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头穴透刺治疗椎-基底动脉供血不足性眩晕

[Penetrating needling on head points for vertigo caused by vertebral-basilar arterial blood-supply insufficiency].

作者信息

Qi Xiu-jie, Wang Shun

机构信息

TCM School of Hainan Medical College, Haikou 571101, China.

出版信息

Zhongguo Zhen Jiu. 2011 Jun;31(6):503-7.

Abstract

OBJECTIVE

To observe the differences in therapeutic effect between penetrating needling on head points and acupuncture of syndrome division in the treatment of vertigo caused by vertebral-basilar arterial blood-supply insufficiency.

METHODS

Sixty cases of vertigo caused by vertebral-basilar arterial blood-supply insufficiency were divided into 2 groups: a penetrating needling on head points group (group A) and an acupuncture of syndrome division group (group B), 30 cases in each one. In group A, penetrating needling technique was applied from Baihui (GV 20) towards Qianding (GV 21), Shuaigu (GB 8) towards Qubin (GB 7) and Yuzhen (BL 9) towards Tianzhu (BL 10). Electric stimulation was added. In group B, the acupoints were selected according to syndromes. For example, upper disturbance of wind yang: Ganshu (BL 18), Xingjian (LR 2),etc. were selected; upper disturbance of turbid phlegm: Yinlingquan (SP 9), Fenglong (ST 40), etc. were selected; qi and blood deficiency: Baihui (GV 20), Xuehai (SP 10), etc. were selected; liver and kidney yin deficiency: Ganshu (BL 18), Shenshu (BL 23), etc. were selected. Electric stimulation and needling manipulation were conducted on those acupoints. Ten treatments made one session. After continuous 2 sessions of treatment, the efficacy, symptom score and physical sign score were compared between two groups. Transcranial Doppler (TCD) examination was done to observe hemodynamic changes of anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) before and after treatment.

RESULTS

The total effective rate in group A was 96.7% (29/30) that was obviously better than 83.3% (25/30) in group B (P<0.05). The scores of vertigo degree, vertigo frequency, duration and accompanied symptoms after treatment were lower obviously as compared with those before treatment in two groups (all P<0.05). The improvements in group A were much significant (all P<0.05). The highest mean velocity(Vm) of bilateral MCA, ACA and PCA were apparently reduced after treatment in two groups (P< 0.05, P<0.01). The improvements in group A were much more apparently (all P<0.05).

CONCLUSION

The penetrating needling on head points can effectively relieve vertigo caused by vertebral-basilar arterial blood-supply insufficiency, reduce the attack frequency and improve in its accompanied symptoms. Its clinical efficacy is significantly superior to that in acupuncture of syndrome division group.

摘要

目的

观察头部穴位透刺与辨证针刺治疗椎-基底动脉供血不足性眩晕的疗效差异。

方法

将60例椎-基底动脉供血不足性眩晕患者分为2组:头部穴位透刺组(A组)和辨证针刺组(B组),每组30例。A组采用从百会(GV 20)透向囟会(GV 21)、率谷(GB 8)透向曲鬓(GB 7)、玉枕(BL 9)透向天柱(BL 10)的透刺手法,并加电针刺激。B组根据辨证选穴,如肝阳上扰证选肝俞(BL 18)、行间(LR 2)等;痰浊上扰证选阴陵泉(SP 9)、丰隆(ST 40)等;气血亏虚证选百会(GV 20)、血海(SP 10)等;肝肾阴虚证选肝俞(BL 18)、肾俞(BL 23)等。对所选穴位进行电针刺激及针刺手法操作。10次治疗为1个疗程。连续治疗2个疗程后,比较两组疗效、症状评分及体征评分。治疗前后行头颅多普勒(TCD)检查,观察大脑前动脉(ACA)、大脑中动脉(MCA)及大脑后动脉(PCA)的血流动力学变化。

结果

A组总有效率为96.7%(29/30),明显优于B组的83.3%(25/30)(P<0.05)。两组治疗后眩晕程度、眩晕频率、持续时间及伴随症状评分均较治疗前明显降低(均P<0.05),A组改善更显著(均P<0.05)。两组治疗后双侧MCA、ACA及PCA的最高平均血流速度(Vm)均明显降低(P<0.05,P<0.01),A组改善更明显(均P<0.05)。

结论

头部穴位透刺能有效缓解椎-基底动脉供血不足性眩晕,降低发作频率,改善伴随症状,其临床疗效明显优于辨证针刺组。

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