發(fā)布時間：2018-05-30 19:38

  本文選題：頸性眩暈 + 四位一體　； 參考：《河南中醫(yī)藥大學》2016年碩士論文

【摘要】：目的:本課題旨在基于觀察研究頸性眩暈(cervical vertigo,CV)患者治療前后的椎-基底動脈血流速度、頸性眩暈癥狀與功能評估量表評分等指標,證實四位一體整脊法對CV具有良好的治療作用。方法:篩選河南省中醫(yī)院骨病二科2015年4月至2015年12月門診及病房的18-65歲的CV患者60例,均符合納入標準,設立治療組與對照組,其中治療組有30例患者,包含男性12例,女性18例,應用牽引、整脊手法、中藥湯劑半夏白術天麻湯口服及頸部功能鍛煉的方法,即四位一體整脊法。對照組有3 0例患者,其中男性1 1例,女性1 9例,運用常規(guī)手法,其余三項與治療組相同。兩組操作順序均為:牽引→手法→鍛煉→中藥,每天一次,10次為一療程,連續(xù)治療兩個療程,分別在治療前后觀察記錄每個患者的頸性眩暈癥狀與功能評估量表評分、椎-基底動脈血流速度等指標,評估兩組患者治療后恢復情況,記錄各項數(shù)據(jù)并給予統(tǒng)計學分析。結(jié)果:治療組治療后的椎-基底動脈血流速度、頸性眩暈癥狀與功能評估量表評分均高于對照組。治療組治療后頸性眩暈癥狀與功能評估量表評分為(25.02±2.42)分,對比對照組的(21.28±2.48)分,差異有統(tǒng)計學意義(p0.05);治療組治療后的左側(cè)椎動脈收縮峰期血流速度為(54.40±6.89)cm/s,右側(cè)椎動脈為(55.27±7.37)cm/s,基底動脈為(57.43±7.11)cm/s,對照組分別為左側(cè)椎動脈(50.57±6.73)c m/s,右側(cè)椎動脈(4 9.9 0±7.2 4)c m/s,基底動脈(5 2.3 7±6.9 5)c m/s,兩組血管分別比較差異均有統(tǒng)計學意義(p0.05)。治療組治療后的左側(cè)椎動脈舒張末期血流速度為(25.67±4.12)cm/s,右側(cè)椎動脈為(25.73±4.37)cm/s,基底動脈為(29.07±4.72)cm/s,對照組分別為左側(cè)椎動脈(23.37±4.33)cm/s,右側(cè)椎動脈(23.30±4.46)cm/s,基底動脈(26.60±4.40)cm/s,兩組血管分別比較差異均有統(tǒng)計學意義(p0.05)。最終治療組治愈10例,顯效14例,有效5例,無效1例,總有效率96.67%,對照組治愈6例,顯效8例,有效10例,無效6例,總有效率80.00%,兩組比較差異有統(tǒng)計學意義(P0.05)。兩組均無嚴重不良事件發(fā)生。通過對各個數(shù)據(jù)進行統(tǒng)計學分析,證明相對于采用常規(guī)手法的對照組,四位一體整脊法臨床治療效果更好,患者病情改善更佳。結(jié)論:經(jīng)過系統(tǒng)的臨床觀察、統(tǒng)計學分析,結(jié)果示:對照組與治療組患者病情均有改善,且在治療過程中均具有較高的安全性。四位一體整脊法在緩解患者眩暈等臨床癥狀體征、改善患者的生活與工作狀況、增加患者治療信心等方面均優(yōu)于對照組的治療方法,四位一體整脊法治療CV療效肯定,安全可靠。
[Abstract]:Objective: to investigate the blood flow velocity of vertebrobasilar artery, symptom and function evaluation scale of cervical vertigo before and after treatment in patients with cervical vertigo. It has been proved that the quadrilateral chiropractic method has a good therapeutic effect on CV. Methods: 60 CV patients aged 18-65 years from April 2015 to December 2015 in Department of Osteopathy, Henan traditional Chinese Medicine Hospital were selected, all of which met the inclusion criteria. A treatment group and a control group were set up. There were 30 patients in the treatment group, including 12 males. Eighteen cases of female were treated with traction, chiropractic manipulation, traditional Chinese medicine decoction Banxia Atractylodes Tianma decoction, oral administration and neck function exercise, that is, quadrilateral chiropractic method. There were 30 patients in the control group, including 11 males and 19 females. The other three items were the same as those in the treatment group. The operation order of the two groups was as follows: traction manipulation exercises Chinese medicine, 10 times a day as a course of treatment and two consecutive courses of treatment. The symptoms of cervical vertigo and the score of function evaluation scale were recorded before and after treatment. The blood flow velocity of vertebrobasilar artery was used to evaluate the recovery of the two groups after treatment and the data were recorded and analyzed statistically. Results: the blood flow velocity of vertebrobasilar artery, the symptom of cervical vertigo and the score of function evaluation in the treatment group were higher than those in the control group. The scores of symptom and function evaluation scale of cervical vertigo were 25.02 鹵2.42 in the treatment group and 21.28 鹵2.48 in the control group. The peak systolic velocity of left vertebral artery in treatment group was 54.40 鹵6.89 cm / s, the right vertebral artery was 55.27 鹵7.37 cm / s, the basilar artery was 57.43 鹵7.11 cm / s, the control group was 50.57 鹵6.73 cm / s, the right vertebral artery was 49.90 鹵7.2 cm / s, the basilar motility was 57.43 鹵7.11 cm / s, respectively. There were significant differences in blood vessels between the two groups (P 0.05). The end diastolic velocity of left vertebral artery was 25.67 鹵4.12 cm / s, the right vertebral artery was 25.73 鹵4.37 cm / s, the basilar artery was 29.07 鹵4.72 cm / s, the control group was 23.37 鹵4.33 cm / s of left vertebral artery, 23.30 鹵4.46 cm / s of right vertebral artery and 26.60 鹵4.40 cm / s of basilar artery respectively. In the final treatment group, 10 cases were cured, 14 cases were effective, 5 cases were effective, 1 case was ineffective. The total effective rate was 96.67%. In the control group, 6 cases were cured, 8 cases were effective, 10 cases were effective, 6 cases were ineffective, and the total effective rate was 80.005.The difference between the two groups was statistically significant (P 0.05). No serious adverse events occurred in both groups. Through the statistical analysis of the data, it was proved that compared with the control group, the four-in-one chiropractic therapy was more effective and the patient's condition was improved better. Conclusion: after systematic clinical observation and statistical analysis, the results showed that the patients in the control group and the treatment group were improved and had higher safety in the course of treatment. The four-in-one chiropractic method was superior to the control group in relieving the clinical symptoms and signs such as vertigo, improving the living and working condition of the patients, increasing the patients' confidence in treatment, etc. The curative effect of the four-in-one chiropractic therapy on CV was positive. Safe and reliable.
【學位授予單位】：河南中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R244.1

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