针刺结合颈交感神经阻滞治疗椎动脉型颈椎病及其对血流动力学的影响

目的观察针刺结合颈交感神经阻滞治疗方法对椎动脉型颈椎病患者的疗效及对血流动力学的影响。方法选择诊断明确的椎动脉型颈椎病患者60例,随机分为对照组和治疗组各30例。对照组仅行针刺治疗,治疗组患者在针刺治疗后行颈交感神经阻滞治疗。1个疗程结束后评估治疗效果,运用TCD观察两种疗法治疗前后椎动脉、基底动脉Vs、Vd及Vm的变化并进行组间比较。结果两组总有效率及治愈率比较,差异均有统计学意义(P<0.05)。治疗组双侧椎动脉、基底动脉的Vs、Vd、Vm值经治疗后明显加快,接近或已经恢复到正常值范围,与对照组比较差异有统计学意义(P<0.05)。结论针刺结合颈交感神经阻滞治疗椎动脉型颈椎病疗效优于单纯针刺疗法,能显著改善椎-基底动脉血流。

Effect of acupuncture plus cervical sympathetic nerve block on cervical spondylotic arteriopathy and its influence on hemodynamics

Objective To observe the effects of acupuncture plus cervical sympathetic nerve block on cervical spondylotic arteriopathy and its influence on hemodynamics.Methods Sixty patients with CSA were randomized into control group(CG,n=30)and treatment group(TG,n=30),and patients of both groups were treated by acupuncture.The patients in TG received CSNB after acupuncture.In CG,the patients only received acupuncture.Clinical outcome was evaluated after one therapeutic course.The Vs,Vd and Vm of bilateral vertebral arteries and basilar artery before and after treatment in the two groups were detected and compared by transcranial doppler.Results The differences in total effective rate and cure rate were both significant between the groups(P < 0.05).Compared with pre-treatment,Vs,Vd and Vm of the bilateral VA and BA in TG,and Vs of the left VA in CG increased significantly(P < 0.05).Conclusion The effect of acupuncture plus CSNB is superior to that of acupuncture alone in treating CSA,which could significantly improve VA-BA blood flow.