Abstract:

Objective　To explore the clinical application value of cervical vertebra positioning rotation manipulation combined with parallel insertion of multiple needles in patients with cervicogenic vertigo. Methods　A total of 124 patients with cervicogenic vertigo admitted to the Department of Orthopedics of Xi'an Hospital of Traditional Chinese Medicine from January 22 to December 2024 were selected and divided into a control group (62 cases) and an observation group (62 cases) by the random number table method. There were 28 males and 34 females in the control group; they were (45.29±3.83) years old; their course was 3(2, 5) years. There were 25 males and 37 females in the observation group; they were (45.32±3.78) years old; their course was 3(2, 5) years. The control group was given routine tuina treatment. The observation group was additionally treated with cervical vertebra positioning rotation manipulation combined with parallel insertion of multiple needles on this basis. The clinical efficacy, symptoms and influences [Modified Neck-related Vertigo Symptom and Function Assessment Scale (ESCV), Dizziness Handicap Inventory (DHI), Neck Disability Index (NDI)], the blood flow velocity of vertebrobasilar artery [blood flow velocity of basilar artery (BA), blood flow velocity of left vertebral artery (LVA), and blood flow velocity of right vertebral artery (RAV)], and neck pain [Visual Analogue Scale (VAS)] of the patients in the two groups were compared. The statistical methods were t test, Mann-Whitney U test and χ² test. Results　The total effective rate of the observation group was 93.55% (58/62), which was higher than 80.65% (50/62) of the control group, and the difference was statistically significant (P<0.05). After treatment, the ESCV scores of the observation group were higher than those of the control group [25.46±2.50 vs. 20.18±2.32, (35.28±3.16) cm/s vs. (32.15±3.10) cm/s, (37.05±3.20) cm/s vs. (34.98±3.22) cm/s, and (35.89±3.09) cm/s vs. (33.15±3.02) cm/s], and the scores of DHI, NDI, natural state and pain during pressing were lower than those of the control group (30.32±5.09 vs. 38.25±5.48, 10.12±1.98 vs. 14.05±2.08, 2.12±0.88 vs. 3.18±0.95, and 3.15±0.90 vs.4.12±0.98), the differences were statistically significant (all P<0.05 ). In the control group, 1 case (1.61%) had mild soreness discomfort, and 2 cases (3.23%) in the observation group had soreness or transient dizziness at the acupuncture site, the difference was not statistically significant (P>0.05). Conclusion　Cervical vertebra positioning rotation manipulation combined with parallel insertion of multiple needles for the treatment of cervicogenic vertigo can more effectively relieve vertigo symptoms, improve cervical vertebra dysfunction, and increase the blood flow velocity of vertebrobasilar artery compared with routine tuina therapy, and it has good value for clinical promotion and application.

Key words:

Cervicogenic vertigo, Cervical vertebra positioning rotational traction manipulation, Parallel insertion of multiple needles, Dizziness handicap, Cervical spine dysfunction

摘要：

目的　探讨颈椎定位旋转扳法联合排针平刺在颈源性眩晕患者中的临床应用价值。方法　采用前瞻性随机对照研究设计，选取2022年1月至2024年12月西安市中医医院骨科收治的颈源性眩晕患者124例，采用随机数字表法分为对照组（62例）和观察组（62例）。对照组男28例、女34例，年龄（45.29±3.83）岁，病史3（2，5）年，给予常规推拿治疗；观察组男25例、女37例，年龄（45.32±3.78）岁，病史3（2，5）年，在对照组基础上加用颈椎定位旋转扳法联合排针平刺。两组均每日治疗1次，5 d/周，共治疗4周。对比两组患者临床疗效、症状及影响［改良颈性眩晕症状与功能评估量表（ESCV）、眩晕残障程度评定量表（DHI）、颈椎功能障碍指数（NDI）］、椎基底动脉血流速度［基底动脉血流速度（BA）、左椎动脉血流速度（LVA）、右椎动脉血流速度（RAV）］及颈部疼痛［视觉模拟评分（VAS）］变化情况。统计学方法采用t检验、Mann-Whitney U检验或χ²检验。结果　观察组总有效率为93.55%（58/62），高于对照组的80.65%（50/62），差异有统计学意义（P<0.05）。治疗后，观察组ESCV评分［（25.46±2.50）分］及BA［（35.28±3.16）cm/s］、LVA［（37.05±3.20）cm/s］、RAV［（35.89±3.09）cm/s］均高于对照组［（20.18±2.32）分、（32.15±3.10）cm/s、（34.98±3.22）cm/s、（33.15±3.02）cm/s］，DHI［（30.32±5.09）分］、NDI［（10.12±1.98）分］、自然状态［（2.12±0.88）分］、按压时疼痛评分［（3.15±0.90）分］均低于对照组［（38.25±5.48）分、（14.05±2.08）分、（3.18±0.95）分、（4.12±0.98）分］，差异均有统计学意义（均P<0.05）。对照组有1例（1.61%）出现轻度酸胀不适，观察组有2例（3.23%）出现针刺部位酸胀感或一过性头晕，差异无统计学意义（P>0.05）。结论　与常规推拿疗法相比，颈椎定位旋转扳法联合排针平刺治疗颈源性眩晕患者可有效缓解眩晕症状，改善颈椎功能障碍，提高椎基底动脉血流速度，具有良好的临床推广应用价值。

关键词:

眩晕, 颈椎定位旋转扳法, 排针平刺, 眩晕残障, 颈椎功能障碍