小针刀结合推拿手法对CSA椎-基底动脉血流的影响

目的：探求小针刀结合推拿手法治疗椎动脉型颈椎病（CSA）的作用机制。方法：400例CSA患者随机分成A（药物治疗组）、B（小针刀治疗组）、C（推拿手法治疗组）、D（小针刀结合推拿手法治疗组）4组，采用经颅多普勒（TCD）对400例患者在治疗前、后分别观察椎动脉（VA）、基底动脉（BA）的平均血流速度（Vm）、搏动指数（PI）及治疗有效率。结果：B、C、D 3组VA、BA的Vm在治疗后均有明显改善，PI接近正常。A组治疗总有效率66.0%，B组总有效率78.6%，C组总有效率80.2%，D组总有效率96.0%。结论：小针刀结合推拿手法治疗对椎动脉型颈椎病有明确的治疗作用，其作用机制可能与改善椎-基底动脉Vm、PI有关。

Effects of Vertebral Basilar Artery Bloodstream about CSA Treated by Small Needle Knife Combining with Massage Manipulation in Clinical Practice

This study was aimed to explore the action mechanism of massage treatment in combination with small needle knife to cervical spondylotic vertebral arteriopathy (CSA). A total of 400 CSA patients were randomly divided into four groups, which included group A (medicine treatment group), group B(small needle knife therapy group), group C(massage treatment group) and group D (small needle knife combined with massage treatment group). The observation was given on the average blood flow velocity (Vm), pulsatility index (PI) and treatment efficiency of vertebral artery(VA) and basilar artery (BA) before and after treatment among 400 cases using transcranial doppler (TCD). The results showed that TCD detection of Vm of VA and BA in group B, C and D were obviously improved after treatment; and the PI of them was close to normal. The total effective rate of group A was 66.0%, 78.6% in group B, 80.2% in group C, and 96.0% in group D. It was concluded that the treatment by massage in combination with small needle knife therapy of vertebral artery type of cervical spondylosis had a clear effect. Its mechanism may be related to the improvement of Vm and PI of vertebral basilar artery.