| Objective: this study adopted a randomized controlled trial.Patients diagnosed as chronic cerebral hypoperfusion(CCH)were selected,the changes of hemodynamics of vertebral artery and basilar artery,cognitive function,vertigo symptoms and sleep were compared among the three groups before and after the intervention of acupotomy minimally invasive technique combined with abdominal Tui-na,simple acupotomy minimally invasive technique and simple abdominal Tui-na on the basis of oral Yangxueqingnao granule,so as to provide new clinical ideas for the treatment and rehabilitation of CCH patients.Methods:According to the inclusion criteria and exclusion criteria,90 patients with chronic cerebral hypoperfusion were randomly divided into acupotomy group(n= 30),Tui-na group(n = 30)and combined group(n = 30)for 2 weeks.The basic data of the three groups were analyzed and compared.The changes of mean blood flow velocity(Vm)of bilateral vertebral arteries(VA)and basilar arteries(BA)were evaluated by transcranial Doppler(TCD)before and after treatment.The changes of Montreal Cognitive Assessment scale(Mo CA),Dizziness Handicap Inventory(DHI)and Pittsburgh Sleep quality Index(PSQI)were compared before and after treatment.Results:(1)Hemodynamic detection: The results showed that the mean blood flow velocity(Vm)of TCD-measured VA in all three groups decreased after treatment than before.After treatment,the Vm of VA in the acupotomy group and the combined group was lower than that in the Tui-na group,there was no significant difference between the combined group and the acupotomy group(P>0.05),in acupotomy group and the combined group compared with Tui-na group and there was statistical significance(P < 0.05);Within-group comparisons showed that there was a statistically significant difference(P < 0.05)in Tui-na group and there was significant difference(P < 0.01)in acupotomy group and the combined group.After treatment,the Vm of BA in the three groups was slower than that before treatment,the Vm of BA in the acupotomy and combined groups was lower than that in the Tui-na group,there was no significant difference between the combined group and the acupotomy group(P >0.05),and there was a significant difference between the Tui-na group and the other two groups(P < 0.01).Compared with before treatment,there was a statistical difference(P < 0.05)in Tui-na group and there was statistically significant difference(P < 0.01)in acupotomy group and the combined group.It indicates that the acupotomy group and the combined group were better than the Tui-na group in improving the Vm of VA and BA.(2)Evaluation of cognitive function: the Mo CA scores of the three groups were increased after treatment.The Mo CA score of the combined group was higher than that of the acupotomy group and the Tui-na group,there was statistical difference in each group compared with that before treatment(P < 0.05).After treatment,there was no statistical difference between the acupotomy group and the Tui-na group(P >0.05),but there was statistical difference between the acupotomy group and the combined group(P < 0.05),and there was significant difference between the Tui-na group and the combined group(P<0.01).The treatment of acupotomy group and Tuina group can improve the cognitive function of patients,and there is no difference in efficacy,while the effect of the combined group was better than that of the other two groups.(3)Evaluation of vertigo symptoms: After treatment,the DHI scores of the three groups were lower than those before treatment.The DHI score of the combined group was lower than that of the acupotomy group,and the DHI score of the acupotomy group was also lower than that of the Tui-na group.There was significant difference between the acupotomy group and the Tui-na group after treatment(P < 0.01),and there was significant difference between the combined group and the other two groups(P < 0.01).There were significant differences between before and after treatment in the each group(P < 0.01).Indicating that the vertigo symptoms of the three groups were relieved,but the effect of the combined group was better than that of the other two groups.(4)Evaluation of sleep status: PSQI scores decreased after treatment in all three groups compared to before,and the PSQI score of the combined group was lower than the other two groups after treatment.There was significant differences in each group after treatment compared to before treatment(p < 0.01).There was no statistical difference between the acupotomy group and the Tui-na group after treatment(P > 0.05),a vsignificant difference between the acupotomy group and the combined group(P < 0.01),and a statistical difference between the Tui-na group and the combined group(P < 0.05).This indicates that the combined group was more effective than the other two groups in improving sleep disorders in CCH patients,and the Tui-na group was similar to the acupotomy group in improving sleep disorders.(5)There was a significant difference in the clinical efficacy of the three groups after the end of treatment,with a statistical difference between the Tui-na group and combined group(P < 0.05),and a statistically significant difference between the Tuina group and the combined group(P < 0.01),and the therapeutic effect of the combined treatment plan was better than that of the other two groups.Conclusion:1.On the premise of Yangxueqingnao granule as the basic treatment,acupotomology minimally invasive combined with abdominal Tui-na has a significant effect on improving cerebral hypoperfusion,and cognitive function,vertigo symptoms and sleep disorders in patients with CCH,which is superior to the two single applications.2.There are no obvious adverse reactions and toxic side effects in the combined application of needle knife minimally invasive and abdominal massage,and it can be safely used. |
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