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目的:观察祛风通络温肾汤联合针灸对椎动脉型颈椎病椎-基底动脉血流动力学的改善.方法:纳入2014年11月～ 2016年11月我院94例椎动脉型颈椎病患者随机分组,47例行常规西医配合针灸治疗者归为针灸组,47例行常规西医+针灸+祛风通络温肾汤治疗者归为联合组,比较两组疗效,中医症候积分改善和椎-基底动脉血流动力学指标变化.结果:联合组治疗总有效率95.74％,针灸组74.47％,两组差异具有统计学意义(P＜0.05);治疗后,两组眩晕、头痛、颈肩痛、恶心呕吐、旋颈试验评分和中医症候总积分均显著提高(P＜0.05),且联合组提升程度显著高于针灸组,差异具有统计学意义(P＜0.05);联合组症侯积分改善指数(76.51±23.51)％,针灸组(38.51±15.68)％,两组差异显著(P＜0.05);治疗后两组左椎动脉、右椎动脉、椎-基底动脉的PI指数显著降低(P＜0.05),平均血流速(MV)显著上升(P＜0.05),血流阻力指数(RI)显著降低(P＜0.05),血清内皮素(ET)水平下降,一氧化氮(NO)水平上升,且联合组治疗后各指标变化幅度显著高于针灸组,差异具有统计学意义(P＜0.05).结论:中药配合针灸治疗椎动脉型颈椎病,可显著改善患者椎-基底动脉血流动力学情况,改善颈眩晕、疼痛等症状,改善血管内皮功能,治疗总有效率高,临床推广价值高.“,”Objective:1o observe the effect of using Quteng Tongluo Wenshen Decoction combined with acupuncture for vertebral artery type of cervical spondylosis vertebro-basilar artery hemodynamics.Methods:A total of 94patients with cervical spondylosis of vertebralartery type who were admitted to our hospital from November 2014to November 2016were divided into acupuncture group (n=47,treated with routine western medicine combined with acupuncture) and the combined group (n=47,treated with routine western medicine and acupuncture combined with Qufeng Tongluo Wenshen Decoction).The efficacy,improvement of traditional Chinese medicine (TCM) syndrome score and changes of vertebro-basilar artery hemodynamic indexes were compared between the two groups.Results:The total effective rate of the combined group was 95.74％ and 74.47％ in the acupuncture group (P＜0.05).After treatment,scores of vertigo,headache,neck and shoulder pain,nausea and vomiting,revolvecervix test and total score of TCM syndrome were significantly improved (P＜0.05),and the improvement was more significant in combined group than the acupuncture group (P＜0.05).The improved index of symptoms in the combined group was (76.51 ±23.51) ％ while in the acupuncture group was (38.51 ± 15.68) ％ (P＜0.05).After treatment,PI of left and right vertebral arteries and vertebro-basilar artery in both groups were decreased significantly,nean velocity (MV) was increased significantly,resistance index (RI) was decreased significantly,levels of serum endothelin (ET) and nitric oxide (NO) were increased,and the changes were more significant in the combined group than the acupuncture group (all P＜0.05).Conclusion:The application of TCM combined with acupuncture in treating cervical spondylosis of vertebral artery type can significantly improve vertebro-basilar hemodynamics,relieve cervical vertigo,pain and other symptoms and improve vascular endothelial function.The total effective rate and clinical value is high.