颈腰同治针刺联合手法推拿治疗椎动脉型颈椎病临床研究  

Clinical Study on Combination Use of Cervical and Lumbar Joint Therapy with Acupuncture and Tuina with Manipulation for Cervical Spondylosis of Vertebral Artery Type

作　　者：张静 焦建坤 张森 ZHANG Jing;JIAO Jiankun;ZHANG Sen(Department of Chinese Medicine,The Second Affiliated Hospital of Luohe Medical College,Luohe Henan 462000,China;Department of Rehabilitation,The Second Affiliated Hospital of Luohe Medical College,Luohe Henan 462000,China)

机构地区：[1]漯河医学高等专科学校第二附属医院中医科,河南漯河462000 [2]漯河医学高等专科学校第二附属医院康复科,河南漯河462000

出　　处：《新中医》2025年第7期148-152,共5页New Chinese Medicine

摘　　要：目的:观察颈腰同治针刺联合手法推拿治疗椎动脉型颈椎病(CSA)的临床疗效。方法:选取2022年4月—2024年6月漯河医学高等专科学校第二附属医院收治的CSA患者105例,按随机数字表法分为联合组53例和推拿组52例。推拿组实施手法推拿治疗,联合组在推拿组基础上予颈腰同治针刺治疗,2组均治疗4周。评价2组临床疗效,比较2组治疗前后中医证候评分、颈椎功能障碍指数(NDI)、颈椎屈伸、旋转活动度、椎基底动脉血流动力学[基底动脉平均流速(Vm)、双侧椎动脉Vm]、血清因子[前列环素(PGI2)、血栓素A2(TXA2)、内皮素(ET)]水平。结果:联合组总有效率为92.45%(49/53),高于推拿组78.85%(41/52)(P<0.05)。治疗后,2组各项中医证候评分较治疗前降低(P<0.05),且联合组各项中医证候评分低于推拿组(P<0.05)。治疗后,2组NDI评分较治疗前降低,颈椎屈伸、旋转活动度较治疗前升高(P<0.05);且联合组NDI评分低于推拿组,颈椎屈伸、旋转活动度高于推拿组(P<0.05)。治疗后,2组基底动脉Vm、双侧椎动脉Vm较治疗前升高(P<0.05);且联合组治疗后基底动脉Vm、双侧椎动脉Vm高于推拿组(P<0.05)。治疗后,2组PGI2水平较治疗前升高,TXA2、ET水平较治疗前降低(P<0.05);且联合组PGI2水平高于推拿组,TXA2、ET水平低于推拿组(P<0.05)。结论:颈腰同治针刺联合手法推拿治疗CSA疗效显著,可有效缓解中医证候,改善椎基底动脉血流动力学,促进颈椎功能、活动度恢复,其机制可能与调节血管功能有关。Objective:To observe the clinical effect of the combination use of cervical and lumbar joint therapy with acupuncture and tuina with manipulation on cervical spondylosis of vertebral artery type(CSA).Methods:A total of 105 CSA patients admitted to the Second Affiliated Hospital of Luohe Medical College from April 2022 to June 2024 were selected and divided into the combination group(53 cases)and tuina group(52 cases)according to the random number table method.The tuina group was treated with manual tuina,and the combination group was additionally treated with neck and waist acupuncture based on the treatment of the tuina group.Both groups were treated for four weeks.The clinical effects in the two groups were evaluated.The traditional Chinese medicine syndrome scores,neck disability index(NDI),range of motion of cervical flexion,extension and rotation,hemodynamics of vertebrobasilar artery[mean velocity(Vm)of basilar artery and bilateral vertebral artery],and levels of serum factors[prostaglandin I2(PGI2),thromboxane A2(TXA2)and endothelin(ET)]were compared before and after treatment between the two groups.Results:The total effective rate was 92.45%(49/53)in the combination group,higher than that of 78.85%(41/52)in the tuina group(P<0.05).After treatment,the traditional Chinese medicine syndrome scores in the two groups were reduced when compared with those before treatment(P<0.05),and the above scores in the combination group were lower than those in the tuina group(P<0.05).After treatment,the NDI scores in the two groups were down-regulated when compared with those before treatment,and the motion of range of cervical flexion,extension and rotation were elevated when compared with those before treatment(P<0.05).The NDI score in the combination group were lower than that in the tuina group,and the motion of range of cervical flexion,extension and rotation was higher than that in the tuina group(P<0.05).After treatment,the Vm of basilar artery and bilateral vertebral artery in the two groups were up-regulated when

关 键 词：椎动脉型颈椎病 颈腰同治 针刺 手法推拿 颈椎功能 颈椎活动度 椎基底动脉血流动力学 

分 类 号：R274.9[医药卫生—中西医结合]