[1]黄仁俊,全锐,于栋,等.定眩汤联合清宫正骨手法治疗痰浊上蒙型颈性眩晕的临床研究[J].中国中医骨伤科杂志,2024,32(09):21-25+30.[doi:10.20085/j.cnki.issn1005-0205.240905]
 HUANG Renjun,QUAN Rui,YU Dong,et al.Clinical Study of Dingxuan Decoction Combined with Qing's Palace Bone Setting Manipulation on the Treatment of Cervical Vertigo with Phlegm-Turbidity[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(09):21-25+30.[doi:10.20085/j.cnki.issn1005-0205.240905]
点击复制

定眩汤联合清宫正骨手法治疗痰浊上蒙型颈性眩晕的临床研究()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年09期
页码:
21-25+30
栏目:
临床研究
出版日期:
2024-09-15

文章信息/Info

Title:
Clinical Study of Dingxuan Decoction Combined with Qing's Palace Bone Setting Manipulation on the Treatment of Cervical Vertigo with Phlegm-Turbidity
文章编号:
1005-0205(2024)09-0021-05
作者:
黄仁俊12全锐12于栋2张云辉12方心2张清烽2刘侃2刘恒平2△李晋玉3△
1北京中医药大学(北京,100029)
2北京中医药大学第三附属医院
3北京中医药大学东直门医院
Author(s):
HUANG Renjun12QUAN Rui12YU Dong2ZHANG Yunhui12FANG Xin2ZHANG Qingfeng2LIU Kan2LIU Hengping2△LI Jinyu3△
1Beijing University of Chinese Medicine,Beijing 100029,China;
2Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;
3Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China.
关键词:
定眩汤 颈性眩晕 正骨手法 椎基底动脉系统 随机对照临床试验
Keywords:
Dingxuan decoction cervical vertigo bone setting manipulation vertebral basilar artery system randomized controlled trial
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.240905
文献标志码:
A
摘要:
目的:探讨定眩汤联合清宫正骨手法治疗痰浊上蒙型颈性眩晕患者疗效改善情况,评价联合治疗对血流动力学及颈椎矢状面参数的影响。方法:采用随机、双盲、安慰剂对照的设计方法,将80例患者随机分为观察组和对照组各40例,两组患者在均接受清宫正骨手法治疗的基础上(2次/周,30 min/次,治疗2周),观察组口服定眩汤颗粒,对照组口服定眩汤颗粒安慰剂,1袋/次,2次/d,治疗2周,比较两组患者血流动力学指标(左侧椎动脉流速、右侧椎动脉流速、血管收缩期最大流速)、颈性眩晕症状(颈性眩晕评价量表(ESCV)评分)、生存质量(生理健康总分、心理健康总分)、影像学检查指标(T1倾斜角、C2~7 Cobb角、C2~7矢状面轴向距离)四类指标治疗前后变化并进行统计学分析。结果:治疗后观察组的血流动力学指标(左侧椎动脉流速、右侧椎动脉流速、血管收缩期最大流速)和颈性眩晕评价量表评分、生理健康评分、心理健康评分均优于对照组,组间比较差异有统计学意义(P<0.05),影像学检查指标治疗前后差异均无统计学意义(P>0.05),两组患者在治疗期间均未发生不良反应。结论:定眩汤联合清宫正骨手法治疗痰浊上蒙型颈性眩晕在改善脑部供血状况方面发挥协同作用,在清宫正骨手法治疗基础上加用定眩汤对患者的眩晕症状恢复具有明显增效作用,且安全性较好。
Abstract:
Objective:To explore the efficacy of Dingxuan decoction combined with Qing's Palace bone setting manipulation on the treatment of cervical vertigo patients with phlegm and cloudiness,and to evaluate the effect of the combination treatment on hemodynamics and cervical spine sagittal plane parameters.Methods:80 patients were randomly divided into the observation group(40 patients)and the control group(40 patients)according to a randomized,double-blind,placebo-controlled design method.Based on both groups receiving Qing's Palace bone setting manipulation(2 times a week,30 min each time,2 weeks of treatment),the observation group orally took Dingxuan decoction granules,and the control group took Dingxuan decoction granules placebo,one sachet each time,2 times a day for 2 weeks of treatment.The hemodynamics of the two groups(left vertebral artery(LVA),right vertebral artery(RVA),peak systolic velocity(PSV)),cervical vertigo symptoms(evaluation scale for cervical vertigo(ESCV)score),quality of life(total physical health score,total mental health score),imaging(T1 tilt angle,C2-7 Cobb angle,C2-7 sagittal axial distance)before and after the treatment of the four types of indexes changes were compared and statistical analyzed.Results:The hemodynamic indexes(LVA,RVA,PSV),ESCV scores,physical health scores,and mental health scores of the observation group were better than those of the control group after treatment,and had statistically significant(P<0.05).There was no statistical difference in the imaging indexes before and after the treatment(P>0.05),and no adverse reactions occurred on the treatment period of the patients in both groups.Conclusion:The treatment of cervical vertigo of phlegm and cloudy cervical dizziness with Qing's Palace bone setting manipulation plays a synergistic role in improving the blood supply of the brain.The addition of Dingxuan decoction based on Qing's Palace bone setting manipulation has a significant synergistic effect on the recovery of vertigo symptoms of the patients,and the safety is good.

参考文献/References:

[1] DE VESTEL C,VEREECK L,REID S A,et al. Systematic review and meta-analysis of the therapeutic management of patients with cervicogenic dizziness[J].The Journal of Manual & Manipulative Therapy,2022,30(5):273-283.
[2] REILEY A S,VICKORY F M,FUNDERBURG S E,et al.How to diagnose cervicogenic dizziness[J].Archives of Physiotherapy,2017,7:12.
[3] LU J,SONG Q,ZHU Y,et al.The effect of acupuncture used for cervical spondylosis of vertebral artery type:a protocol for systematic review and meta-analysis[J].Medicine(Baltimore),2022,101(8):e28956.
[4] 谭曾德,王军,宋仲涛,等.经络点穴推拿联合曲度牵引对交感神经型颈椎病临床疗效的观察[J].海南医学院学报,2020,26(14):1098-1104.
[5] MACHALY S A,SENNA M K,SADEK A G.Vertigo is associated with advanced degenerative changes in patients with cervical spondylosis[J].Clinical Rheumatology,2011,30(12):1527-1534.
[6] 简家威,郑移兵,齐越峰.“清宫正骨”手法治疗椎动脉型颈椎病的诊疗特色[J].北京中医药,2022,41(9):1035-1037.
[7] 殷京,孙树椿,赵宝力,等.清宫正骨流派传承与其特色理筋手法运用探析[J].中华中医药杂志,2021,36(1):267-271.
[8] 李焰生.掌握正确的头晕眩晕诊断思路与方法:《眩晕诊治多学科专家共识》解读与启示[J].中国现代神经疾病杂志,2018,18(2):79-82.
[9] 中华外科杂志编辑部.颈椎病的分型、诊断及非手术治疗专家共识(2018)[J].中华外科杂志,2018,56(6):401-402.
[10] 《实用中医内科杂志》编辑部.眩晕的诊断依据、证侯分类、疗效评定——中华人民共和国中医药行业标准《中医内科病证诊断疗效标准》(ZY/T001.194)[J].实用中医内科杂志,2022,36(8):85.
[11] 孙树椿.清宫正骨手法图谱[M].北京:中国中医药出版社,2012:41-42.
[12] 马小闵,张春娇,孙敦坡,等.毫针速刺法联合颈舒颗粒治疗气滞血瘀型颈性眩晕的效果[J].实用医学杂志,2023,39(16):2136-2141.
[13] LIN Y,YU Y,ZENG J,et al.Comparing the reliability and validity of the SF-36 and SF-12 in measuring quality of life among adolescents in China:a large sample cross-sectional study[J].Health Qual Life Outcomes,2020,18(1):360.
[14] 邓元,倪斌.颈椎矢状序列测量方法的研究进展[J].中国脊柱脊髓杂志,2014,24(7):655-659.
[15] 曹胜,孔令伟,徐昆,等.颈椎矢状面序列参数对脊髓型颈椎病患者疼痛、颈椎功能及临床疗效的评估价值[J].中国组织工程研究,2022,26(3):419-424.
[16] 翟宏伟.椎动脉型颈椎病的发病机制[J].中国康复医学杂志,2006(7):668-670.
[17] 唐彬,朱立国,魏戌,等.颈痛颗粒治疗神经根型颈椎病临床应用专家共识[J].中国中药杂志,2023,48(8):2260-2264.
[18] 范淑敏.针刺配合功能锻炼治疗肝肾不足型颈性眩晕35例[J].中国针灸,2016,36(9):938.
[19] 李燕,谢淼,邵明莎,等.近10年来天麻的药理作用及化学成分研究进展[J].中华中医药学刊,2017,35(12):2987-2993.
[20] 武越,银河,陈琳,等.基于网络药理学的定眩汤治疗颈性眩晕的作用机制研究[J].世界中医药,2021,16(10):1501-1506.
[21] 葛胜宇,范琢玉,田玉顺,等.川芎的化学成分、药理作用及提取工艺的研究进展[J].吉林医药学院学报,2023,44(6):465-467.
[22] 孙华,刘颖,刘晓丽.桂枝葛根汤治疗颈性眩晕疗效及对血流动力学和血管内皮功能的影响[J].中国实验方剂学杂志,2023,29(15):96-102.
[23] 雷鸣,王美元.半夏白术天麻汤加减内服配合中药熏蒸治疗颈性眩晕56例[J].实用中医药杂志,2017,33(12):1375-1377.
[24] 孔亮,狄美琪,李超生,等.半夏白术天麻汤加减治疗椎-基底动脉供血不足性眩晕60例临床研究[J].中医杂志,2013,54(4):315-317.
[25] 赵国东,韩涛,王尚全,等.孙树椿应用清宫正骨手法联合中药治疗椎动脉型颈椎病临床经验[J].国际中医中药杂志,2021,43(10):1039-1040.
[26] 赵建,齐立卿,崔书国.定眩汤治疗椎动脉型颈椎病70例临床观察[J].河北中医药学报,1999,14(1):11.
[27] 王冠.中医针灸联合推拿手法治疗椎动脉型颈椎病临床疗效观察[J].世界中西医结合杂志,2016,11(2):207-210.
[28] 毛刚,刘磊,范广岩.颈晕定眩汤及熏蒸推拿并用对椎动脉型颈椎病患者血液流变学及椎动脉血流速度的影响[J].中国临床康复,2005(23):9-20.
[29] AHMED J A,AHMED K A,AHMED M H.Severe bilateral vertebral arterial disease masquerading as vertigo[J].Cureus,2023,15(12):e50410.
[30] 何天傲,皮红林.活血定眩汤配合针灸治疗椎动脉型颈椎病的临床疗效观察[J].中医药信息,2020,37(6):109-113.

备注/Memo

备注/Memo:
基金项目:北京中医药大学2020年重点攻关项目(2020-JYB-ZDGG-111)
北京中医药大学第三附属医院2022年度院内培育项目(BZYSY-2022-PYMS-18)
2022年北京中医药大学第三附属医院教育部工程研究中心项目(BZYSY-2022-GCYJZXQX-08)
通信作者 E-mail:leery_5566@163.com(李晋玉) zydsky@126.com(刘恒平)
更新日期/Last Update: 2024-09-05