Chen Dong, Zhong Jian, Hong Yan-Bo, Chen Da-Dian, Deng Lie-Hua, Cai Ming-Xue, Zhang Yue-Juan, Lin Xiu-Hua, Zheng Fu-Shi
Department of New Medicine and Needle-Pricking Therapy, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
Zhen Ci Yan Jiu. 2009 Oct;34(5):344-8.
To observe the effect of needle-pricking bleeding combined with pulling-rotating manipulation and simple manipulation on blood rheology in vertebral artery type cervical spondylosis (VATCS) patients, so as to analyze their mechanisms in relieving VATCS.
A total of 198 VATCS patients were randomly divided into treatment group (n=101) which was treated with needle-pricking plus pulling-rotating manipulation, and control group (n=97) which was treated with simple pulling-rotating manipulation, according to the random number table. The treatment was given once every 7 days, 9 times altogether. The peak systolic blood flow velocity (Vpeak), end-diastolic blood velocity (Vmin), pulsatility index (PI) and resistent index (RI) of bilateral vertebral arteries (VA) and basilar artery (BA) were detected by transcranial doppler sonography (TCD). Whole blood apparent viscosity and the plasma viscosity in the treatment group were determined by using a blood viscosimeter.
Of the 101 and 97 VATCS cases in the treatment and control groups, 62 (61.38%) and 12 (12.37%) were cured basically, 23 (22.77%) and 26 (26.80%) experienced marked improvement, 14 (13.86%) and 41 (42.27%) were improved. 2 (1.98%) and 18 (18.55%) failed in the treatment, with the total effective rates being 98.01% and 81.44% separately. The effective rate of the treatment group was significantly higher than that of control group (P<0.05). Compared with pretreatment, Vpeak and Vmin of the bilateral VA and BA in the treatment group, and Vpeak of the right VA in the control group increased significantly (P<0.01, P<0.05), PI and RI of the bilateral VA and BA in the treatment group, and PI and RI of the right VA in the control group decreased significantly (P<0.01, P<0.05), suggesting a marked reduction of the vascular resistance and an apparent increase of the cerebral blood supply after the treatment. The therapeutic effects of the above-mentioned indexes of 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).
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.
观察针刺放血结合拔伸旋转手法与单纯手法对椎动脉型颈椎病（VATCS）患者血液流变学的影响，分析其治疗VATCS的作用机制。
将198例VATCS患者按随机数字表法随机分为治疗组（n = 101）和对照组（n = 97）。治疗组采用针刺加拔伸旋转手法治疗，对照组采用单纯拔伸旋转手法治疗。治疗每7天1次，共9次。采用经颅多普勒超声（TCD）检测双侧椎动脉（VA）及基底动脉（BA）的收缩期峰值血流速度（Vpeak）、舒张末期血流速度（Vmin）、搏动指数（PI）及阻力指数（RI）。治疗组采用血液粘度计测定全血表观粘度和血浆粘度。
治疗组101例、对照组97例VATCS患者中，基本治愈分别为62例（61.38%）和12例（12.37%），显效分别为23例（22.77%）和26例（26.80%），有效分别为14例（13.86%）和41例（42.27%），无效分别为2例（1.98%）和18例（18.55%），总有效率分别为98.01%和81.44%。治疗组有效率显著高于对照组（P<0.05）。与治疗前比较，治疗组双侧VA及BA的Vpeak、Vmin，对照组右侧VA的Vpeak显著升高（P<0.01，P<0.05）；治疗组双侧VA及BA的PI、RI，对照组右侧VA的PI、RI显著降低（P<0.01，P<0.05），提示治疗后血管阻力明显降低，脑供血明显增加。治疗组上述指标的治疗效果显著优于对照组（P<0.05）。与治疗前比较，治疗组治疗后全血表观粘度（高、中、低切变率）及血浆粘度明显降低（P<0.01，P<0.05）。
针刺疗法结合拔伸旋转手法能显著改善VATCS患者的临床症状，这可能与其降低血管血流阻力、血液粘度及增加脑供血的作用密切相关。
