CAJ | 학술논문

目的:比较挑刺结合牵旋手法与单纯牵旋手法对椎动脉型颈椎病(Artery Type of Cervical Spondylosis,CSA)椎基底动脉血液流变量、血管舒缩弹性、血液粘度的影响,探讨其作用机理.方法:将216例患者按数字表法随机分成2组,治疗组108例,采用挑刺结合牵旋手法治疗.对照组108例采用单纯牵旋手法治疗.即时经颅多普勒超声(Transcranial Doppler Sonography,TCD)进行左右双侧椎动脉(Vertebtal Arteries,VA)、基底动脉(Basilar Arteries,BA)的收缩峰期血流速度(Peak Systolic Blood Velocity,Vpeak)、舒张末期血流速度(End Diastolic Blood Velocity,Vmin)、搏动指数(Pulsatility Index,PI)、阻力指数(Resistant Index,RI)值检测,并检测治疗组治疗前、后全血表观粘度和血浆粘度值,比较两组治疗前后各指标变化情况.结果:治疗后治疗组双侧VA、BA的Vpeak、Vmin明显加快,接近或已经恢复至正常值范围,而VA、BA的PI及RI值有显著下降,与对照组比较差异有显著性(P<0.05),治疗组治疗后全血表观粘度和血浆粘度值比治疗前有明显改善(P<0.01,P<0.05).结论:针挑与牵旋手法能明显改善椎基底动脉血流及血管舒缩弹性,增加脑部血供,降低血流粘稠度.
목적:비교도자결합견선수법여단순견선수법대추동맥형경추병(Artery Type of Cervical Spondylosis,CSA)추기저동맥혈액류변량、혈관서축탄성、혈액점도적영향,탐토기작용궤리.방법:장216례환자안수자표법수궤분성2조,치료조108례,채용도자결합견선수법치료.대조조108례채용단순견선수법치료.즉시경로다보륵초성(Transcranial Doppler Sonography,TCD)진행좌우쌍측추동맥(Vertebtal Arteries,VA)、기저동맥(Basilar Arteries,BA)적수축봉기혈류속도(Peak Systolic Blood Velocity,Vpeak)、서장말기혈류속도(End Diastolic Blood Velocity,Vmin)、박동지수(Pulsatility Index,PI)、조력지수(Resistant Index,RI)치검측,병검측치료조치료전、후전혈표관점도화혈장점도치,비교량조치료전후각지표변화정황.결과:치료후치료조쌍측VA、BA적Vpeak、Vmin명현가쾌,접근혹이경회복지정상치범위,이VA、BA적PI급RI치유현저하강,여대조조비교차이유현저성(P<0.05),치료조치료후전혈표관점도화혈장점도치비치료전유명현개선(P<0.01,P<0.05).결론:침도여견선수법능명현개선추기저동맥혈류급혈관서축탄성,증가뇌부혈공,강저혈류점주도.
Objective: To compare the effects of needle pricking therapy plus rotating-pulling manipulation and rotating-pulling manipulation on blood velocity,angiokinesis,and blood viscosity in patients with vertebral artery type of cervical spondylosis(CSA),and discuss its mechanisms.Methods: 216 patients were randomly divided into 2 groups according to numeric representation,108cases in the treatment group were treated by needle pricking therapy plus rotating pulling manipulation,and 108 cases in the control group were treated by rotating pulling manipulation.The peak systolic blood velocity(Vpeak),end diastolic blood velocity(Vmin),pulsatile index(PI)and resistant index(RI)of the bilateral vertebral arteries(VA)and basilar arteries(BA)were examined by transcranial doppler sonography(TCD).The values of whole blood apparent viscosity and plasma viscosity of both groups were recorded.The indexes before and after treatment of both groups were compared.Results: The therapeutic effects of the above-mentioned indexes of the treatment group were significantly superior to those of the control group(P<0.05).In comparison with pre-treatment,the whole blood apparent viscosity(high,medium and low shear rates)and plasma viscosity of the treatment group post-treatment were obviously reduced(P<0.01,P<0.05).Conclusion: Needle pricking therapy combined with pulling-rotating manipulation can significantly improve VATCS patients' clinical symptoms,which may be closely related to its effects in lowering vascular blood resistance and blood viscosity and increasing cerebral blood supply.