本文關(guān)鍵詞：電針暈聽區(qū)治療后循環(huán)缺血性眩暈（痰濕中阻型）的臨床研究　出處：《河南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的觀察后循環(huán)缺血性眩暈(痰濕中阻型)的患者,在西醫(yī)給予相同內(nèi)科治療的基礎(chǔ)上,電針暈聽區(qū)結(jié)合辨證選穴與單純辨證選穴對患者眩暈癥狀的改善情況,通過頭顱多普勒超聲(TCD)觀察治療前后患者基底動脈(BA)、左側(cè)椎動脈(LVA)和右側(cè)椎動脈(RVA)峰值血流速度及其血管搏動指數(shù)的變化情況,探討電針暈聽區(qū)對于改善患者眩暈癥狀的作用機(jī)制,為后循環(huán)缺血性眩暈(痰濕中阻型)的中西醫(yī)綜合治療提供新的方法。方法研究對象來自河南中醫(yī)藥大學(xué)第一附屬醫(yī)院,腦病三區(qū)住院病人,挑選西醫(yī)診斷為“后循環(huán)缺血”、中醫(yī)診斷“為眩暈(痰濕中阻型)”患者。將所選取的60例病人隨機(jī)分成對照組(辯證選穴)和治療組(電針暈聽區(qū)結(jié)合辯證選穴),每組患者均為30例。在相同西醫(yī)內(nèi)科治療的基礎(chǔ)上,兩組患者給予不同的針刺方法,對照組:辨證選穴進(jìn)行普通針刺;治療組:電針暈聽區(qū)結(jié)合辨證選穴。暈聽區(qū)操作方法:針刺暈聽區(qū)后接入電針儀,給予連續(xù)波,電針刺激強(qiáng)度以患者舒適為度,同時(shí)結(jié)合辨證選穴進(jìn)行普通針刺。兩中針刺治療方法在針刺后均留針30min,每天1次,7天為1療程,共治療2療程,每個療程期間休息1天。療效評定方法:根據(jù)記錄患者治療前1天及治療15天后中醫(yī)證候積分和BA、LVA、RVA的收縮期峰值血流速度(Vs)、搏動指數(shù)(PI)的改變情況,評定兩組治療效果,判定臨床療效。結(jié)果1.統(tǒng)計(jì)治療前后患者眩暈中醫(yī)證候積分量表的相關(guān)數(shù)據(jù),通過治療前后組內(nèi)比較,對照組P=0.049,治療組P=0.014,P0.05,兩組治療后眩暈的中醫(yī)證候積分均可明顯改善;統(tǒng)計(jì)兩組治療后眩暈的證候積分,P=0.011,P0.05,治療組對于證候積分的改善情況優(yōu)于對照組。2.兩組組內(nèi)相比,兩組治療前后對照組:P_B=0.001、P_L=0.001、P_R=0.001;治療組P_B=0.001、P_L=0.001、P_R=0.001:兩組P0.05,兩組療效均可增強(qiáng)患者BV、RVA、LVA的收縮期峰值血流速度。治療后兩組組間相比P_B=0.004,P_L=0.011,P_R=0.002,P0.05,兩組治療對于峰值血流速度的改善差值相比,P_B=0.004,P_L=0.011,P_R=0.002.P0.05.治療組對于增強(qiáng)患者雙側(cè)椎動脈及基底動脈峰值血流速度方面優(yōu)于對照組。3.兩組治療前后對照組:P_B=0.03、P_L=0.001、P_R=0.001;治療組P_B=0.02、P_L=0.001、P_R=0.001;兩組P0.05,兩組療效均降低患者BV、RVA、LVA的動脈搏動指數(shù)。治療后兩組相比P_B=0.233,P0.05.P_L=0.003,P_R=0.009.P0.05;兩組差值相比P_B=0。151,P0.05.P_L=0.004、P_R=0.045.P0.05.兩組針刺方法均可降低基底動脈及雙側(cè)椎動脈搏動指數(shù),且治療組能更好的降低雙側(cè)椎動脈的搏動指數(shù)。對于基底動脈搏動指數(shù)降低情況,兩組無明顯差異。結(jié)論1.電針暈聽區(qū)可增強(qiáng)BA、LVA、RVA的收縮期峰值血流速度,同時(shí)降低LVA、RVA的搏動指數(shù),對于BA的搏動指數(shù)無明顯效果。2.電針暈聽區(qū)主要對患者眩暈的癥狀的改善程度較為明顯,對于患者其的相關(guān)伴隨癥狀如視物模糊、肢體麻木等改善程度不太明顯。3.電針暈聽區(qū)對于輕證單純性眩暈癥狀比較明顯的患者療效顯著,對于病情嚴(yán)重且伴隨癥狀較多的患者療效不太明顯。4.后循環(huán)缺血的發(fā)病較急,缺血的主要原因是動脈粥樣硬化,針刺和西藥雖不能改變腦血管的硬化病變,但西醫(yī)內(nèi)科治療在缺血時(shí)可增強(qiáng)缺血部位的腦血流量,改善頭部供血,同時(shí)針刺對于中醫(yī)證候的調(diào)整有著重要的意義。西藥配合針刺可以縮短治療時(shí)間,提高臨床治愈率,因而對后循環(huán)缺血性眩暈的治療應(yīng)該長期堅(jiān)持中西醫(yī)結(jié)合。
[Abstract]:Objective To observe the effect of posterior circulation ischemic vertigo (phlegm in the resistance type) patients, given the same treatment in western medicine on the improvement of electro acupuncture at Yunting area combined with dialectical point selection and simple dialectical point selection of vertigo patients, by transcranial Doppler ultrasound (TCD) were observed before and after treatment in patients with basilar artery (BA) the left vertebral artery, right vertebral artery (LVA) and (RVA) the changes of peak flow velocity and pulsatility index, electroacupuncture Yunting area mechanism for improving the symptoms of vertigo patients, for posterior circulation ischemic vertigo (phlegm in the resistance type) provides a new method of TCM and Western Medicine treatment methods. From the First Affiliated Hospital of Henan TCM University, three District encephalopathy inpatients, selected "western medicine for the diagnosis of posterior circulation ischemia", "TCM diagnosis of vertigo (phlegm in the resistance type) patients. 60 patients will be selected randomly divided into The control group (the dialectical point selection) and treatment group (acupuncture combined with dialectical point selection Yunting area), each group of patients were 30 cases. On the basis of the same Western medicine treatment, two groups of patients were given different acupuncture methods, the control group: the dialectical point selection of ordinary acupuncture; treatment group: Electroacupuncture Yunting region combination dialectical point selection. Yunting area operation method: Acupuncture at Yunting area access after electroacupuncture given continuous wave EA stimulation intensity patient comfort degree, combined with the dialectical point selection of ordinary acupuncture. Two acupuncture methods in acupuncture were for 30min, 1 times a day, 7 days for a total of 1 courses. The 2 course of treatment, each treatment during the 1 days of rest. The curative effect evaluation method: according to the records of patients before treatment, 1 days and 15 days after treatment of TCM syndrome integral and BA, LVA, RVA, peak systolic velocity (Vs), pulsatility index (PI) changes, evaluating therapeutic effect of the two groups, to determine the clinical efficacy. Results the patients with vertigo syndromes data related to the scores before and after treatment by 1. statistics, compared before and after treatment group, P=0.049 control group, P=0.014 treatment group, P0.05, TCM Syndromes of vertigo score can be significantly improved in two groups after treatment; statistical syndrome after treatment in two groups of vertigo points, P=0.011, P0.05, treatment for the group of syndrome score better than the control group.2. in the two groups compared to the control group before and after treatment in two groups: P_B=0.001, P_L=0.001, P_R=0.001; group P_B=0.001, P_L=0.001, P_R=0.001: two P0.05 group, two groups can be increased in patients with BV, RVA, peak systolic velocity of LVA. The two groups after treatment between the groups P_B=0.004, P_L=0.011, P_R=0.002, P0.05, compared two groups of treatment to improve the difference of the peak velocity of P_B=0.004, P_L=0.011, P_R=0.002.P0.05. treatment group for patients with enhanced bilateral vertebral artery and basilar artery peak blood The flow rate is better than the control group.3. and control group before and after treatment in two groups: P_B=0.03, P_L=0.001, P_R=0.001; group P_B=0.02, P_L=0.001, P_R=0.001; two P0.05 group, the efficacy of the two groups were decreased in patients with BV, RVA, LVA of the artery pulsatility index. The two groups after treatment compared with P_B=0.233, P0.05.P_L=0.003, P_R=0.009.P0.05; the difference between the two groups compared to P_B=0.151 P0.05.P_L=0.004, P_R=0.045.P0.05., two groups of acupuncture method can reduce the basilar artery and bilateral vertebral artery pulsatility index, and the treatment group can reduce the bilateral vertebral artery pulsatility index better. In the basilar artery pulsatility index decreased, no significant difference between the two groups. Conclusion the 1. EA Yunting area can enhance the BA, LVA, peak systolic velocity RVA at the same time, reduce LVA, RVA pulsatility index, the degree of improvement for the BA pulsatility index had no significant effect.2. electroacupuncture Yunting area mainly on patients with symptoms of dizziness is obvious, for In patients with symptoms such as blurred the numbness of the degree of improvement is not too obvious.3. EA Yunting area for light / simple vertigo symptoms in patients with obvious curative effect for patients with serious illness significantly, and with more symptoms was not obvious after.4. onset of lack of blood circulation is more acute, atherosclerosis is the main causes of ischemia, atherosclerosis of acupuncture and Western medicine can not change the blood vessels of the brain, but western medicine treatment can improve the cerebral blood flow in the ischemic area of ischemia, improve the blood supply to the head, while acupuncture has an important significance for the syndrome of traditional Chinese medicine combined with western medicine. Acupuncture can shorten the treatment time, improve the clinical cure rate, treatment the posterior circulation ischemic vertigo should insist on combining traditional Chinese and Western medicine.

【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.6

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