电针晕听区治疗后循环缺血性眩晕（痰湿中阻型）的临床研究

发布时间：2018-01-05 13:09

本文关键词：电针晕听区治疗后循环缺血性眩晕（痰湿中阻型）的临床研究　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的观察后循环缺血性眩晕(痰湿中阻型)的患者,在西医给予相同内科治疗的基础上,电针晕听区结合辨证选穴与单纯辨证选穴对患者眩晕症状的改善情况,通过头颅多普勒超声(TCD)观察治疗前后患者基底动脉(BA)、左侧椎动脉(LVA)和右侧椎动脉(RVA)峰值血流速度及其血管搏动指数的变化情况,探讨电针晕听区对于改善患者眩晕症状的作用机制,为后循环缺血性眩晕(痰湿中阻型)的中西医综合治疗提供新的方法。方法研究对象来自河南中医药大学第一附属医院,脑病三区住院病人,挑选西医诊断为“后循环缺血”、中医诊断“为眩晕(痰湿中阻型)”患者。将所选取的60例病人随机分成对照组(辩证选穴)和治疗组(电针晕听区结合辩证选穴),每组患者均为30例。在相同西医内科治疗的基础上,两组患者给予不同的针刺方法,对照组:辨证选穴进行普通针刺;治疗组:电针晕听区结合辨证选穴。晕听区操作方法:针刺晕听区后接入电针仪,给予连续波,电针刺激强度以患者舒适为度,同时结合辨证选穴进行普通针刺。两中针刺治疗方法在针刺后均留针30min,每天1次,7天为1疗程,共治疗2疗程,每个疗程期间休息1天。疗效评定方法:根据记录患者治疗前1天及治疗15天后中医证候积分和BA、LVA、RVA的收缩期峰值血流速度(Vs)、搏动指数(PI)的改变情况,评定两组治疗效果,判定临床疗效。结果1.统计治疗前后患者眩晕中医证候积分量表的相关数据,通过治疗前后组内比较,对照组P=0.049,治疗组P=0.014,P0.05,两组治疗后眩晕的中医证候积分均可明显改善;统计两组治疗后眩晕的证候积分,P=0.011,P0.05,治疗组对于证候积分的改善情况优于对照组。2.两组组内相比,两组治疗前后对照组:P_B=0.001、P_L=0.001、P_R=0.001;治疗组P_B=0.001、P_L=0.001、P_R=0.001:两组P0.05,两组疗效均可增强患者BV、RVA、LVA的收缩期峰值血流速度。治疗后两组组间相比P_B=0.004,P_L=0.011,P_R=0.002,P0.05,两组治疗对于峰值血流速度的改善差值相比,P_B=0.004,P_L=0.011,P_R=0.002.P0.05.治疗组对于增强患者双侧椎动脉及基底动脉峰值血流速度方面优于对照组。3.两组治疗前后对照组:P_B=0.03、P_L=0.001、P_R=0.001;治疗组P_B=0.02、P_L=0.001、P_R=0.001;两组P0.05,两组疗效均降低患者BV、RVA、LVA的动脉搏动指数。治疗后两组相比P_B=0.233,P0.05.P_L=0.003,P_R=0.009.P0.05;两组差值相比P_B=0。151,P0.05.P_L=0.004、P_R=0.045.P0.05.两组针刺方法均可降低基底动脉及双侧椎动脉搏动指数,且治疗组能更好的降低双侧椎动脉的搏动指数。对于基底动脉搏动指数降低情况,两组无明显差异。结论1.电针晕听区可增强BA、LVA、RVA的收缩期峰值血流速度,同时降低LVA、RVA的搏动指数,对于BA的搏动指数无明显效果。2.电针晕听区主要对患者眩晕的症状的改善程度较为明显,对于患者其的相关伴随症状如视物模糊、肢体麻木等改善程度不太明显。3.电针晕听区对于轻证单纯性眩晕症状比较明显的患者疗效显著,对于病情严重且伴随症状较多的患者疗效不太明显。4.后循环缺血的发病较急,缺血的主要原因是动脉粥样硬化,针刺和西药虽不能改变脑血管的硬化病变,但西医内科治疗在缺血时可增强缺血部位的脑血流量,改善头部供血,同时针刺对于中医证候的调整有着重要的意义。西药配合针刺可以缩短治疗时间,提高临床治愈率,因而对后循环缺血性眩晕的治疗应该长期坚持中西医结合。
[Abstract]:Objective To observe the effect of posterior circulation ischemic vertigo (phlegm in the resistance type) patients, given the same treatment in western medicine on the improvement of electro acupuncture at Yunting area combined with dialectical point selection and simple dialectical point selection of vertigo patients, by transcranial Doppler ultrasound (TCD) were observed before and after treatment in patients with basilar artery (BA) the left vertebral artery, right vertebral artery (LVA) and (RVA) the changes of peak flow velocity and pulsatility index, electroacupuncture Yunting area mechanism for improving the symptoms of vertigo patients, for posterior circulation ischemic vertigo (phlegm in the resistance type) provides a new method of TCM and Western Medicine treatment methods. From the First Affiliated Hospital of Henan TCM University, three District encephalopathy inpatients, selected "western medicine for the diagnosis of posterior circulation ischemia", "TCM diagnosis of vertigo (phlegm in the resistance type) patients. 60 patients will be selected randomly divided into The control group (the dialectical point selection) and treatment group (acupuncture combined with dialectical point selection Yunting area), each group of patients were 30 cases. On the basis of the same Western medicine treatment, two groups of patients were given different acupuncture methods, the control group: the dialectical point selection of ordinary acupuncture; treatment group: Electroacupuncture Yunting region combination dialectical point selection. Yunting area operation method: Acupuncture at Yunting area access after electroacupuncture given continuous wave EA stimulation intensity patient comfort degree, combined with the dialectical point selection of ordinary acupuncture. Two acupuncture methods in acupuncture were for 30min, 1 times a day, 7 days for a total of 1 courses. The 2 course of treatment, each treatment during the 1 days of rest. The curative effect evaluation method: according to the records of patients before treatment, 1 days and 15 days after treatment of TCM syndrome integral and BA, LVA, RVA, peak systolic velocity (Vs), pulsatility index (PI) changes, evaluating therapeutic effect of the two groups, to determine the clinical efficacy. Results the patients with vertigo syndromes data related to the scores before and after treatment by 1. statistics, compared before and after treatment group, P=0.049 control group, P=0.014 treatment group, P0.05, TCM Syndromes of vertigo score can be significantly improved in two groups after treatment; statistical syndrome after treatment in two groups of vertigo points, P=0.011, P0.05, treatment for the group of syndrome score better than the control group.2. in the two groups compared to the control group before and after treatment in two groups: P_B=0.001, P_L=0.001, P_R=0.001; group P_B=0.001, P_L=0.001, P_R=0.001: two P0.05 group, two groups can be increased in patients with BV, RVA, peak systolic velocity of LVA. The two groups after treatment between the groups P_B=0.004, P_L=0.011, P_R=0.002, P0.05, compared two groups of treatment to improve the difference of the peak velocity of P_B=0.004, P_L=0.011, P_R=0.002.P0.05. treatment group for patients with enhanced bilateral vertebral artery and basilar artery peak blood The flow rate is better than the control group.3. and control group before and after treatment in two groups: P_B=0.03, P_L=0.001, P_R=0.001; group P_B=0.02, P_L=0.001, P_R=0.001; two P0.05 group, the efficacy of the two groups were decreased in patients with BV, RVA, LVA of the artery pulsatility index. The two groups after treatment compared with P_B=0.233, P0.05.P_L=0.003, P_R=0.009.P0.05; the difference between the two groups compared to P_B=0.151 P0.05.P_L=0.004, P_R=0.045.P0.05., two groups of acupuncture method can reduce the basilar artery and bilateral vertebral artery pulsatility index, and the treatment group can reduce the bilateral vertebral artery pulsatility index better. In the basilar artery pulsatility index decreased, no significant difference between the two groups. Conclusion the 1. EA Yunting area can enhance the BA, LVA, peak systolic velocity RVA at the same time, reduce LVA, RVA pulsatility index, the degree of improvement for the BA pulsatility index had no significant effect.2. electroacupuncture Yunting area mainly on patients with symptoms of dizziness is obvious, for In patients with symptoms such as blurred the numbness of the degree of improvement is not too obvious.3. EA Yunting area for light / simple vertigo symptoms in patients with obvious curative effect for patients with serious illness significantly, and with more symptoms was not obvious after.4. onset of lack of blood circulation is more acute, atherosclerosis is the main causes of ischemia, atherosclerosis of acupuncture and Western medicine can not change the blood vessels of the brain, but western medicine treatment can improve the cerebral blood flow in the ischemic area of ischemia, improve the blood supply to the head, while acupuncture has an important significance for the syndrome of traditional Chinese medicine combined with western medicine. Acupuncture can shorten the treatment time, improve the clinical cure rate, treatment the posterior circulation ischemic vertigo should insist on combining traditional Chinese and Western medicine.

【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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