针刀疏筋解结术对椎动脉型颈椎病患者眩晕及椎-基底动脉血流的影响OA

Objective To observe the clinical efficacy of needle-knife loosening technique for cervical spondylosis of vertebral artery type(CSA).Methods Seventy-six patients with CSA were randomly divided into a needle-knife group(38 cases,2 cases dropped out)and a medication group(38 cases,2 cases dropped out,1 case was excluded).The medication group was treated with oral flunarizine hydrochloride capsules,10 mg each time,once daily for 12 consecutive days.The needle-knife group was treated with needle-knife loosening technique at the nodal sites of the Taiyang meridian tendons in the neck and shoulder regions,such as the suboccipital triangle and the insertion of the levator scapulae muscle.The treatment was performed once every 4 days,for a total of 3 sessions.The evaluation scale for cervical vertigo(ESCV)and dizziness handicap inventory(DHI)scores were evaluated before and after treatment and during follow-up at 3 months after treatment.Transcranial Doppler ultrasound(TCD)was used to observe the mean blood flow velocity(Vm)of the left vertebral artery(LVA),right vertebral artery(RVA),and basilar artery(BA),as well as the pulsatility index(PI)and resistance index(RI)of the BA,before and after treatment.Clinical efficacy and safety were evaluated in the two groups.Results Compared before treatment,ESCV scores were increased and DHI scores were decreased after treatment and at follow-up in both groups(P＜0.05).Compared with post-treatment,the medication group showed a decrease in ESCV score and an increase in DHI score at follow-up(P＜0.05).After treatment and at follow-up,the ESCV scores in the needle-knife group were higher than those in the medication group(P＜0.05),while the DHI scores were lower than those in the medication group(P＜0.05).Compared before treatment,the LVA-Vm,RVA-Vm,BA-Vm were increased after treatment(P＜0.05),and BA-PI and BA-RI were decreased(P＜0.05)in both groups.The LVA-Vm and BA-Vm in the needle-knife group were higher than those in the medication group(P＜0.05,P＜0.01),while BA-PI and BA-RI were lower than those in the medication group(P＜0.05,P＜0.01).The total effective rate in the needle-knife group was 94.4%(34/36),which was higher than 77.1%(27/35)in the medication group(P＜0.01).There were no adverse reactions in both groups.Conclusion The needle-knife loosening technique could improve vertigo symptoms and balance function in CSA patients and enhance the elasticity and mean blood flow velocity of the vertebrobasilar arteries.