电针结合督脉熏灸治疗气血亏虚型椎-基底动脉供血不足性眩晕的临床观察

文章信息/Info

• Title:电针结合督脉熏灸治疗气血亏虚型椎-基底动脉供血不足性眩晕的临床观察

• 卷期:2024年22卷19期

• 作者:郭婷婷，刘瑜婕※

• 上海市芷江西路街道社区卫生服务中心中医科，上海，200070

• Author(s):Guo Tingting, Liu Yujie

• Shanghai West Zhijiang Road Community Health Service Center TCM Department

• 关键词 电针；督脉熏灸；气血亏虚；椎-基底动脉供血不足；眩晕

• Keywords:Electroacupuncture; Moxibustion of Governor Vessel; Deficiency of qi and blood; Vertebrobasilar artery insufficiency; Vertigo

• 摘要: 目的  探究电针结合督脉熏灸治疗气血亏虚型椎-基底动脉供血不足（VBI）性眩晕的临床疗效。 方法  选择174名气血亏虚型VBI性眩晕患者作为研究对象，选用随机数字表法分组，分别采用电针风池、足三里结合督脉熏灸大椎、命门与单纯电针、单纯督脉熏灸进行治疗，观察和比较患者治疗前后眩晕症状积分、中医临床证候积分以及经颅多普勒超声中双侧椎动脉及基底动脉的平均血流速度。 结果  电针组有效率87.93%、督脉熏灸组有效率74.14%、电针结合督脉熏灸组总有效率93.10％，电针结合督脉熏灸组优于电针组和督脉熏灸组 (P＜0.05)。三组治疗后中医临床证候积分、眩晕指数、TCD检查数值均有改善，其中电针结合督脉熏灸组改善明显并优于电针组和督脉熏灸组(P＜0.05)。 结论  电针结合督脉熏灸组治疗气血亏虚型VBI性眩晕疗效肯定，可以作为一种新的治疗方案为临床上治疗气血亏虚型VBI性眩晕提供方案。                                                                                                                                                                                

• Abstract To explore the clinical efficacy of electroacupuncture combined with Du Mai fumigation moxibustion on the treatment of  qi and blood deficiency type VBI. Methods  174 patients with qi blood deficiency type VBI were selected as the research objects, and randomly divided into groups by using the random number table method. They were treated with electro acupuncture at Fengchi, Zusanli combined with Dumai fumigation and moxibustion at Dazhui, Mingmen and simple electro acupuncture, and simple Dumai fumigation and moxibustion, respectively. Before and after treatment，the vertigo symptom score, TCM clinical syndrome score，average blood flow velocity of bilateral vertebral arteries and basilar arteries in transcranial Doppler ultrasound were observed and compared.  Results  The effective rate was 87.93% in the electroacupuncture group, 74.14% in the Dumai fumigation moxibustion group, and 93.10% in the electroacupuncture plus Dumai fumigation moxibustion group. The electroacupuncture plus Dumai fumigation moxibustion group was superior to the electroacupuncture plus Dumai fumigation moxibustion group (P<0.05). After treatment, the TCM clinical syndrome score, vertigo index and TCD examination value of the three groups were improved, and the improvement of the electroacupuncture combined with Dumai fumigation moxibustion group was obvious and better than that of the electroacupuncture group and Dumai fumigation moxibustion group (P<0.05).  Conclusion  The therapeutic effect of electroacupuncture combined with Du Mai fumigation moxibustion group on VBI vertigo of qi and blood deficiency type is positive, which can be used as a new therapeutic scheme for clinical treatment of VBI vertigo of qi and blood deficiency type.

  椎一基底动脉供血不足(Vertebro—basilar insuffieiency，VBI)是由于颈椎骨质病变、椎动脉粥样硬化、解剖异常等原因引起的椎基底动脉血管循环不畅[1]，属于中医 “眩晕”范畴，临床分型以气血亏虚证和风阳上扰证为主[2]。近年来，VBI性眩晕的患病率呈上升趋势[3]，且发病人群呈年轻化。多项研究表明，本病若反复发作会有相当一部分患者发展成为梗死型脑卒中[4-9]，应当引起临床重视。本研究试图以椎动脉、基底动脉血流速度和血液流变学改变是导致眩晕发生的主要原因为切入点，探讨电针结合督脉熏灸治疗VBI性眩晕的有效性和可行性，以期为临床上治疗气血亏虚型VBI性眩晕提供一种更为有效的治疗方案。