青年高流速型颈性眩晕的治疗手法研究

目的:探讨旋转扳法和穴位推拿对青年高流速型颈性眩晕患者椎基底动脉(VBA)流速的影响和两种手法的疗效差异.方法:76例青年高流速型颈性眩晕患者随机分为旋转扳法组(A组,38例)和穴位推拿组(B组,38例),分别施加相应的治疗手法.应用经颅超声多普勒(TCD)检测手法治疗前后VBA流速并观察流速改变和临床疗效.结果:治疗1周后,B组左侧椎动脉(LVA)、基底动脉(BA)及A组BA流速明显下降(P＜0.05,P＜0.01),两组间LVA流速改变有显著性差异(P＜0.01);治疗3周后,A、B两组LVA、右侧椎动脉(RVA)、BA流速较治疗前均明显下降(P＜0.01),两组间LVA、RVA流速改变均有显著性差异(P＜0.01).B组疗效优于A组(P＜0.05).结论:在青年高流速型颈性眩晕的治疗手法中,穴位推拿对VBA流速的影响较旋转扳法明显,并可能具有比旋转扳法更好的疗效.

Study on the Treatment of Younger Cervical Vertigo of High Velocity Type by Manipulative Therapy

Objective: To explore the effect of rotatory reduction manipulation and acupoint massage on velocity of vertebrobasilar artery(VBA) in younger cervical vertigo of high velocity type,and observe the difference of clinical therapeutic effect between two manipulations.Methods:Seventy-six patients diagnosed as high velocity type of younger cervical vertigo were randomly divided into rotatory reduction manipulation group(group A,38cases) and acupoint massage group(group B,38 cases),both groups were given manipulative therapy correspondingly.The changes of velocity of VBA before and after treatment were observed using transcranial Doppler(TCD),and therapeutic effects were observed also.Results: One week after treatment,both the mean velocity in left vertebral artery(LVA) and basilar artery(BA) of group B and in BA of group A were significantly decreased as compared with those before treatment(P<0.05,P<0.01);There was significant difference in the change of mean velocity in LVA between two groups(P<0.01).Three weeks after treatment,the mean velocity in LVA,right vertebral artery(RVA) and BA were obviously lower than those before treatment in two groups(P<0.01);There was obvious difference in LVA,RVA between two groups(P<0.01).The therapeutic effects of group B was superior to that of group A(P<0.05).Conclusion: The effect of acupoint massage on velocity of VBA was superior to that of rotatory reduction manipulation,and the therapeutic effect of acupoint massage might be better than that of rotatory reduction manipulation in treating younger cervical vertigo of high velocity type.