凌耀权++++++杨仁轩++++++邓聪++++++廖醒龙++++++高洁++++++郭程湘++++++余葆楠++++++王伟聪

[摘要] 目的 研究“畅气通络”手法联合针刺百会穴治疗椎动脉型颈椎病的效果及对血流速度的影响。 方法 选取广东省中医院珠海医院康复科2014年10月～2016年10月收治的90例椎动脉型颈椎病患者为研究对象，将患者抽签随机分为实验组与对照组，每组45例。实验组给予“畅气通络”手法联合针刺百会穴治疗，对照组给予基础西药治疗。比较两组治疗前后症状积分、颈椎活动度，以及左侧椎动脉、右侧椎动脉、基底动脉的平均血流速度（Vm）。 结果 治疗后，两组头痛、眩晕、耳鸣、视物不清、颈痛等症状积分均较治疗前显著降低（P < 0.05），且实验组治疗后头痛、眩晕、耳鸣、视物不清、颈痛等症状积分均明显低于对照组，差异有统计学意义（P < 0.05）。治疗后，两组颈椎活动度均较治疗前提高（P < 0.05），且实验组治疗后颈椎活动度明显高于对照组，差异有统计学意义（P < 0.05）。两组左侧椎动脉、右侧椎动脉及基底动脉Vm均较治疗前提高（P < 0.05），且治疗后实验组左侧椎动脉、右侧椎动脉及基底动脉Vm均明显高于对照组，差异有统计学意义（P < 0.05）。 结论 “畅气通络”手法联合针刺百会穴治疗椎动脉型颈椎病效果顯著，可明显提高颈椎活动度，缓解患者临床症状，其主要作用机制可能与提高椎动脉及基底动脉Vm有关。

[关键词] 颈椎病；畅气通络；针刺；百会穴；血流速度

[中图分类号] R681.55 [文献标识码] A [文章编号] 1673-7210（2017）06（a）-0082-05

Curative effect of "Changqi Tongluo" manipulation combined with acupuncture in Bǎihuì acupoint in the treatment of cervical spondylosis and its influence on the blood flow velocity

LING Yaoquan1 YANG Renxuan1 DENG Cong1 LIAO Xinglong2 GAO Jie2 GUO Chengxiang3 YU Baonan1 WANG Weicong1

1.Department of Rehabilitation， Zhuhai Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine， Guangdong Province， Zhuhai 519015， China； 2.Department of Rehabilitation， Zhuhai Second Hospital of Traditional Chinese Medicine， Guangdong Province， Zhuhai 519125， China； 3.Guo's Medical Care Institute of Guangdong， Guangdong Province， Guangzhou 510120， China

[Abstract] Objective To investigate the effect of "Changqi Tongluo" manipulation combined with acupuncture in Bǎihuì acupoint in the treatment of vertebral artery type of cervical spondylosis and its influence on the blood flow velocity. Methods Ninety patients with vertebral artery type of cervical spondylosis admitted to Department of Rehabilitation， Zhuhai Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine from October 2014 to October 2016 were selected as research objects， and they were randomly divided into experimental group and control group by draw method， with 45 cases in each group. The experimental group was given "Changqi Tongluo" manipulation combined with acupuncture in Bǎihuì acupoint， the control group was given basic western medicine. The symptom scores， cervical range of motion， and mean flow velocity （Vm） of left vertebroarterial artery， right vertebroarterial artery， basilar artery before and after treatment between the two groups were compared. Results After treatment， the symptom scores of headache， dizziness， tinnitus， blurred vision， neck pain in the two groups were all significantly lower than those before treatment （P < 0.05）， and the symptom scores of headache， dizziness， tinnitus， blurred vision， neck pain in the experimental group after treatment were significantly lower than those of the control group， the differences were statistically significant （P < 0.05）. After treatment， the cervical ranges of motion in the two groups were higher than those before treatment （P < 0.05）， and the cervical range of motion in the experimental group after treatment was significantly higher than that of the control group， the difference was statistically significant （P < 0.05）. After treatment， the Vm of left vertebroarterial artery， right vertebroarterial artery， basilar artery in the two groups were higher than those before treatment （P < 0.05）， and the Vm of left vertebroarterial artery， right vertebroarterial artery， basilar artery in the experimental group after treatment were significantly higher than those of the control group， the differences were statistically significant （P < 0.05）. Conclusion "Changqi Tongluo" manipulation combined with acupuncture in Bǎihuì acupoint in the treatment of vertebral artery type of cervical spondylosis has obvious curative effect， which can significantly improve the cervical range of motion， relieve the clinical symptoms， its main mechanism may be associated with the improvement of Vm of vertebroarterial artery and basilar artery.

[Key words] Cervical spondylosis； Changqi Tongluo； Acupuncture； Bǎihuì acupoint； Blood flow velocity

近年来，随着网络普及和高度信息化，以及办公和生活方式的转变，颈椎病的发病率持续增加[1]。颈椎病是一种以椎间盘组织退行性变为基础的疾病，椎动脉型颈椎病是其中一种常见类型，多见于中老年人，发病率较高，占颈椎病的20%～31%，且近年来发病年龄趋于年轻化[2]，其主要临床症状为头痛、眩晕、耳鸣、视物不清、颈痛及颈部运动功能受限等，给患者的日常工作和生活带来了极大的不便[3]。目前西医对椎动脉型颈椎病的治疗比较局限和单一，口服止晕及消炎镇痛等药物，甚至采取手术治疗，远期疗效不佳且副作用多。临床研究表明，推拿和针灸治疗椎动脉型颈椎病均取得了较好的效果，但笔者发现临床运用“畅气通络”手法联合针刺百会穴治疗椎动脉型颈椎病效果更佳，且安全性高。……