世界中医药
文章摘要
针灸推拿联合治疗椎动脉型颈椎病患者对其血流动力学、神经元特异性烯醇酶和内皮素的影响
Mechanism of Acupuncture,Moxibustion and Tuina Combined Treatment of Cervical Spondylosis of Vertebral Artery Type Based on Hemodynamics,NSE and ET
投稿时间:2019-01-31  
DOI:10.3969/j.issn.1673-7202.2019.07.053
中文关键词: 推拿  针灸  颈椎病  椎动脉型  血流动力学  神经元特异性烯醇酶  内皮素  疗效  机制
英文关键词: Tuina  Acupuncture and moxibustion  Cervical spondylosis  Vertebral artery type  Hemodynamics  NSE  ET  Curative effect  Mechanism
基金项目:湖北省卫生计生委医药院校科研专项一般项目(WJ2016-Y-03)
作者单位
张慧,刘李文姬 湖北省鄂东医疗集团黄石市中医医院推拿科黄石435002 
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中文摘要:
      目的:探讨针灸推拿治疗椎动脉型颈椎病患者的疗效及其机制。方法:选取2017年4月至2018年12月于鄂东医疗集团黄石市中医医院就诊的椎动脉型颈椎病患者120例作为研究对象,通过随机数字表法随机纳入对照组和观察组,每组60例。对照组采用颈项部夹脊穴,观察组则在对照组的基础上联合推拿治疗。在治疗结束后分别观察2组患者的临床疗效,并对2组患者治疗前后的椎动脉-基底动脉平均血流速度(TMFV)、收缩期峰值血流速度(PSV)、血管搏动指数(PI)、阻力指数(RI)等血流动力学指标,并抽取血液分析2组治疗前后的神经元特异性烯醇酶(NSE)和内皮素(ET)值。结果:治疗后2组患者临床症状和功能积分均明显提高,且观察组优于对照组,差异有统计学意义(P<0.05)。治疗后,对照组治疗有效率为76.67%,观察组治疗有效率为91.67%,差异有统计学意义(P<0.05)。治疗前2组患者应用血流动力学比较,差异统计学意义(P>0.05);治疗后2组患者椎动脉-基底动脉的TMFV、PSV均明显提高,而2组患者椎动脉-基底动脉的PI、RI均明显下降,且观察组血流动力学指标均优于对照组,差异有统计学意义(P<0.05);治疗后2组的NSE和ET水平均明显降低,且观察组优于对照组,差异有统计学意义(P<0.05)。结论:推拿联合针灸治疗可以有效的改善椎动脉型颈椎病患者的临床症状,其作用机制与NSE和ET水平的降低,血流动力学的改变有关。
英文摘要:
      To explore the efficacy and mechanism of acupuncture,moxibustion and tuina for the treatment of vertebral artery type cervical spondylosis.Methods:A total of 120 patients with vertebral artery type cervical spondylosis from April 2017 to December 2018 were randomly divided into a control group and an observation group by random number table method,with 60 cases in each group.The control group was treated with Jiaji(EX-B2)point on neck,while the observation group was treated with tuina on the basis of the control group.At the end of the treatment,the clinical efficacy of the 2 groups was observed,and the hemodynamic indexes such as time mean flow velocity(TMFV),peak systolic blood flow velocity(PSV),pulsatility index(PI),resistance index(RI)of the vertebral artery-basilar artery before and after treatment were observed.The neuron-specific enolase(NSE)and endothelin(ET)value of the 2 groups before and after treatment were extracted and analyzed.Results:(1)After treatment,the clinical symptoms and functional scores of the 2 groups were significantly improved(P<0.05),and the observation group was better than the control group(P<0.05).After treatment,the total effective rate of the control group was 76.67%,and that of the observation group was 91.67%.The treatment group was significantly better than that of the control group(P<0.05).(2)There was no significant difference in hemodynamic evaluation between the 2 groups before treatment(P>0.05); TMFV and PSV of vertebral artery-basilar artery in the 2 groups were significantly increased after treatment(P<0.05),while P I and RI of vertebral artery-basilar artery in the 2 groups were significantly decreased(P<0.05),and the hemodynamic indexes in the observation group were better than those in the control group(P<0.05);(3)After treatment,the levels of NSE and ET in both groups decreased significantly(P<0.05),and the observation group was better than the control group(P<0.05).Conclusion:Tuian combined with acupuncture and moxibustion can effectively improve the clinical symptoms of patients with vertebral artery type cervical spondylosis.Its mechanism is related to the decrease of NSE and ET levels and the change of hemodynamics.
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