The Clinical Effect of Electrical Puncturing Points along Du Meridian for Cervical Spondilopathy of Vertebral Artery
|School||Guangzhou University of Traditional Chinese Medicine|
|Course||Acupuncture and Massage|
|Keywords||Cervical Spondylopathy of Vertebral Artery(CSA) Acupuncture Therapy Governor Vessel Vertigo|
Cervical Spondylopathy of Vertebral Artery(CSA)is a common disease basedon cervical spaine disks degeneration. The degenerated tissues and structurescompress or stimulate the cervical spinal cord, nerves, blood vessel, and softtissues. Thereby it leads to ischemia of vertebrobasilar system, and causes aseries of clinical manifestations such as dizziness, tinnitus, vomitting,headache, visual disorder, cataplexy, and so on. According to statistics, theincidence of cervical spondylosis is 17.3% in our country, of the total TypeVA is 20-30%. And the incidence is increasing while the patients are youngerand younger. Foreign and domestic scholars are widely concerned about theresearch of CSA. For CSA treatment, two means are used according to modernmedicine. First, vasodilator agent drugs such as Nimodipine, BetahistineHydrochloride, Flunarizine are applied. But it is unstable though has certaintherapeutic effect. Second, the operation treatment is applied to the patients,but most of them claim that it’s hard to accept the treatment.In the view point of Traditional Chinese Medicine(TCM), CSA classifies to"vertigo". We considered that CSA focused on the neck, and reflected in thebrain. Blood deficiency of brain was pathogenesis of CSA. Thus, the cause ofvertigo had a close relationship with the deficiency of brain marrow. Justas Lingshu·Hailun said "If the sea of marrow is deficient, we will feel vertigo,tinnitus, eyes blurred, and tired."Lingshu·Kouwen said" Tinnitus and eyesblurred are due to the deficiency of upper Qi in brain."There is a closerelationship between brain marrow and the Governor Vessel. Just as Xichun Zhangsaid "Where there is the Governor Vessel, there is the brain marrow and nerves."We know that the governor vessel is the sea of Yang meridians, it governs theYang Qi of our whole body. The indications of points of the governor vesselare widily used in clinic. Especially in treating with neuropathic mentaldisorders. The Governor Vessel ascends posteriorly along the interior of the spinal column to Fengfu at the nape, where it enters the brain, and it furtherascends to the vertex. So, the governor vessel has the effect of tonifying brainmarrow, regaining consciousness and stopping endogenous wind to lessenvertigo, and calming the nerves.According to the theory "The course of achannel is amenable to treatment", we used the Governor Vessel points to treatCAS, and brought a new idea about the coordination of acupoints for thisdisease.Acupunture as a therapy for CAS has had a history of certain years. The effectof electro-acupuncture on governor vessel points for CAS was affirmed. It hadascendancy of good therapeutic effect, holo-accommodation and uneasyrecurrence. There were few clinical reports about governor vessel points forCAS. In oder to consummate individuation therapeutic system, and develop thetheory "syndrome differentiation and treatment" of TCM to improve the appliedsystem of living quality, and to further evaluate and use acupoints of theGovernor Vessel for CAS treatment, we observed the influence ofelectro-acupuncture on governor vessel points on cerebral blood flow of theCSA. The research aims to evaluate the therapeutic effects and explore thetherapeutic mechanism.These studies were performed under the direction of Professor Lixing Zhuang,and based on the prior clinical researches on press and moxibustion on BAIHUI point as main therapy for CSA. The aim was to summarize the clinicalexperience of electro-acupuncture on governor vessel points in the past fewyears, and to screen the points. Thus it made the therapy more directly. Ittested the levels of plasma ET and PGI2 (6-keto-PGF1a) to observe the effectof electro-acupuncture on governor vessel points of the CSA. Then it clarifiedthe therapeutic mechanism on the effect of acupuncture therapy of the CSA,and verified the hypothesis that acupuncture therapy, which regulates thewhole body by neurohumoral pathway to treat CSA, adjusts the movement of bloodvessels and improves the supply of arteries.All the cases which were according to the unified diagnostic code, eliminationcode and internalize code, came from the out-patient clinic of acupunctureand moxibustion department in the First Affliciated Hospital of GuangzhouUniversity of Chinese Medicine. Among these, 50 cases of the therapeutic groupwere given electro-acupuncture on the acupoints of the Governor Vessel while46 cases of the control group were given electro-acupuncture on the acupoints of Neck 4-6 Jiaji. There was no significant difference as compared betweenthe two groups on the common situation(P＞0.05).The main acupoints of thetherapeutic group were Yingtang, Shenting, Shangxing, Baihui, Naohu, Fengfu,and double Tianzhu. And the modifications were as follows: Deficiency of Qiand Blood: Zusanli; Insufficiency of the Liver and Kidney: Sanyinjiao; Phlegmand dampness in the collaterals: Fenglong; Qi stagnation and blood stasis:Xuehai. Needles with gauge 28 in diameter and 1 cun in length are used toacupuncture the above mentioned acupoints. When Qi arrived(refers to thesensation of numbness and distension around the acupoint after the needle isinserted),the needle was twirled and rotated backward and forward with thefrequency of 180～200 times per minute. Then needles were connected to G6805-1Electro-acupuncture Stimulator(made in Qingdao Xinsheng IndustryCo, Ltd.,China) with the output wires. The disperse-dense waves were appliedwith the frequency 2～4Hz/50～100Hz once thirty minutes. It’s manipulated onceevery day and two weeks a course. With three days’ rest the second coursecontinued. Totally three courses were taken and after treatment thetherapeutic effect was checked according to statistics. The levels of plasmaET, 6-keto-PGF1a were tested before the first treatment and after the lasttreatment respectively. The main acupoints of the control group were Neck 4-6Jiaji and double Tianzhu. And the modifications were the same with thetherapeutic group. Needles with gauge 28 in diameter and 1 cun in length areused to acupuncture the above mentioned acupoints. When Qi arrived(refers tothe sensation of numbness and distension around the acupoint after the needleis inserted),the needle was twirled and rotated backward and forward with thefrequency of 180～200 times per minute. Then needles were connected to G6805-1Electro-acupuncture Stimulator(made in Qingdao Xinsheng IndustryCo, Ltd.,China) with the output wires. The disperse-dense waves were appliedwith the frequency 2～4Hz/50～100Hz once thirty minutes. It’s manipulated onceevery day and two weeks a course. With three days’ rest the second coursecontinued. Totally three courses were taken and after treatment thetherapeutic effect was checked according to statistics. The levels of plasmaET, 6-keto-PGF1a were tested before the first treatment and after the lasttreatment respectively. And the results were as follows:1. To quantize and judge therapeutic effect according to the therapeutic effectcriteria of State Administration of TCM in 1995. The result manifests that in 50 cases of therapeutic group, 15 cases were healed, 25 cases had markedtherapeutic effects;7 cases had certain improvement;3 cases did not respondto the treatment, the total efective rate was 94%. In 46 cases of controlgroup, 6 cases were healed,13 cases had marked therapeutic effects;18 caseshad certain improvement;9 cases did not respond to the treatment, the totalefective rate was 80.43%. All clinical information was handled by statistics.The result manifests that there was significant difference of therapeuticeffects between the two groups (P＜0.05). At the same time, it shown norelationship between therapeutic effect and TCM syndrome in therapeuticgroup. The therapeutic effect of deficiency of qi and blood was thebest;insufficiency of the liver and kindey came second while qi-stagnancy andblood stasis came third;and blockage of collaterals by phlegmatic hygrosiswas the last. There were negative correlation between therapeutic effect andthe course of disease in therapeutic group. As the course was shorter, thetherapeutic effect was better.2. The results of plasma ET and 6-keto-PGF1a: After treatment, the level ofplasma ET obviously decreased from 84.45±18.89 (ng/L) to 57.81±14.36(ng/L), while the level of plasma 6-keto-PGF1a significantly increased from105.88±54.35 (Pg/ml) to 246.36±41.28 (Pg/ml);the levels of plasma ETand,6-keto-PGF1a had significant differences as compared with pretherapyrespectively, and the difference of therapeutic group C was more obvious.