31毫针齐刺治疗椎动脉型颈椎病142例.DOC

毫針齊刺治療椎動脈型頸椎病142例 涂小華鄧艷業孫華 （重慶市第三人民醫院康復醫學科） [摘要]目的探討毫針齊刺對椎動脈型頸椎病的治療效果。方法142例患者隨機分為針刺組68例，對照組74例，治療組用齊刺方法，主穴為雙側風池穴，對照組為西藥治療。兩組每天治療一次，總共治療30次後觀察治療效果，採用經顱多普勒（transcranial doppler, TCD）檢測臨床治療效果和椎基底動脈平均血流速（Vm）的改變情況。結果針刺組臨床總有效率為98.5％，西藥對照組臨床總有效率為79.7％，經統計學處理針刺組優於對照組（P0.01）；兩組治療前後對照，治療組椎基底動脈平均血流速度（Vm）改善明顯（P0.01），對照組椎基底動脈平均血流速度（Vm）改善不明顯（P0.05）。結論毫針齊刺是治療椎動脈型頸椎病的良好方法。 [關鍵詞]頸椎病；椎動脈型；針刺療法；齊刺 [Abstract] Propose To explore the curative effect of triple puncture on venrtebroartrial cervical spondylopathy by little needle. Methods one hundred Forty-two patients were randomly divided into the acupuncture treatment group (68 cases) and the western medicine control group (74 cases). The patients of the treatment group were treated with triple puncture, the main points are Fengchi point (two side), the patients of the control group were treated with western medicine. After 30 days, the two groups were compared with clinical effect and the changes of blood velocity. The clinical effect were observed and the blood supply from vertebrobaslar arteries was examined by transcranial doppler, (TCE). Results The total clinical effective rate of the treatment group was 98.5%, the western medicine control group was 79.7%. There was a significant difference between the treatment group and the control groups (P0.01). The changes of blood velocity of the two groups were compared self-control before and after treatment, the changes in Vm (mean blood velocity) were better in the acupuncture group than in the control group. There were significant differences between the the treatment group and the control groups (P0.01). Conclusion Acupuncture is a good treatment for vertebroarterial cervical spondylopathy. [Key words] Cervical spondylopathy; vertebroartrial type; Acupuncture therapy; Triple puncture 頸椎病是臨床常見病，椎動脈型頸椎病約佔10％左右，但椎動脈型頸椎病直接導致「椎-基底動脈供血不足」（VBI），表現為後循環缺血引起的肢體乏力、眩暈、共濟失調等症狀。對「椎-基底動脈供血不足」（VBI）進行早期干預，有效改善後循環缺血（posterior circulation ischema, PCI），對預防椎動脈缺血性腦血管病有着重大意義。目前臨床對椎動脈型頸椎病的治療多用西藥對症治療，但遠期療效欠佳，