| Backgrounds:Cervical spondylotic vertebral arteriopathy is a common disease of department of osteology, After cervical lesions involving the vertebral artery, stimulate the sympathetic nervous system cause vertigo, blurred vision, migraines, tinnitus, nausea, vomiting, even cataplexy and other clinical symptoms. Also known as vertebral artery compression syndrome, cervical vertigo, vertebral artery ischemia syndrome or vertebral-Basilar Artery insufficiency. Western medicine treatment have no satisfactory means for this disease. The Chinese medicine massage of this disease have definite therapeutic effect, is preferred and widely used in the treatment of the disease treatment.Screwing and raising Manipulation was a professor of orthopedics Chinese chief researcher at the Chinese Academy of Sciences Zhu Liguo after years of experience, adjusted and innovated the traditional Screwing manipulation, renamed Screwing and raising Manipulation. This methods has the characteristics of easy operation, quick effect, low risk coefficient and so on. The methods by improving static and dynamic balance of cervical vertebra, correcting joint displacement, improving blood circulation to achieve the goal of treatment.Spine Department II in Wangjing Hospital found that the occipital fascia in the upper cervical section of patients with cervical spondylotic vertebral arteriopathy are often more stiff in the long-term clinical observation, and obvious nodules can be touched. Combined with the patient’s cervical vertebrae X-ray, Contrasted with cervical lateral position and function position of patients, We found the distance between the upper cervical vertebrae spinous process and the clearance of The atlanto occipital and occipital bone are often no change or a little change. After treatment. Patients’s neck muscles becomes soft. The symptoms can be significantly improved. And the distance between the upper cervical vertebrae spinous process and the clearance of The atlanto occipital and occipital bone have significantly changed in X-ray.In the process of reviewing the existing literature in recent ten years, we have not yet found a clinical study on the X-ray diagnosis for this. And have no corresponding study confirmed between CSA patients and the vertigo symptom index with X-ray. It influence the further research and popularization of the X-ray diagnosis about cervical spondylotic vertebral arteriopathy.Purpose:Objective to evaluate the clinical symptoms of dizziness and X-ray changes of the patients with cervical spondylotic vertebral arteriopathy after Screwing and raising Manipulation theatment from the perspective of evidence-based medicine. This will provide a strong scientific basis for further study of cervical spondylotic vertebral arteriopathy in the future, especially in the X-ray diagnosis.Methods:1 Randomized control method was used in this study. choosing from the outpatients of Wangjing Hospital. Meet CSA diagnostic criteria. And in the state of TCM Special topics on business construction of clinical research base of traditional Chinese Medicine 《A multi center randomized controlled study on the treatment of CSA by screwing and raising Manipulation》 has been completed treatment. A total of 115 cases, including 60 cases in the experimental group and 55 cases in the control group.2. The experimental group was treated with the Screwing and raising Manipulation, two days a time, a total of seven times. The control group was treated with traction therapy, once a day, each time 20min, a total of 14 times. Before treatment and after the end of the treatment, evaluate the dizziness symptom score and both the lateral and function position X-ray of the cervical spine were taken. Measure The atlas and occipital angle, The angle between atlas and axis, The angle between the Axis and the 3 cervical vertebra of each film and calculate the difference of angle between the lateral and function position. The data will be processed by SPSS 17.0 statistical software for analysis. The experimental data will be performed using two-sided test, median and four-digit distance, and P<0.05 is considered significant statistically.Results:1 Dizziness symptoms1.1 The experimental group before and after treatment, the curative rate was 95%, the curative rate of control group was 76.4%. Two treatment method is effective both for symptoms of dizziness in CSA treatment.1.2 The experimental group, Comparison of dizziness symptom score before and after treatment, by statistical analysis, P<0.01. With statistical significance. Prove that the experimental group patients after treatment of dizziness symptoms improved significantly. The control group, Comparison of dizziness symptom score before and after treatment, by statistical analysis, P<0.01. With statistical significance. Prove that the control group patients after treatment of dizziness symptoms improved significantly. Comparison of dizziness symptom score differences between the two groups of patients before and after treatment, after statistical analysis, P<0.05. With statistical significance. That experimental group dizziness symptom scores improved significantly compared with the control group.2 X-ray index2.1 The statistical analysis on the X-ray indexes of the experimental and control group patients. The change of atlas and occipital angle in anterior flexion, The change of atlas and occipital angle in posterior extension, The change of angle between atlas and axis in anterior flexion, The change of angle between atlas and axis in posterior extension, The change of angle between the Axis and the 3 cervical vertebra in anterior flexion, The change of angle between the Axis and the 3 cervical vertebra in posterior extension. Before and after treatment. P>0.05, No statistically significant. The results prove that the X-ray index before and after treatment showed no obvious change.2.2 The statistical analysis on the X-ray indexes of the patients that the curative effect in the treatment of dizziness is more than 70%. The change of atlas and occipital angle in anterior flexion, The change of atlas and occipital angle in posterior extension, The change of angle between atlas and axis in anterior flexion, The change of angle between atlas and axis in posterior extension, The change of angle between the Axis and the 3 cervical vertebra in anterior flexion, The change of angle between the Axis and the 3 cervical vertebra in posterior extension. Before and after treatment. P>0.05, No statistically significant. The results prove that the X-ray index before and after treatment showed no obvious change for the patients that the curative effect in the treatment of dizziness is more than 70%.Conclusion:1 Effect of CSA dizziness1.1 Screwing and raising manipulation before and after treatment in patients with dizziness symptoms curative rate was 95%, significantly better than the traction group (76.4%).1.2 In the course of treatment, no adverse events occurred, prove the security of the screwing and raising manipulation.2 After the screwing and raising manipulation treatment. The X-ray index of the atlas and occipital angle, the angle between atlas and axis, the angle between the Axis and the 3 cervical vertebra have no significant changes. Prove that the dizziness symptoms and the X-ray index have no close contact. The above mentioned X-ray index could not be used as an index to evaluate the therapeutic effect of dizziness. |
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