蒙医温针治疗椎动脉型颈椎病临床研究

【作者】 陈牧仁；

【导师】 阿古拉；

【作者基本信息】 北京中医药大学 ， 民族医学， 2011， 博士

【摘要】 研究目的蒙医学考证椎动脉型颈椎病及其病因、诱因、临床特征及治疗方法的基础上制定此病蒙医得色临床疗效观察标准并通过临床研究观察蒙医温针治疗椎动脉型颈椎病的疗效。研究方法一、通过蒙医文献研究考证和统计分析回顾性医案300例椎动脉型颈椎病患者的主要症状、诱发因素、病变部位、发病季节、生活环境、病人特性、病人年龄、生活习惯、病人体质、病变急缓等蒙医诊断疾病《十要素》内容,探讨椎动脉型颈椎病及其病因、诱因、临床特征及临床治疗方法。二、与其他蒙医传统疗法比较：将108例椎动脉型颈椎病患者随机分为3组,每组各36例,分别用蒙医温针、蒙医推拿和蒙医拔罐放血疗法治疗一个疗程。观察两组患者治疗前后临床症状、体征积分变化和总疗效,分析蒙医温针疗法对椎动脉型颈椎病患者的治疗效果和安全性。三、与中医针刺比较,将180例患者随机分为治疗组和对照组,每组各90例,分别用蒙医温针和中医针刺治疗一个疗程,观察两组患者治疗前后临床症状、体征积分变化和总疗效以及经颅彩色多普勒(TCD)、彩色超声观察指标基底动脉(BA)、椎动脉(VA),观测平均血流速度(Vm)、搏动指数(PI)、阻力指数(RI)及椎动脉血管内径的变化,分析蒙医温针疗法对椎动脉型颈椎病患者的治疗效果和安全性。研究结果一、通过蒙医文献研究考证和统计分析300例椎动脉型颈椎病患者的主要症状、诱发因素、病变部位、发病季节、生活环境、病人本性、病人年龄、病人体征、病人本性、生活习惯、病人体质、病变急缓等蒙医诊断疾病《十要素》内容,发现椎动脉型颈椎病属蒙医“赫依性眩晕”、“头部胡阳病”、头部“白脉病”范畴,病因为“赫依或赫依巴达干”所致,诱因为“伏案工作及睡姿不当”引起,临床特点为除眩晕等主症外多数患者均有失眠、多梦、健忘、注意力不集中、心悸等次要症状并主张蒙医针灸治疗等记载。且300例医案分析证明多数患者诸多《十要素》内容均具备了诱发赫依的条件。二、与其他蒙医传统疗法比较：A、B、C三组治疗后与组内治疗前比较治疗均有效,但三组患者在临床症状、体征积分变化方面A组与B、C组比较,P<0.05,有显著性意义,总有效率方面A组与B、C组比较,P<0.01,有极显著性意义。A组疗效优于B、C组。三、与中医针刺比较：1.两组治疗后,与组内治疗前比较,治疗均有效,但两组患者治疗结束时和一个月后随访时在临床症状、体征积分变化及总有效率比较,P<0.01,均有极显著性意义,治疗组疗效优于对照组。2.两组治疗后,经颅彩色多普勒(TCD)及彩色超声观察指标BA、VA的Vm、PI、RI及椎动脉血管内径比较差异有统计学意义(P<0.05或P<0.01),治疗组疗效优于对照组。研究结论一、本研究考证了蒙医对椎动脉型颈椎病认识及其病因、诱因、蒙医临床特点及治疗方法,为今后的研究提供了依据。二、蒙医温针是治疗椎动脉型颈椎病的有效方法,且具有操作方便、起效快、疗效维持时间长、副作用少、经济、安全等优点,临床上值得推广和应用。三、根据蒙医对椎动脉型颈椎病认识和临床特点制定了此病临床疗效观察标准,通过临床实验研究证明此标准具有全面性和科学性并体现了蒙医诊治疾病的整体观。更多还原

【Abstract】 Research purpose:According to Mongolian medicine textual criticism, vertebral artery cervical spondylosis and it’s spathogeny,remote cause clinical characteristic and clinical treatment technique.The observation standard of clinical mongolian medicine features is on that basis it. It observes the curative effect of Mongolia medicine needle warming moxibustion treatment of vertebral artery cervical spondylosis.Research techniques:一.According to Mongolian medicine literature research and statistical analysis,300 retrospective medical records and the main symptom and induced factors, pathology position, disease season, life environment, patients’natural instincts, ages, signs, life habits, physique and pathology speed and <<the ten main factors>> Mongolia medicine disease diagnose, discuss the Mongolian medicine pathogen of vertebral artery cervical spondylosis and it’s spathogeny,remote cause clinical characteristic and clinical treatment technique二.Compare it with other traditional Mongolian medicine treatment techniques,108 patients of vertebral artery cervical spondylosis are divided into 3 groups random and every 36 patients. Every group is treated with the needle warming moxibustion of Mongolian medicine, the massage of Mongolian medicine, the cupping therapy of Mongolian medicine separately, and observe the patients’changes of clinical manifestation and signs integral, and analyse the treatment effect and security of Mongolian medicine needle warming moxibustion to vertebral artery cervical spondylosis patients.三Compare it with the needle of traditional Chinese medical,108 patients are divided into treatment group and contrast group random, every 90. every group is treated a course with the needle warming moxibustion of Mongolian medicine and with the needle of traditional Chinese medical separately, and observe the change og the clinical symptom and signs integral According to TCD, with color ultrasound observing BV and VA, average Vm, PI, RI and the bore change of vertebral artery vessel, I analyse the treatment effect and security of Mongolian medicine needle warming moxibustion to vertebral artery cervicao spondylosis patients.Research results:一.According to Mongolian medicine literature research, textual research and statistical analysis,300 retrospective medical records and the main symptom of induced factors, pathology position, disease season, life environment, patients’natural instincts, ages, sign, life habits, physique and pathology speed and <<the ten main factors>> of Mongolia medicine disease diagnose, I find out that vertebral artery cervical spondylosis belongs to the category of heyi dizziness, huyang disease of head, whitevein of head, both most of the 300 retrospective medical records and the most of content of<< the ten main factors>> have qualification for inducing heyi. Pathogeny is caused by heyi or heyibadagan. Remote cause is bending over one’s desk working and wrong sleeping posture. Main clinical characteristic is dizziness, besides, sleepless, dreaminess, forgetful, aprosexia and palpitation, and these patients ask to be treated with needle acupuncture-moxibustion therapy. The analysis of 300 medical records prove that most of contents of <<the main ten factors>> have qualification for inducing heyi.二.Compare it with other traditional Mongolia medicine treatment:A, B and C, the three groups, compare after treatment with before treatment, the treatments are effective. But I compare the integral change of A group in clinical manifestation, sign, daily life and work, psychology and social fit ability with B and C, p<0.05, it has outstanding significance. In total efficiency, compare A group with B and C, p< 0.01. The curative effect of A group is better than B group. 三.Compare it with the needle of traditional Chinese medical:1. compare after treatment with before treatment, both are effective, but at the end of treatment and after a month, when following-up visit, compare the integral change patients’clinical manifestation, signs, daily life and work, psychology, and social fit ability with total efficiency, p<0.01, both have outstanding significance. The curative effect of treatment group is better than contrast group.2. After both groups are treated, according TCD and color ultrasound observing BA, the Vm of VA, PI and RI and the bore of vertebral artery vessel. The contrast differences have statistics significance. (p< 0.05, P< 0.01). The curative effect of treatment group is better than contrast group.Research conclusion:一.The research studies the Mongolian medicine cognition, pathogeny, remote cause, clinical Mongolian medicine characteristics and treatment technique of vertebral artery cervical spondylosis.It provides basis for following study.二.The needle warming moxibustion of Mongolian medicine is effective technique and operates easily, works effectively, maintains curative effect for a long time, has little side effect, doesn’t have to spend much money and it is safe. It is worth spreading and applying.三.I make the observation standard of clinical curative effect according to the knowledge and clinical characteristics of Mongolian medicine to vertebral artery cervical spondylosis. Clinical experiment research proves that the standard is global and scientific and embodies the wholeness of Mongolian medicine treatment.更多还原