| Objective:To analyze the correlation between axial transversal foramen and the pathogenesis of CSA,and to discuss the value of point pressing combined with acupuncture of tianyou point in improving the clinical symptoms of CSA.Methods:1.The neck of 10 formaldehyde-fixed cadavers was dissected,the vertebral arteries between C1-C2 superficial and deep musclefascia and transverse foramen were fully exposed and the vertebral arteries were observed,the external diameter of the vertebral artery at the turning point of the V3 segment vertebral artery was measured,and the internal diameter of the transverse foramen of the C1 and C2 cervical vertebrae was measured,and the angle of the turning points in the V3 segment was measured,The structures were observed.2.A total of 50 patients who met the diagnostic criteria of vertebral artery type of cervical spondylosis were examined by MRI from December2018 to December 2019,in the meantime,examining the patients'physical signs and recording the induced angle of rotation neck test?the patients specific clinical symptoms and inducing factors,the blood flow rate of vertebral artery?the segment and degree of transverse foramen stenosis,and the segmentand degree of vertebral artery stenosis were recorded by experimental examination.Using a random number table,the 50patients were randomlydivided into control group and observation group.The two groups were treated for 3weeks.The control group was treated with acupuncture.Tianzhu acupoint,Houxi acupoint,Shenmai acupoint,Baihui acupoint,Fengchi acupoint,Tinggong acupoint and Waiguanacupoint were selected.The observation group was treated with point pressing and acupuncture at Tianyou acupoint on the basis of control group.SPSS21.0 statistical software was used to analyze the recorded data.Thechisquare test was used for thecounting data,rate or composition ratio,and the measurement data wereall described as mean±standarddeviation(`x±S),which was consistent withthe normal distribution and wasmeasured by t-test for P value,and was considered statistically significant when P<0.05.Results:1.The vertebral artery of V3 segment has more angulation.The small diameter of angulation at the upper edge of transverse foramen of axis and atlas is narrow,which is easy to cause the decrease of blood flow and velocity flow of vertebral artery.2.V3 segment of vertebral artery has many branches and variations.It can greatly improve the success rate and efficiency of cranio-cervical operation by fully understanding the branches and surrounding structures of vertebral artery before operation.3.The atlantoaxial vertebral artery shows a network of nerve fibers that runs alongside the anterior branches of the 2 cervical nerves and the lesser occipital nerve,while the transverse foramen of the axis has the largest cervical Sympathetic ganglion and is easily stimulated,muscle?nerve and blood vessel interact with each other and produce corresponding clinical symptoms.4.The body surface projection position of the transverse process of the second cervical vertebra is close to tianyou acupoint,which provides anatomical basis for clinical treatment.5.Among the 50 cases,There were 25 cases of CSA induced by fatigue(16 cases bowed their heads and bent over their desks,9 cases did housework),and 15 cases(30%)were induced by wind?cold and dampness,5 cases were induced by other factors(4 cases were induced by bad posture for a long time,1 case was induced by sudden neck rotation),2 cases(4%)were induced by emotional factors,and 3 cases(6%)were induced by no obvious factors.6.The induced angle of back rotation neck test in the two groups was greater than before treatment,P<0.05,the difference was statistically significant.The induced angle of the treatment group was(66.96±3.52)degrees,which was significantly higher than that of the control group(62.90±4.40)degrees,P<0.05,it showed that the effect of the observation group was more obvious than that of the control group in the degree of remission of symptoms induced by traction of vertebral artery.7.The blood flow rate of vertebral artery after treatment was higher than that before treatment in both groups,and the difference was statistically significant(P<0.05).The blood flow velocity in the observation group was(28.00±3.17)cm/s,which was higher than that in the control group(23.56±3.16)cm/s,the difference was statistically significant(P<0.05),indicating that the recovery of vertebral artery blood flow velocity in the observation group was better than that in the control group.8.The scores of symptom and function in both groups were higher after treatment than before treatment,P<0.05,the differences were stat istically significant.The scores of symptom and function in the observation group were(26.52±1.26)points higher than those in the control group(23.00±1.26)points,P<0.05,the difference was statistically significant,indicating that the recovery of symptoms and functions in the observation group is significantly better than that in the control group after treatment.9.The total effective rate was 92.0%(23/25)in the observation group,76.0%(19/25)in the control group,c~2=9.131,P=0.028,P<0.05,the difference was statistically significant,indicating that the curative effect of the observation group was better than that of the control group.Conclusion:1.The atlantoaxial vertebral artery is a high-risk segment for vertebral artery stenosis.The axis transverse foramen is of great significance for the etiology,pathogenesis and treatment of vertebral artery type of cervical spondylosis,the axis transverse process is the high stress point of cervical motion,and it is easy to form the lesion,the stenosis of the axis transverse foramen can directly or indirectly lead to vertebral artery stenosis and cause CSA clinical symptoms.2.Point pressing combined with acupuncture of tianyou acupoint can improve the clinical symptoms of CSA,point pressing combined with acupuncture of tianyou acupoint can be added into the comprehensive treatment program,it has positive therapeutic significance to improve the symptom and sign of CSA and to restore the blood flow of vertebral artery. |
PDF Full Text Request