【摘要】 目的 观察手法复位加针刺经筋结点治疗寰枢关节错缝失眠的疗效及对睡眠质量的影响。方法 将60例寰枢关节错缝失眠患者按照随机数字表法分为2组，对照组30例予单纯手法按摩复位治疗，治疗组30例予手法复位加针刺经筋结点治疗。2组均治疗10天。比较2组治疗前后中医证候评分、匹兹堡睡眠质量指数量表(PSQI)、世界卫生组织生活质量测定量表(WHOQOL-100)、疼痛视觉模拟评分(VAS)、舒适状况量表(GCQ)评分变化及血流动力学指标[双侧颈内动脉平均血流速度(Vm)、搏动指数(PI)和收缩期最大血流速度(PSV)]。并统计2组疗效。结果 治疗组总有效率96.67%(29/30),对照组总有效率80.00%(24/30),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后PSQI、疼痛VAS均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05),2组治疗后WHOQOL-100、GCQ评分均升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后Vm、PI均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05),2组治疗后PSV均降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。结论 手法复位加针刺经筋结点治疗寰枢关节错缝失眠的疗效确切，不仅有助于改善患者临床症状和血流动力学，还有利于提高睡眠质量。更多还原

【Abstract】 Objective To observe the curative effect of manipulation combined with acupuncture at meridian sinew nodal point on insomnia of atlantoaxial joint dislocation and its influences on sleep quality. Methods Sixty patients with insomnia of atlantoaxial joint dislocation were randomly assigned to control group(n=30, manipulation massage) or treatment group(n=30, acupuncture at meridian sinew nodal point plus manipulation massage). All patients were treated for 10 days. The changes in scores of traditional Chinese medicine(TCM) syndromes, Pittsburgh Sleep Quality Index(PSQI), the 100-item World Health Organization Quality of Life Assessment(WHOQOL-100), visual analogue scale(VAS) and General Comfort Questionnaire(GCQ) before and after treatment, and hemodynamics indexes(mean velocity [Vm] of bilateral internal carotid arteries, pulsatility index [PI], peak systolic velocity [PSV]) were included as comparators between the two groups. The curative effect in the two groups was statistically analyzed. Results The total effective rate in treatment group was significantly higher than that of control group(96.67% [29/30] vs 80.00% [24/30], P<0.05). After treatment, the dimension scores of TCM symptoms in both groups were significantly decreased compared to before treatment(P<0.05), which were significantly lower in the treatment group than in the control group(P<0.05). The scores of PSQI and VAS in both groups were significantly decreased than before treatment(P<0.05), while the scores of WHOQOL-100 and GCQ were significantly higher(P<0.05), and the treatment group was superior to the control group for PSQI and VAS, WHOQOL-100 and GCQ(P<0.05). After treatment, Vm and PI in both groups were significantly elevated than before treatment(P<0.05), while PSV was significantly lower(P<0.05), and there was a significant difference in Vm, PI and PSV between the two groups(P<0.05). Conclusion Curative effect of manipulation combined with acupuncture at meridian sinew nodal point is significant on insomnia of atlantoaxial joint dislocation. It not only helps to improve clinical symptoms and hemodynamics, but also improves sleep quality.更多还原