目的观察针灸联合推拿手法治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的临床疗效。方法将90例CSA患者按照随机数字表法分为对照组和观察组,每组45例。对照组仅接受针灸治疗,观察组接受针灸联合推拿手法治疗。采用椎动脉型颈椎病功能评定量表(functional scale for CSA,FS-CSA)和颈椎病临床评价量表(clinical assessment scale for cervical spondylosis,CASCS)评估2组患者临床症状改善情况;采用经颅多普勒超声检测2组患者左侧椎动脉(left vertebral artery,LVA)、右侧椎动脉(right vertebral artery,RVA)及基底动脉(basilar artery,BA)的舒张末期血流速度(end diastolic velocity,EDV)和收缩期峰值血流速度(peak systolic velocity,PSV)变化。结果治疗后,观察组总有效率明显高于对照组(P<0.05)。2组FS-CSA评分均较治疗前降低(P<0.05),且观察组降低幅度明显大于对照组(P<0.05);2组CASCS评分均较治疗前升高(P<0.05),且观察组升高幅度明显大于对照组(P<0.05)。2组LVA、RVA、BA的PSV与EDV均较前升高,且观察组上述指标明显高于对照组(P<0.05)。结论采用针灸联合推拿手法治疗CSA能够获得较好的治疗效果,其可有效改善患者的临床症状和颈椎功能,同时还可以明显增加局部血流量,有效缓解脑部组织血液供应不足,在临床中具有良好应用前景和价值。
Objective To observe the clinical effect of acupuncture combined with massage manipulation on cervical spondylosis of vertebral artery type(CSA).Methods A total of 90 patients with CSA were divided into control group and observation group by random number table,with 45 cases in each group.The control group received only acupuncture treatment,and the observation group received acupuncture combined with massage manipulation.Functional scale for CSA(FS-CSA)and clinical assessment scale for cervical spondylosis(CASCS)were used to evaluate the improvement of clinical symptoms in both groups.The changes of end diastolic velocity(EDV)and peak systolic velocity(PSV)in the left vertebral artery(LVA),right vertebral artery(RVA)and basilar artery(BA)in the two groups were detected by transcranial doppler ultrasound.Results After treatment,the total effective rate in the observation group was significantly higher than that in the control group(P<0.05).The FS-CSA scores of the two groups were lower than those before treatment(P<0.05),and the reduction in the observation group was significantly larger than that in the control group(P<0.05).The CASCS scores of the two groups were higher than those before treatment(P<0.05),and the increase in the observation group was significantly larger than that in the control group(P<0.05).PSV and EDV of LVA,RVA,and BA in the two groups were all higher than before(P<0.05),and the above indicators in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Acupuncture combined with massage therapy for CSA can obtain better treatment effects,which can effectively improve the clinical symptoms and cervical spine function of patients.Meanwhile,it can also significantly improve local blood flow,effectively alleviate the lack of blood supply to the brain tissue,and has good application prospect and value in clinical practice.
Research of Integrated Traditional Chinese and Western Medicine
cervical spondylosis of vertebral artery type
cervical vertebra function