针刀治疗椎动脉型颈椎病及对脑血流量的影响

目的:探求针刀治疗椎动脉型颈椎病(CSA)的临床效果。方法:86例CSA患者按照随机数字表法分为针刀组45例、针灸组41例。治疗2个疗程后通过颈椎病临床评价量表(CSACS)、疼痛程度标尺法(VAS)、经颅多普勒(TCD)评价治疗结果。结果:针刀组和针灸组CSACS评分较治疗前均显著提高,差异具有统计学意义(P<0.05)。两组间比较,针刀组对于CSACS评分的改善优于针灸组,差异具有统计学意义(P<0.05)。3个月后与治疗后CSACS评分比较无统计学意义(P> 0.05)。两组VAS评分较治疗前均显著提高,差异具有统计学意义(P<0.05)。两组间比较,针刀组对于VAS评分的改善优于针灸组,差异具有统计学意义(P<0.05)。3个月后与治疗后VAS评分相比无统计学意义(P> 0.05)。针刀组TCD收缩期峰值血流速度(SPV)值较治疗前显著提高,差异具有统计学意义(P<0.05)。针灸组VS值较治疗前无显著变化。针刀组TCD平均血流速度(VM)中的基底动脉(BA)值较治疗前显著提高,差异具有统计学意义(P<0.05)。结论:针刺组及针刀组均能改善其CSACS评分、VAS评分及TCD指标,针刀组疗效优于针灸组,TCD可以作为评价CSA疗效的重要指标。

Treatment of Cervical Spondylosis of Vertebral Artery Type with Acupotome and Its Effect on Cerebral Blood Flow

Objective:To explore the clinical efficacy of acupotome in the treatment of cervical spondylosis of vertebral artery type(CSA). Methods:Total 86 patients with CSA were divided into acupotome group(45 cases) and acupuncture group(41 cases) according to random number tablet. After 2 courses of treatment,the treatment results were evaluated by the clinical evaluation scale for cervical spondylosis(CSACS),pain scale method(VAS),and transcranial doppler(TCD). Results:The CSACS scores of acupotome group and acupuncture group were significantly higher than those before treatment,the difference was statistically significant(P< 0.05). In comparison between the two groups,the improvement of CSACS score in acupotome group was better than that in acupuncture group,and the difference was statistically significant(P< 0.05).There was no statistically significant in CSACS score between 3 months after treatment and after treatment(P> 0.05). The VAS scores of the two groups were significantly higher than those before treatment(P< 0.05),and there was statistically significant between the two groups(P< 0.05). The improvement of VAS score in the acupotome group was better than that in the acupuncture group,and the difference was statistically significant between the two groups(P< 0.05).There was no significant difference in VAS score between 3 months after treatment and after treatment(P> 0.05). The systolic peak velocity(SPV) of TCD in acupotome group was significantly higher than that before treatment(P< 0.05). There was no significant change in VS of acupuncture group compared with that before treatment. The basilar artery(BA) of mean velocity(VM) in acupotome group was significantly higher than that before treatment(P< 0.05). Conclusions:The CSACS score,VAS score and TCD index were improved in both acupotome group and acupuncture group. The curative effect of acupotome group was better than that of acupuncture group. TCD can be used as an important index to evaluate the curative effect of CSA.