朱俊岭

[關键词] 颈性眩晕;葛根汤;针灸;临床疗效

[中图分类号] R255.3          [文献标识码] B          [文章编号] 1673-9701（2021）14-0151-04

Clinical efficacy of Modified Puerariae Decoction combined with acupuncture and moxibustion on patients with cervical vertigo

ZHU Junling

Department of Traditional Chinese Medicine， Shaoxing Central Hospital， Zhejiang， Shaoxing   312030， China

[Abstract] Objective To observe the clinical efficacy of Modified Puerariae Decoction combined with acupuncture and moxibustion on patients with cervical vertigo. Methods A total of 60 patients with cervical vertigo admitted to the outpatient of Department of Rheumatology in Traditional Chinese Medicine of Shaoxing Central Hospital from January 2016 to January 2019 were selected. They were divided into the treatment group （n=30） and the control group（n=30） according to the random number table method. Both the treatment group and the control group were treated with acupuncture and moxibustion. On the basis of acupuncture and moxibustion， the treatment group was treated with Modified Puerariae Decoction， which was decocted with water， one dose per day. The control group was treated with acupuncture and moxibustion alone. The course of treatment was 14 days in both groups. The visual analogue scale（VAS） scores were used to evaluate vertigo VAS score， headache VAS score and neck pain VAS score before and after treatment in the two groups， respectively. Results The total effective rate of the treatment group after treatment was significantly higher than that of the control group， with statistically significant difference（P<0.05）. After treatment， the VAS scores of headache， vertigo and neck pain in the treatment group were significantly lower than those before treatment（P<0.01 or P<0.05）. After treatment， the VAS scores of headache， vertigo and neck pain in the control group were significantly lower than those before treatment（P<0.05）. After treatment， the VAS scores of shoulder pain， headache， vertigo and neck pain in the treatment group were significantly lower than those in the control group（P<0.01 or P<0.05）. Conclusion Modified Puerariae Decoction combined with acupuncture and moxibustion is remarkably superior to the acupuncture and moxibustion alone in improving vertigo and relieving headache and neck pain. Therefore， it is worthy of clinical promotion.

[Key words] Cervical vertigo; Pueraria Decoction; Acupuncture and moxibustion; Clinical efficacy

颈性眩晕指由于颈部病变产生椎动脉供血不足所引起的眩晕，又称发作性眩晕，临床表现有时伴有恶心、呕吐、耳鸣、耳聋、眼球震颤等症状[1]。颈性眩晕在成年人中的发病率约为10%，在中老年人群中更为常见[2-4]。随着人们生活习惯的改变，颈性眩晕的发病年龄趋于年轻化，并且发病率逐渐增加[5-6]。颈性眩晕高发于老年人，病程长，且难治愈，严重患者影响工作及生活质量[7]。目前对颈性眩晕的治疗主要以药物治疗和手术治疗为主。然而，这些治疗方法疗效有限，并常伴有一定的不良反应[8]。笔者用葛根汤加味联合针灸治疗颈性眩晕30例，临床效果显著，现报道如下。

1 资料与方法

1.1 一般资料

60例颈性眩晕患者，全部来自绍兴市中心医院中医风湿科2016年1月至2019年1月门诊患者。按照随机数字表方法分为治疗组和对照组，每组各30例。两组患者临床检查提示均为颈椎退行性改变合并椎-基底动脉供血不足。其中，治疗组男12例，女18例;年龄20～67岁，平均（45.5±3.4）岁;病程5 d～9年。对照组男11例，女19例;年龄21～65岁，平均（42.3±2.1）岁;病程7 d～10年。两组患者的性别、年龄、病程等一般资料比较，差异无统计学差异义（P>0.05），具有可比性。

1.2 诊断标准

西医诊断标准：参照《中医骨伤科病症诊断疗效标准》中关于颈椎动脉型颈椎病的诊断标准的确定[9]。以主要表现为头晕目眩、视物旋转， 伴恶心呕吐、眼球震颤、耳鸣耳聋等。颈椎正侧位片或颈椎CT 提示颈椎退行性改变;彩色多普勒超声（TCD） 提示椎-基底动脉供血不足。