针灸对颈动脉粥样硬化患者颈动脉形态学和动力学的影响

目的 观察针灸对缺血性脑血管病颈动脉粥样硬化(CAS)患者颈动脉形态学和血流参数的影响。方法将90例缺血性脑血管病颈动脉粥样硬化患者随机分为针灸观察组、针刺对照组、药物对照组各30例。通过颈动脉彩超的测定，观察颈动脉内径，颈动脉内-中内膜厚度(IMT)，收缩期最大血流速度(Vmax)；舒张期最小血流速度(Vmin)；收缩期峰值血流速度(PS)；舒张末期最小值(MD)；阻力指数(RI)；搏动指数(n)；有无动脉粥样硬化斑块等。结果针灸对颈动脉粥样硬化斑块有消退作用，其中以扁平斑、软斑效果较好，能够明显减小颈动脉粥样硬化斑块的厚度和面积；针灸对患者颈总动脉、颈内动脉、颈外动脉的PS、MD和PI均有不同程度的增加，降低RI，增加双侧颈动脉的内径厚度，减小IMT。结论针灸可改善颈动脉和脑动脉血流状况，有助于减轻和防止颈动脉粥样硬化的发生和发展。

Influence of Acupuncture and Moxibustion and Carotid Morphology and Dynamics in Patients with Carotid Atherosclerosis

Objective To investigate the influence of acupuncture and moxibustion on carotid morphology and bloodstream parasmeters in patients with carotid atherosclerosis due to ischemic cerebrovascular diseases. Method Ninety patients with carotid atherosclerosis due to ischemic cerebrovascular disease were randomly divided into acupuncture-moxibustion observation, acupuncture control and medication control groups, 30 cases each. Observed were carotid inside diameter, endo-mesendocarotid thickness, systolic maximal flow velocity(V max), systolic minimal flow velocity(V min), systolic peak flow velocity(PS), late systolic minimum(MD), resistance index(RI) and pulse index(PI) and if there was atheromatous plaque. Results Acupuncture and moxibustion had an eliminating effect on carotid atheromatous plaque, especially flat and soft ones, and could markedly reduce the thickness and area of carotid atheromatous plaque. In the patients, acupuncture and moxibustion increased common, internal and external carotid PS, MD and PI in different degress, decreased RI, increased bilateral carotid inside-diameter thickness and reduced IMT. Conclusion Acupuncture and moxibustion can improve carotid and cerebro-arterial blood flow and help to slow and prevent the generation and development of carotid atherosclerosis.