| Posterior circulation ischemia (PCI) is a kind of ischemic cerebrovascular disease that becomes more popular in the elderly. PCI stands for vertebrobasilar ischemia, caused by various factors, such as atherosclerosis, the main artery stenosis or occlusion, arterial embolism, etc. The common symptom of PCI includes vertigo or dizziness, and it is hard to be cured. PCI usually shows effect repeatedly, and severe cases can result in cerebral infarction, which lead to the extensive attention of the medical experts. Routine treatment of western medicine could have some clinical efficacy in thrombolysis, anticoagulation and to improve brain blood supply, but the same treatment is generally given to all the PCI patients regardless of their individual difference, and the results are often not satisfactory. Besides, some patients can not take the western medicine because of side effects of the drugs. Surgery and endovascular treatment have some clinical efficacy, but this kind of treatment is still under study, and it is difficult to popularize as a result of the trauma, high costs and variety of complications. To cure posterior circulation ischemic vertigo (PCIV) by acupuncture treatment has fewer side effects and the operations are simple. My supervisor. Professor Chen Feng, proposed the therapeutic method by acupuncture seven points under the skull (Fengchi, Wangu, Tianzhu, Yamen) based on years of clinical work, and it shows significant effect on the treatment of PCIV. This paper makes a randomized controlled study of acupuncture skull base seven points, so as to evaluate its clinical efficacy objectively.ObjectiveTo observe the clinical therapeutic efficacy of curing PCIV, we try to cure the patients by acupuncture seven points under the skull (the treatment group), and compare that with the treatment result of hydrochloric acid fluoride Gui Cinnarizine (the control group). We evaluate the treatment effect in the two groups, and observe the recurrence of PCI after stopping the treatments.MethodsWe diagnose the patients according to the standards of PCIV in western medicine, and that of vertigo in Traditional Chinese Medicine (TCM), and then divide the65cases into two groups using simple random method control principles,33cases in the treatment group (to apply acupuncture skull) and32cases in the control group (to take flunarizine triazine) respectively. The treatment group patients were given seven points under the skull acupuncture every other day, three to four times a week, and the control group patients were treated with hydrochloric acid flunarizine5mg per night. The basic treatment of both groups is taking aspirin enteric-coated tablets (the worship aspirin)100mg every night before going to bed and giving appropriate treatment measures for complications like hypertension, diabetes and hyperlipidemia. It takes one week for a course of treatment, and all the patients were treated for two courses, a total of two weeks. We follow up after two weeks of treatment and two weeks off. We evaluate the primary and secondary symptoms with the TCM vertigo symptoms observation table and understand the illness of patients with transcranial Doppler (TCD) examination. The clinical effect are evaluated by symptom score and TCD results, and we compare and evaluate the results and observe the recurrence after stopping the treatments.Results1Both the treatment group and the control group showed significant efficacy after treatment, compared with the symptom before that, but the treatment group has better effect than the control group. The total effective rate of the treatment group was93.94%, comparing to that of the control group which was87.5%. The two groups was statistically significant different (P=0.030, P<0.05).2We compare the symptoms of the two groups of patients before and after the treatment in the traditional Chinese medicine way. The result is that the acupuncture group has highly significant differences (P<0.01), and the Western Medicine group has significant differences (P<0.05), which shows that both the treatment group and the control group has good therapeutic effect. After the treatment, both groups shows significant statistical differences (P<0.01) regarding the symptom improvement of palpitation, choking sensation in chest and soreness and weakness of waist and knees. The main symptoms of vertigo and part of the secondary symptoms such as headache and insomnia have significant statistical improvement differences (P<0.05), while the other symptoms do not have significant statistically difference (P>0.05). The total score of traditional Chinese medicine symptoms have highly significant statistically difference (P<0.01), indicating that the total effect of the treatment group is better than the control group in the improvement of systemic symptoms.3We compare the TCD results of the two groups of patients after the treatment with that of themselves before the treatment. Both the vertebrobasilar artery blood flow velocity and pulsatility index in the acupuncture group and western medicine group are significantly improved (P=0.000and P<0.01respectively), with a very significant statistical difference. Comparing the two groups of patients after the treatment, the vertebrobasilar arterial systolic, diastolic, mean blood flow velocity and pulsatility index have a significant difference (P<0.05). It shows that the acupuncture and western medicine can effectively improve the blood supply of vertebrobasilar artery and increase the cerebral blood flow for the two group of patients, and the acupuncture group has a better result than the western medicine group.4We follow up the recurrence of the two groups of patients two weeks after the discontinuation of the treatment, and the recurrence rate of the treatment group and the control group are18.12%and31.25%respectively. Both of the recurrence rates in the two groups show significant statistically differences (P=0.027, P<0.05), which indicates that the treatment group has lower recurrence rate than the control group.Conclusion1To cure posterior circulation ischemic vertigo by acupuncture "seven points under the skull" has good clinical efficacy.2The treatment of acupuncture "seven points under the skull" can improve the clinical symptoms of posterior circulation ischemia vertigo, and the total efficacy is better than the control group regarding the systemic symptom improvement.3The treatment of acupuncture "seven points under the skull" can be effective in improving the blood supply of the vertebrobasilar system and increasing cerebral blood flow, which is better than the control group.4To cure posterior circulation ischemic vertigo by acupuncture,"seven points under the skull " has stable efficacy and low relapse rate after stopping the treatment.5During treatment of acupuncture "seven points under the skull ", we did not find any adverse reactions, and it shows the better security of the treatment. |
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