the treatment of posterior circulation ischemic vertigo(PCIV),and to explore its therapeutic mechanism.Methods 60 PCIV patients were randomly divided into treatment group(n=30)and control group(n=30)from October 2021 to October 2022 in the third department of encephalopathy,the second affiliated hospital of Anhui university of traditional Chinese medicine.On the basis of routine treatment such as controlling blood pressure,blood glucose and blood lipids,the control group was given oral flunarizine hydrochloride capsule,daily 5 mg,once a night for 4 weeks.Treatment group was given cervical vertebra transverse process acupuncture combined with head massage,acupuncture for 30 minutes,massage for 20 minutes,the above treatment is once a day,six times a week,12 times as a course of treatment,a total of 2 courses of treatment.To observe the changes of TCM vertigo symptom scores between the two groups before and after treatment;Changes of systolic peak velocity(Vs),diastolic peak velocity(Vd)and pulsatility index(PI)of bilateral intracranial and extracranial vertebral arteries(VA)and basilar arteries(BA)were measured by transcranial doppler,and evaluate the clinical curative effect.Results After treatment,the total effective rate of the treatment group was 90%,which was higher than that of the control group(76.67%,P<0.05).After treatment,the Vs of BA,LVA and RVA in both groups were higher than those before treatment(P<0.05),the treatment group was significantly higher than the control group(P<0.05).After treatment,the Vd of both groups was higher than that before treatment(P<0.05),and the treatment group was significantly higher than that of the control group(P<0.05).After treatment,the PI of both groups decreased(P<0.05),the treatment group was significantly lower than that of the control group(P<0.05).After treatment,the scores of TCM vertigo symptoms in the two groups were decreased(P<0.05),the scores

关 键 词：颈椎横突旁针刺 循经推拿 后循环缺血性眩晕 脑血流量 

分 类 号：R255.3[医药卫生—中医内科学]