旋提手法治疗椎动脉型颈椎病的时效性研究
Time-Effectiveness Study on the Treatment of Cervical Spondylosis of Vertebral Artery Type by Manipulation
张旭斌 1贺莉 1张宏蕾 1梁永胜 1李婉 1张法尧1
作者信息
- 1. 西安市中医医院(西安,710021);陕西中医药大学西安附属医院
- 折叠
摘要
目的:观察旋提手法对椎动脉型颈椎病患者眩晕症状改善的时效性及安全性.方法:选择2022年6月至2023年6月就诊的椎动脉型颈椎病患者90例,按随机数字表法随机分为全程手法组、亚急性期手法组、急性期-氟桂利嗪+亚急性期-手法组合组(以下称为A、B、C组),各30例,分别予48 h内开始手法治疗、48 h后开始手法治疗、48 h内服氟桂利嗪和48 h后手法治疗,疗程1周.应用椎动脉型颈椎病功能评估量表(FS-CSA)评分观察治疗前和治疗后第1,3,7天及1个月后随访患者的眩晕情况,观察治疗前后三组患者椎动脉超声血流动力学指标变化.记录不良反应.结果:治疗后三组患者眩晕改善有效率、临床控制率均较高,C组优于A、B组,差异无统计学意义(P＞0.05).治疗后三组患者的FS-CSA评分显著降低,差异有统计学意义(P＜0.01).组间对比,C组FS-CSA评分降低最明显,治疗后第3天更加显著,差异有统计学意义(P＜0.05或P＜0.01).治疗后三组患者的收缩期峰值流速(PSV)和舒张期末流速(EDV)明显增加,血管阻力指数(RI)明显降低,差异有统计学意义(P＜0.01).组间对比,治疗后右侧的PSV和左右两侧的EDV,C组明显优于A、B组(P＜0.05或P＜0.01).结论:旋提手法改善椎动脉型颈椎病眩晕症状的疗效明确,48 h内服用扩血管药物,48 h后再行旋提手法治疗,改善效果更佳.此研究可为手法分期治疗颈性眩晕方案的制定提供参考.
Abstract
Objective:To observe the timeliness and safety of lifting manipulation in the improvement of vertigo symptoms in patients with cervical spondylosis of vertebral artery type.Methods:From June 2022 to June 2023,90 patients with cervical spondylosis of vertebral artery type were selected.According to the random number table method,they were ran-domly divided into the whole manipulation group,the subacute manipulation group,the acute phase combined with flunari-zine,and the subacute phase combined with manipulation group(group A,B,C),with 30 cases in each group.The patients were given manual therapy within 48 h,after 48 h,flunarizine within 48 h and after 48 h,respectively.The course of treat-ment was 1 week.FS-CSA score was used to observe the vertigo of the patients before treatment,1,3,7 d after treatment and 1 month after follow-up.The changes of ultrasonic hemodynamic indexes of vertebral artery were observed before and after treatment in the three groups.Adverse reactions were recorded.Results:After treatment,the effective rate and clinical control rate of vertigo improvement in the three groups were higher,and group C was better than group A and group B(P＞0.05).After treatment,the FS-CSA scores of the three groups were significantly decreased(P＜0.01).Compared with the con-trol group,the FS-CSA score in group C decreased the most significantly,and it was more significant after 3 d of treatment(P＜0.05 or P＜0.01).After treatment,the PSV and EDV values of the three groups were significantly increased,and the RI value was significantly decreased(P＜0.01).After treatment,the PSV value of the right side and EDV value of the left and right sides in group C were significantly better than those in groups A and B(P＜0.05 or P＜0.01).Conclusion:The lifting maneuver is effective in improving the vertigo symptoms of cervical spondylosis of vertebral artery type.Taking vasodilator drugs within 48 h and applying the lifting maneuver after 48 h can improve the effect better.At the same time,this study can provide reference for the formulation of manual staged treatment of cervical vertigo.
关键词
椎动脉型颈椎病/旋提手法/眩晕/时效性Key words
cervical spondylosis of vertebral artery type/lifting technique/vertigo/effectiveness of time引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据