独龙针治疗椎动脉型颈椎病眩晕的临床观察  

Clinical Observation on Dulong Needling in the Treatment of Vertigo in Cervical Spondylosis of Vertebral Artery

作　　者：尹演萍 王小寅[2] 姜涛 陈远铭 李婉珊 孔萌萌 陈国健[2] 王雨涵 YIN Yanping;WANG Xiaoyin;JIANG Tao;CHEN Yuanming;LI Wanshan;KONG Mengmeng;CHEN Guojian;WANG Yuhan(The Fifth Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China;Shandong University of Tra-ditional Chinese Medicine,Jinan 250355 Shandong,China)

机构地区：[1]广州中医药大学第五临床医学院,广东广州510405 [2]广东省第二中医院,广东广州510095 [3]山东中医药大学,山东济南250355

出　　处：《广州中医药大学学报》2025年第3期662-669,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研资助项目(编号:20231026);广东省科技厅基础与应用基础研究基金资助项目(编号:2023A1515220154)。

摘　　要：【目的】观察独龙针治疗椎动脉型颈椎病(CSA)眩晕的临床疗效。【方法】选取2024年6月至2024年10月广东省第二中医院针灸康复科门诊收治的46例明确诊断为CSA眩晕的患者为研究对象。按随机数字表将患者随机分为观察组和对照组,每组各23例。观察组给予独龙针肩颈十针治疗,对照组给予常规针刺治疗,2组均治疗2周。治疗2周后,评价2组临床疗效,观察2组患者治疗前后颈性眩晕症状与功能评估量表(ESCV)评分的变化情况,应用三维伪连续式动脉自旋标记(3D-pCASL)技术测量感兴趣区(ROI)的脑血流量(CBF)变化值,比较2组患者脑血流量(CBF)变化值的情况。【结果】(1)观察组总有效率为91.30%(21/23),对照组总有效率为78.26%(18/23),观察组疗效优于对照组,差异有统计学意义(P <0.05)。(2)治疗后,2组患者的ESCV评分均明显改善(P <0.05),且观察组在改善ESCV评分方面明显优于对照组,差异有统计学意义(P <0.05)。(3)治疗后,2组患者各ROI的CBF变化值显示升高(正值),对照组的右侧大脑中动脉(R-MCA)的CBF变化值显示降低(负值)。治疗后,观察组在右侧小脑后下动脉(R-PICA)、右侧小脑前下动脉(R-AICA)、右侧大脑前动脉(R-ACA)、椎动脉及基底动脉分支(VA、BA)、双侧小脑上动脉(SCA)和双侧大脑后动脉(PCA)供血区的CBF变化值明显升高,且观察组在改善以上ROI的CBF变化值水平方面明显优于对照组,差异有统计学意义(P <0.05)。【结论】独龙针治疗椎动脉型颈椎病眩晕,能明显改善患者的脑血流量,减轻眩晕、颈肩痛、头痛等临床症状,疗效显著。Objective To observe the clinical efficacy of Dulong needling in the treatment of vertigo in cervical spondylosis of vertebral artery(CSA).Methods A total of 46 cases of patients with definitive diagnosis of vertigo in CSA admitted to the outpatient clinic of the Acupuncture,Muxibustion and Rehabilitation Department of Guangdong Second Traditional Chinese Medicine Hospital from June to October 2024 were selected for the study.The patients were randomly divided into observation group and control group according to the random number table method,with 23 cases in each group.The observation group was treated with Dulong ten-needling in shoulder and neck,and the control group was given conventional acupuncture treatment,the course of treatment for the two groups covered two weeks.After two weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the scores of Evaluation Scale For Cervical Vertigo(ESCV)before and after treatment were observed in the patients of the two groups.Three dimensional pseudo-continuous arterial spin labeling(3D-pCASL)technique was applied to determin the changes in cerebral blood flow(CBF)values in the region of region of interest(ROI),and the changes in CBF values in the patients of the two groups were compared.Results(1)The total effective rate of the observation group was 91.30%(21/23),and that of the control group was 78.26%(18/23),and the efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the ESCV scores of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(3)After treatment,the CBF change values of each ROI in the two groups showed elevated(positive),and the CBF change values of the right middle cerebral artery(R-MCA)in the control group showed decreased(negative).After treatment,the CBF ch

关 键 词：独龙针 椎动脉型颈椎病 眩晕 颈肩痛 头痛 脑血流量 磁共振成像 临床观察 

分 类 号：R246.9[医药卫生—针灸推拿学]