超声治疗椎动脉型颈椎病的临床疗效观察
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时间:2009-02-11 21:57:23 来源: 作者: |
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Clinical observation of ultrasound treatment in vertebra
artery type of cervical spondylopathy
Yang Xiaoyun,Liu Hailing,Zeng Yong,et al.
Physiatrics Department,the Affiliated Hospital of Guangdong Medical College ,Zhanjiang524001.
【Abstract】 Objective To observe the clinical effects of ultrasound treatment in vertebral artery type of cerviˉcal spondylopathy.Methods 160cases were randomly divided into the treatment group and control group.The treatˉment group were treated with ultrasound and liuhe machine.The control group were treated with medium frequency eletrotherapy and ultrashort wave.Results Among the treatment group the cure rate was85%;among the control group was45%.There were significant difference between the two groups.(P<0.05).Conclusion It is suggested that ultrasound with liuhe machine has a better effect for vertebral artery type of cervical spondylopathy.
Key words ultrasound treatment cervical vertebrae vertebral artery
颈椎病是临床常见病,是一种慢性退行性疾病,它的形成经过了一个较长的病理发展过程,椎动脉型颈椎病是由于颈椎不稳、退变、骨刺直接刺激或压迫椎动脉,或者由于刺激了颈椎关节囊韧带或椎动脉壁周围的交感神经引起的反射性椎动脉痉挛而导致椎动脉供血不足的一种症状。它的病变实质以钩椎关节处骨质增生为主并由此引起相应颈椎处软组织痉挛、牵拉导致椎动脉的痉挛与狭窄所致大脑后动脉、小脑下动脉和内耳动脉等供血不足症状。本文对采用超声波等物理因子治疗椎动脉型颈椎病患者的临床疗效作一探讨。
1 资料与方法
1.1 一般资料 160例诊断为椎动脉型颈椎病 [1] 患者均为本院住院和门诊就医患者,男78例,女82例,年龄23~76岁,平均年龄46岁,病程1~27年。其中治疗组80例患者中颈部疼痛及功能受限32例,头痛、眩晕与头体位改变有关的48例,心慌胸闷2例;影像学检查颈椎骨质增生伴椎间隙狭窄65例,钩椎关节增生43例;对照组80例患者中颈部疼痛18例,头痛、眩晕与头体位改变有关的43例,颈椎骨质增生伴椎间隙狭窄51例,钩椎关节增生39例。
1.2 治疗方法 治疗组患者的治疗方法有(1)患者取平卧位,采用北京产SUT-400型多功能超声扫描心脑血管治疗仪,频率0.8MHz,四个声头分别置于双囟门、百会穴及椎基底动脉处,接触剂为耦合剂,超声强度为1.25W/cm 2 ,2cm×4cm及2cm×2cm橡胶电极置颈部患处及双风池穴作生物电中药离子导入,电流强度为耐受量,1次/d,20min/次。(2)患者取平卧位,采用湖南产多功能六合治疗仪,频率50~60Hz,脉冲调制波形,四个电极分别置于大椎、天柱、双肩井穴,电极上用医用脱脂棉花蘸中药水行中药离子导入伴穴位刺激,耐受量,1次/d,20min/次。中药方剂选用杜仲、地龙、桑寄生、丹参、当归、红花、白芍、三七、鸡血藤、乌蛸蛇、蜈蚣、独活等药,用45%酒精浸泡半年,用其滤出液行药物离子导入。(3)患者端坐位,采用四川羊青医疗器械厂生产的手摇颈椎牵引器,每天牵引1次,每次20~30min,连续式牵引,颈屈曲度为5°~15°,牵引力为13.6kg。对照组采用的方法有(1)患者取平卧位,采用北京产电脑中频治疗仪行中药离子导入,中频频率为2kHz,3cm×5cm橡胶电极置颈部患处,耐受量,1次/d,20min/次,药物同治疗组。(2)患者取平卧位,采用上海产超短波治疗仪,频率为40.68MHz,电容电极为颈、胸对置,电极间隙4~6cm,温热量,1次/d,20min/次。
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