火针治疗痰浊上蒙型颈性眩晕的疗效

范春兰

摘 要 目的：評价火针治疗对椎 基底动脉血流动力学改变的影响。方法：收集2015年10月至2017年2月收治的痰浊上蒙型颈性眩晕患者100例，分为观察组50例，采用火针治疗，对照组50例，采用温针治疗，两组均每日治疗1次，共10次。采用临床症候评价量表对两组治疗前后的证候积分进行评定，用经颅多普勒超声检测基底动脉（BA）和左、右椎动脉（VA）的收缩期峰流速。结果：观察组和对照组治疗前的临床症候积分分别为（18.44±4.68）分和（16.94±4.67）分，组间差异无统计学意义（P=0.105）；在第2次治疗前分别为（11.78±3.64）分和（13.34±3.99）分，组间差异有统计学意义（P=0.001）；疗程结束后，分别为（7.34±2.81）分和（9.58±3.85）分，组间差异有统计学意义（t=2.511，P=0.014）。与治疗前比较，两组临床症候积分均有明显改善（P<0.001），且观察组优于对照组。两组治疗后的左VA、右VA、BA的收缩期峰流速均较治疗前改善（P<0.05）；观察组优于对照组（P<0.05）。结论：火针与温针均能有效改善椎 基底动脉血流动力学改变，但火针治疗明显优于温针。

关键词 颈性眩晕；针灸；血流动力学

中图分类号：R657.1 文献标志码：A 文章编号：1006-1533（2017）14-0029-03

Efficacy of fire needle in the treatment of cervical vertigo caused by phlegm turbidity

FAN Chunlan

（Nanmatou Community Health Service Center of Pudong New District， Shanghai 200125， China）

ABSTRACT Objective： To evaluate of the effect of fire needle therapy on the changes of vertebral basilar artery hemodynamics. Methods： One hundred cases of cervical vertigo caused by phlegm turbidity were selected from Oct. 2015 to Feb. 2017 and randomly divided into an observation group with 50 cases who were treated with fire needle and a control group with 50 cases and treated with warm needling， and bboth groups were treated once a day for 10 times. The clinical symptom rating scale was used to evaluate the syndrome score of the two groups before and after treatment， and the systolic peak velocities of basilar artery （BA） and left and right vertebral artery （VA） were measured by transcranial Doppler ultrasonography. Results： The clinical symptom scores of the observation group and the control group before treatment were （18.44±4.68） and （16.94±4.67）， and there was no significant difference between the two groups（P=0.105）. Before the second treatment， the scores were （11.78±3.64） and（13.34±3.99）， respectively， and the difference was statistically significant（P=0.001）. Compared with before treatment， the clinical symptom scores of the two groups were significantly improved（P<0.001）， and the observation group was better than the control group. The peak systolic velocities of left and right VA and BA after treatment in the two groups were better than those before treatment（P<0.05）. The observation group was better than the control group（P<0.05）. Conclusion： Both fire needling therapy and warm needling therapy can effectively improve the hemodynamic changes of the vertebrobasilar artery， but the fire needle treatment is better than the warm needle.

KEY WORDS necky vertigo； acupuncture and moxibustion； hemodynamics

颈性眩晕是由于颈椎病变引起的一种继发性眩晕，是一种慢性退行性疾患[1]，临床表现为眩晕、头痛、恶心、呕吐、耳鸣耳聋、视物不清、颈肩痛、失眠、心悸等症状。本病好发于40～60岁的人群，随着现代生活方式的改变，发病年龄呈下降趋势[2]。本病的中医辨证大多分为痰浊上蒙、风阳上扰、气血亏虚、肝肾阴虚4型[3]，其中痰浊上蒙型最为常见，临床发病率也较高[3-4]。本文报道采用火针治疗痰浊上蒙型颈性眩晕患者的疗效及对患者血管病变和血流动力学改变的影响。

1 资料与方法

1.1 一般资料

收集2015年10月至2017年2月上海市浦东新区南码头社区卫生服务中心门诊收治的颈性眩晕患者100例，均符合《颈椎病诊治与康复指南》（2010版）中诊断标准[5]，中医辨证分型参照2003年的《上海市中医病证诊疗常规》[3]，属痰浊上蒙型。……