头皮针长留针治疗椎动脉型颈椎病的临床研究

发布时间：2018-01-14 17:24

本文关键词：头皮针长留针治疗椎动脉型颈椎病的临床研究　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:运用头皮针为主治疗椎动脉型颈椎病(CSA)患者共64例,根据头皮针留针时间长短的不同分为两组,通过比较两组患者临床疗效及治疗前后《颈性眩晕症状与功能评估量表》评分和颈部血管相关TCD指标的影响,为临床选择头皮针最佳留针时间提供一定依据。方法:64例CSA患者随机分为观察组(头皮针长留针组)和对照组(头皮针短留针组)各32例,两组患者均采用头皮针双侧颞后线及针刺双侧风池穴、颈夹脊穴治疗。诸穴行常规针刺并留针,对照组头皮针留针2h后取针,观察组头皮针留针6h后取针,两组其余穴均留针0.5h后取针。所有患者每日治疗1次,连续治疗10天,并于治疗前后填写《颈性眩晕症状与功能评估量表》及行颈部血管TCD检查,记录量表评分及基底动脉(VBA)的Vp(收缩期峰值血流速度)、Vd(舒张末期血流速度)和Vm(平均血流速度)值,对相关数据进行统计学分析。结果:1、两组患者治疗前后《颈性眩晕症状与功能评估量表》积分的比较:两组患者治疗前后量表总分分别进行组内比较,有明显差异,具有统计学意义(P㩳0.05),经治疗后量表总分均较治疗前明显升高,说明两种治疗方法均对CSA患者症状与功能均有改善作用;两组患者治疗前后量表总分差值进行组间比较,有明显差异,具有统计学意义(P㩳0.05),表明经治疗后,在颈性眩晕症状与功能的总体改善程度上,观察组优于对照组。2、两组患者治疗前后量表各维度改善指数的比较:两组患者治疗前后量表各维度改善指数进行组间比较,在眩晕、头痛、日常生活及工作三个维度上,差异有统计学意义(P0.05),表明观察组在改善这三个维度上较对照组更具优势;在颈肩痛、心理及社会适应两个维度上,差异无统计学意义(P0.05),表明在这两个维度上,两组改善程度无明显差异。3、两组患者治疗前后基底动脉Vp、Vd、Vm值的比较:两组患者在治疗前,基底动脉Vp、Vd、Vm值分别与正常值比较,有明显差异,具有统计学意义(P㩳0.05),表明CSA患者上述值异常降低;两组患者治疗前后基底动脉Vp、Vd、Vm值进行组内比较,有明显差异,具有统计学意义(P㩳0.05),经治后上述异常降低的各值均明显升高,说明两种治疗方法均能使CSA患者异常降低的Vp、Vd、Vm值升高,对上述指标具有改善作用。4、两组患者治疗前后基底动脉Vp、Vd、Vm值差值的比较:两组患者治疗前后基底动脉Vp、Vm、Vd值之差值进行组间比较,有明显差异,具有统计学意义(P㩳0.05),表明观察组改善异常降低的上述值的作用优于对照组。5、两组患者临床疗效的比较:观察组治愈率为20.00%,显效率为46.67%,有效率为23.33%,无效率为10.00%,愈显率为66.67%,总有效率为90.00%;对照组治愈率为16.67%,显效率为20.00%,有效率为46.67%,无效率为16.67%,愈显率为36.67%,总有效率为83.33%。经统计学分析,两组总有效率比较差异性不明显(P0.05),无统计学意义;两组愈显率比较差异性明显(P㩳0.05),具统计学意义。结论:1、头皮针为主治疗CSA临床疗效肯定,能够改善患者《颈性眩晕症状与功能评估量表》评分,具有改善颈性眩晕症状与功能的作用,且对CSA患者基底动脉相关TCD指标具有改善作用;2、头皮针长留针组临床愈显率优于头皮针短留针组,且在改善眩晕、头痛、日常生活及工作三个维度上更具优势;3、头皮针长留针组对基底动脉相关TCD指标的改善优于头皮针短留针组。
[Abstract]:Objective: using scalp acupuncture treatment of cervical vertebral artery disease (CSA) patients in 64 cases, according to the different scalp acupuncture needle retention time for the two groups by comparing the clinical efficacy of the two groups before and after treatment the cervical vertigo symptoms and functional assessment scale > score and neck vascular TCD index effect in order to provide a basis for clinical choice of scalp acupuncture best needle retaining time. Methods: 64 cases of CSA patients were randomly divided into observation group (scalp acupuncture needle length group) and control group (scalp acupuncture group for short) of the 32 cases, two patients were treated with scalp acupuncture and acupuncture bilateral anterior temporal line bilateral Fengchi, Jiaji the acupuncture points for treatment. Routine acupuncture and scalp acupuncture needle needle, the control group 2h after acupuncture, scalp acupuncture observation group for 6h after the needle, the remaining two points were removed after 0.5h needle needle. All patients were treated for 1 times a day, for 10 consecutive days, and fill out the cervical vertigo in before and after treatment Dizzy symptoms and functional assessment scale "and the neck vascular TCD examination, record score and basilar artery scale (VBA) of the Vp (peak systolic velocity (Vd), end diastolic velocity (Vm) and the average blood flow velocity value), the relevant data were statistically analyzed. Results: 1. The comparative evaluation of neck vertigo symptoms and function scale before and after the < > integral of two groups of patients: two groups of patients before and after scores were compared within the group, there are significant differences, with statistical significance (P? 0.05), after treatment scores were significantly higher than those before treatment, two kinds of treatment methods are improved the role of CSA in patients with symptoms and the function were; two groups of patients before and after total score difference was compared between the two groups, there are obvious differences, with statistical significance (P? 0.05), showed that after the treatment, the symptom and function of the overall improvement, the observation group was better than that of According to.2, compared to the dimensions of improved index scale before and after treatment in two groups: two groups of patients before and after treatment to improve the scale of the dimension index were compared between two groups in dizziness, headache, three dimensions of daily life and work, the difference was statistically significant (P0.05), showed that the observation group in the improvement of the three a dimension has more advantages than the control group; in the neck and shoulder pain, psychological and social adaptation in two dimensions, the difference was not statistically significant (P0.05), show that in two dimensions, the improvement of the two groups had no significant difference between the two groups of patients before and after treatment of.3, basilar arterial Vp, Vd, Vm value the patients in the two groups before treatment, basilar artery Vp, Vd, Vm values were compared with normal value, have obvious differences, with statistical significance (P? 0.05), showed that CSA patients the abnormal values decreased; two groups of patients before and after treatment of basilar artery Vp, Vd, Vm values were compared within the group, there was significant difference statistically, Meaning (P? 0.05), after treatment after the abnormally low values were significantly increased, indicating that two methods both could make CSA patients with abnormal lower Vp, Vd, Vm value increased, can improve the effect of.4 on the index of two groups of patients before and after treatment of basilar artery Vp, Vd, the difference between Vm value: two groups of patients before and after treatment of basilar artery Vp, Vm, Vd difference values were compared between the two groups, there are obvious differences, with statistical significance (P? 0.05), the value of the observed group is better than the effect of improvement abnormal decrease of.5 in the control group, compared the clinical efficacy of the two groups: the observation group cure rate 20%, the effective rate was 46.67%, effective rate was 23.33%, no efficiency was 10%, the effective rate was 66.67%, the total effective rate was 90%; the control group cure rate was 16.67%, the effective rate was 20%, effective rate was 46.67%, no efficiency was 16.67%, the effective rate was 36.67%, the total effective rate was 83.33%. statistical analysis of two groups There is no obvious difference between efficiency (P0.05), no statistical significance; the two group rate difference significantly (P? 0.05), with statistical significance. Conclusion: 1. The clinical curative effect of the treatment of scalp acupuncture based CSA definitely can improve the evaluation of patients' cervical vertigo symptoms and function scale score >, with improvement of cervical vertigo symptoms and function, and the basilar artery in patients with CSA related TCD index has improved; 2, scalp needle long needle group clinical curative rate was superior to that of scalp acupuncture group in improving the short needle, dizziness, headache, has more advantages in three dimensions of daily life and work; 3, scalp needle long needle retention group of basilar artery TCD index was better than that of scalp acupuncture needle short group.

【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

【相似文献】