非手术治疗颈性眩晕的临床疗效观察

目的:探讨非手术治疗颈性眩晕的临床疗效。方法:将90例颈源性眩晕病人随机分为3组,每组30例,分别采用中药、西药和手法治疗,并结合应用颈椎颈颌布兜牵引,治疗2周后比较各组的临床疗效。结果:3组病人治疗后症状体征评分均较治疗前降低(中药组:t=39.49,P=0.00;西药组:t=42.42,P=0.00;手法组:t=42.98,P=0.00);治疗后中药组和手法组主要症状体征评分均低于西药组(q=7.73,P=0.00;q=6.76,P=0.00)。中药组与手法组眩晕症状较西药组缓解快(q=12.21,P=0.00;q=13.89,P=0.00);中药组与手法组颈项累痛症状较西药组缓解快(q=10.74,P=0.00;q=12.47,P=0.00)。各组治疗后椎-基底动脉血流速度均较治疗前提高(中药组:t=-15.96,P=0.00;t=-18.93,P=0.00;西药组:t=-9.91,P=0.00;t=-10.37,P=0.00;手法组:t=-23.53,P=0.00;t=-21.79,P=0.00),治疗后中药组与手法组椎动脉血流速度均比西药组快(q=13.82,P=0.00;q=13.76,P=0.00);治疗后中药组与手法组基底动脉血流速度均比西药组快(q=18.43,P=0.00;q=20.61,P=0.00);中药组与手法组的疗效均优于西药组(Z=2.29,P=0.02;Z=-2.10,P=0.04);中药组与手法组的疗效比较,差异无统计学意义(Z=-0.34,P=0.74)。结论:颈椎牵引配合中药或正骨手法治疗颈性眩晕疗效确切,值得在临床推广。

Clinical observation on the curative effect of non-surgical treatment on cervical vertigo

Objective：To explore the curative effect of non-surgical treatment on cervical vertigo. Methods：90 patients with cervical vertigo were randomly divided into 3 groups ,30 cases in each group. Patients in the 3 groups were administrated with traditional Chinese medicine （TCM group）, Western medicine（ WM group） and manipulation（ M group） respectively, meanwhile they were administrated with cervical traction. The clinical effects were compared among the 3 groups after 2 weeks＇ treatment. Results： After treatment, signs and symptoms scores of patients in the 3 groups were all lower than those before treatment （TCM group： t = 39.49,P = 0.00 ; WM group： t = 42.42, P - 0.00; M group： t = 42.98, P = 0.00） ; signs and symptoms scores of TCM and M groups were all lower than those of WM group （ q = 7.73,P = 0.00 ;q = 6.76, P =0.00）. The vertigo symptoms of patients in TCM group and M group were relieved more quickly than those of patients in WM group（q = 12.21, P = 0.00;q = 13.89 ,P = 0.00）, the neck pain and tired symptoms of patients in TCM group and M group were relieved more quickly than those of patients in WM group（ q -- 10.74 ,P = 0.00 ;q = 12.47 ,P = 0. 00）. After treatment, vertebral-basilar artery blood flow velocity of patients in the 3 groups was improved compared with that before the treatment （ TCM group ： t = - 15.96,P = 0.00 ;t = - 18.93, P = 0.00 ; WM group：t = -9.91 ,P =0.00;t = - 10.37,P =0. 00;l group ：t = -23.53 ,P =0.00;t = -21.79,P =0.00） ;vertebral artery blood flow veloc- ity of TCM group and M group was quicker than that of WM group （ q = 13.82, P = 0.00 ; q = 13.76,P = 0.00） ; basilar artery blood flow veloci- ty of TCM group and M group was quicker than that of WM group （ q = 18.43, P = 0.00 ; q = 20.61, P = 0.00 ） ; the curative effects of TCM group and M group were better than that of WM group （ Z -- 2.29,P = 0.02 ;Z = - 2.10,P = 0.04）. There was no statistical difference in the curative effects between TCM group and M group（Z = -0.34,P =0.74）. Condusion：Crvical traction combined with TCM or BONE SETTING MANIPULATION has an exact curative effect on the treatment of cervical vertigo,and it is worth popularizing in clinic.