关键词: calcitonin gene related peptide cervical vertigo hemodynamics hemorheology nape seven needles pressing moxibustion randomized controlled trial (RCT)

Mesh : Humans Male Moxibustion Female Middle Aged Adult Vertigo / therapy physiopathology Aged Acupuncture Therapy Calcitonin Gene-Related Peptide / blood Treatment Outcome Combined Modality Therapy Neuropeptide Y / blood Endothelin-1 / blood Acupuncture Points Young Adult

来  源:   DOI:10.13703/j.0255-2930.20230707-k0002

Abstract:
OBJECTIVE: To observe the clinical effect of nape seven needles combined with pressing moxibustion for cervical vertigo (CV).
METHODS: A total of 70 patients with CV were randomized into an observation group and a control group, 35 cases in each group. In the observation group, nape seven needles combined with pressing moxibustion was delivered, once a day, 6 times a week, for consecutive 2 weeks. In the control group, betahistine hydrochloride tablet and aceclofenac dispersible tablet were given orally, for 2 weeks and 3 days respectively. Before and after treatment, the evaluation scale for cervical vertigo (ESCV) score was observed, the plasma levels of neuropeptide Y (NPY), endothelin-1 (ET-1) and calcitonin gene related peptide (CGRP) were detected, the hemorheologic and hemodynamic indexes were measured, and the clinical efficacy was evaluated after treatment in the two groups.
RESULTS: After treatment, the scores of dizziness, daily life and work ability, psychological and social adaptability, and headache, as well as the total scores of ESCV were increased compared with those before treatment (P<0.01, P<0.05) in the two groups, and the score and total score of neck and shoulder pain of ESCV was increased compared with that before treatment (P<0.01) in the observation group; each sub-item score and total score of ESCV in the observation group were higher than those in the control group (P<0.01, P<0.05). After treatment, the plasma levels of NPY and ET-1 were decreased compared with those before treatment (P<0.01), while the plasma levels of CGRP were increased compared with those before treatment (P<0.01, P<0.05) in the two groups; the plasma levels of NPY and ET-1 in the observation group were lower than those in the control group (P<0.01), the plasma level of CGRP in the observation group was higher than that in the control group (P<0.01). After treatment, the whole blood high shear viscosity, plasma viscosity and whole blood low shear viscosity were decreased compared with those before treatment (P<0.01, P<0.05), the mean velocity of basilar artery (BA), left vertebral artery (LVA) and right vertebral artery (RVA) were increased compared with those before treatment (P<0.05) in the two groups; the whole blood high shear viscosity, plasma viscosity and whole blood low shear viscosity in the observation group were lower than those in the control group (P<0.01), and the mean velocity of BA, LVA and RVA in the observation group were higher than those in the control group (P<0.05). The total effective rate in the observation group was 91.4% (32/35), which was superior to 71.4% (25/35) in the control group (P<0.05).
CONCLUSIONS: Nape seven needles combined with pressing moxibustion can effectively alleviate the clinical symptoms, and improve the hemorheology and hemodynamics in CV patients.
目的:观察项七针联合压灸治疗颈性眩晕(CV)的临床疗效。方法:将70例CV患者随机分为观察组和对照组,每组35例。观察组采用项七针联合压灸治疗,每日1次,每周6次,连续治疗2周。对照组予口服盐酸倍他司汀片(2周)和醋氯芬酸分散片(3 d)。分别于治疗前后观察两组患者颈性眩晕症状与功能评估量表(ESCV)评分,检测血浆神经肽Y(NPY)、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)含量及血液流变学、血流动力学指标,并于治疗后评定两组临床疗效。结果:治疗后,两组患者ESCV眩晕、日常生活及工作能力、心理及社会适应能力、头痛评分及总分较治疗前升高(P<0.01,P<0.05),观察组患者颈肩痛评分较治疗前升高(P<0.01);观察组患者ESCV各项评分及总分均高于对照组(P<0.01,P<0.05)。治疗后,两组患者血浆NPY和ET-1含量较治疗前降低(P<0.01),血浆CGRP含量较治疗前升高(P<0.01,P<0.05);观察组患者血浆NPY、ET-1含量低于对照组(P<0.01),血浆CGRP含量高于对照组(P<0.01)。治疗后,两组患者全血高切黏度、血浆黏度、全血低切黏度均较治疗前降低(P<0.01,P<0.05),基底动脉(BA)、左侧椎动脉(LVA)、右侧椎动脉(RVA)平均血流速度均较治疗前升高(P<0.05);观察组患者全血高切黏度、血浆黏度及全血低切黏度均低于对照组(P<0.01),BA、LVA、RVA平均血流速度均高于对照组(P<0.05)。观察组总有效率为91.4%(32/35),高于对照组的71.4%(25/35,P<0.05)。结论:项七针联合压灸可有效减轻CV患者临床症状,改善血液流变学及血流动力学。.
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