OBJECTIVE: To observe the clinical efficacy of Fu's subcutaneous needling based on "multi-joint muscle spiral balance chain" theory for cervical vertigo (CV) and its effect on blood flow velocity of vertebral artery. METHODS: A total of 60 patients with CV were randomized into a Fu's subcutaneous needling group and a medication group, 30 cases in each one. In the Fu's subcutaneous needling group, Fu's subcutaneous needling was delivered at Dazhui (GV14), the flexible tube was retained for 5 min after sweeping manipulation, and the treatment was given once every other day, 3 times a week for 3 weeks. In the medication group, betahistine mesylate tablet and diclofenac sodium dual-release enteric capsule were taken orally for continuous 3 weeks. Before treatment, after treatment, and in follow-up of one month after treatment completion, the scores of dizziness handicap inventory (DHI) and visual analogue scale (VAS) were observed; before and after treatment, the blood flow velocity of vertebral artery was measured by transcranial Doppler, and the clinical efficacy was evaluated after treatment in the two groups. RESULTS: After treatment and in follow-up, each item scores and total scores of DHI were decreased compared with those before treatment in the two groups (P<0.05); the VAS scores after treatment in the two groups, as well as the VAS score in follow-up of the Fu's subcutaneous needling group, were decreased compared with those before treatment (P<0.05). In the Fu's subcutaneous needling group, after treatment and in follow-up, the physical scores and the total scores of DHI, and the VAS scores were lower than those in the medication group (P<0.05); in follow-up, the emotional and functional scores of DHI were lower than those in the medication group (P<0.05). After treatment, the mean blood flow velocity (Vm) of the left vertebral artery (LVA) and the right vertebral artery (RVA) was increased compared with that before treatment in the two groups (P<0.05), and the Vm of LVA and RVA in the Fu's subcutaneous needling group was higher than that in the medication group (P<0.05). The total effective rate was 100.0% (30/30) in the Fu's subcutaneous needling group, which was superior to 73.3% (22/30) in the medication group (P<0.05). CONCLUSION Fu's subcutaneous needling based on the "multi-joint muscle spiral balance chain" theory can effectively alleviate the vertigo and neck pain, and improve the blood flow velocity of vertebral artery in CV patients, and has a long-term therapeutic effect.
Humans ; Female ; Male ; Middle Aged ; Acupuncture Therapy/instrumentation* ; Vertebral Artery/physiopathology* ; Adult ; Vertigo/physiopathology* ; Aged ; Blood Flow Velocity ; Treatment Outcome ; Acupuncture Points ; Young Adult

OBJECTIVE: To investigate the severity of blood steal and the hemodynamic profiles in patients with subclavian artery stenosis combined with vertebral artery stenosis. METHODS: A retrospective analysis was performed of transcranial Doppler (TCD) data from patients with subclavian artery stenosis (SAS) and concomitant unilateral/bilateral vertebral artery stenosis (VAS, >50%) or occlusion in our institution between February, 2014 and July, 2018.Thirty-seven patients with SAS combined with VAS (SAS+VAS) were reviewed for types of blood steal, peak systolic velocities of blood flow in affected subclavian artery and the contralateral vertebral artery, and the findings of hyperemia testing.These data were also reviewed for 39 SAS patients without VAS (control group) for comparison of blood steal and hemodynamic profiles. RESULTS: In SAS+VAS group, 5 patients showed no blood steal; blood steal in stage Ⅰ was found in 22 patients, stage Ⅱ in 7, and stage Ⅲ in 3, as compared to the numbers of 17, 12 and 10 in the control group, respectively (H=9.431, =0.002).The peak systolic velocity of the contralateral vertebral artery was 43.91±17.43 cm/s in SAS+VAS group, significantly lower than that in the control group (53.56±17.45 cm/s; = 629.5, =0.006).Hyperemia testing showed a significant difference in the negative rate between SAS+VAS group and the control group[35.1%(13/37) 7.7%(3/39);=8.603, =0.003). CONCLUSIONS SAS combined with VAS may lead to reduced compensatory blood flow in the contralateral vertebral artery to lessen the severity of subclavian steal syndrome.
Hemodynamics ; Humans ; Regional Blood Flow ; physiology ; Retrospective Studies ; Subclavian Steal Syndrome ; complications ; physiopathology ; Vertebral Artery ; physiopathology ; Vertebrobasilar Insufficiency ; complications ; physiopathology

OBJECTIVETo compare the difference in the clinical efficacy on cervical spondylosis of vertebral artery type (CSA) treated with thermosensitive moxibustion at different dosages.

METHODSSixty cases of CSA were randomized into a saturated moxa dosage group and a regular moxa dosage group, 30 cases in each one. The thermosensitive moxibustion was adopted in the two groups. The mild suspended moxibustion was applied at two acupoints with the strongest thermosensitization. In the saturated moxa dosage group, the moxibustion time was determined by the disappearance of thermosensitization. In the regular moxa dosage group, 15 min was required on each acupoint. The treatment was given twice a day for first 4 days in the two groups. Since the 5th day, the treatment was given once a day, continuously for 10 times, and totally 14 days were required. The score of symptoms and function and clinical efficacy were compared between the two groups before and after treatment as well as 6-month follow-up after treatment.

RESULTSThe curative and effective rate was 56.7% (17/30) after treatment and 60.0% (18/30) in 6-month follow-up after treatment in the saturated moxa dosage group, which were superior to 26.7% (8/30) and 30.0% (9/30) in the regular moxa dosage group respectively (P < 0.01, P < 0.05). The scores of clinical symptoms and function after treatment and in follow-up were improved apparently as compared with those before treatment in both groups (all P < 0.01). The scores of clinical symptoms and function after treatment and in follow-up in the saturated moxa dosage group were increased much more apparently than those in the regular moxa dosage group (after treatment: 22.32 +/- 4.64 vs 17.43 +/- 3.21; in follow-up: 23.01 +/- 4.76 vs 18.32 +/- 2.13, both P < 0.01).

CONCLUSIONThe thermosensitization moxibustion of saturated dosage achieves the superior short-term and long-term efficacies in the treatment of CSA as compared with the regular moxibustion dosage.

Acupuncture Points ; Adult ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; instrumentation ; Spondylosis ; physiopathology ; therapy ; Vertebral Artery ; physiopathology

Patients with bilateral vertebral artery occlusion have a high incidence of cerebral infarction with poor prognosis. Infarction of bilateral middle cerebellar peduncle (MCP) is extremely rare and only a few cases have been reported in literature. A 74-year-old male patient was admitted to our hospital with a chief complaint of dizziness and walking instability for 13 d. Brain magnetic resonance image showed acute bilateral middle cerebellar peduncle infarction. Digital subtraction angiography showed occlusion of the initiation part of left vertebral artery and whole right vertebral artery, while a large amount of collateral circulations and recanalization were observed. After volume expansion, anti-platelet aggregation and lipid-lowering therapy, the symptoms disappeared. The patient was followed up for 10 months and he recovered well.
Aged ; Angiography, Digital Subtraction ; Cerebellum ; Cerebral Infarction ; Collateral Circulation ; Humans ; Male ; Middle Cerebellar Peduncle ; physiopathology ; Vertebral Artery ; physiopathology

OBJECTIVETo explore the therapeutic effect and mechanism of abdominal acupuncture for cervical spondylosis of vertebral artery type.

METHODSThirty cases of cervical vertigo, in which the color ultrasonography indicated vertebral arterial blood insufficiency, were treated with abdominal acupuncture therapy. The points were Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4), Xiawan (CV 10), Shangqu (KI 17) and Huaroumen (ST 24). The treatment was given once every day and five continuous treatments made one session. Separately, before treatment and in the 1st and 5th treatments, the cervical vertigo symptom and functional assessment scales were adopted for scoring. Simultaneously, the color ultrasonography was applied to observe the blood flow changes of the bilateral cervical arteries.

RESULTSExcept the score for headache in the 1st treatment, the scores in cervical vertigo and function assessment scale in the 1st and 5th treatments were all improved significantly in 30 patients as compared with those before treatment (P < 0.01, P < 0.05). In the 1st and 5th treatments, on the affected side, the vertebral artery diameter, mean velocity and blood flow per minute were all improved significantly as compared with those before treatment (all P < 0.01). In one session treatment, the total effective rate was 100.0% (30/30) and the curative rate was 60.0% (18/30).

CONCLUSIONAbdominal acupuncture therapy not only relieves the clinical symptoms, but also improves vertebral arterial blood supply for the patients of cervical spondylosis of vertebral artery type.

Abdomen ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Regional Blood Flow ; Spondylosis ; physiopathology ; therapy ; Treatment Outcome ; Vertebral Artery ; physiopathology ; Young Adult

OBJECTIVETo observe the differences in therapeutic effect between penetrating needling on head points and acupuncture of syndrome division in the treatment of vertigo caused by vertebral-basilar arterial blood-supply insufficiency.

METHODSSixty cases of vertigo caused by vertebral-basilar arterial blood-supply insufficiency were divided into 2 groups: a penetrating needling on head points group (group A) and an acupuncture of syndrome division group (group B), 30 cases in each one. In group A, penetrating needling technique was applied from Baihui (GV 20) towards Qianding (GV 21), Shuaigu (GB 8) towards Qubin (GB 7) and Yuzhen (BL 9) towards Tianzhu (BL 10). Electric stimulation was added. In group B, the acupoints were selected according to syndromes. For example, upper disturbance of wind yang: Ganshu (BL 18), Xingjian (LR 2),etc. were selected; upper disturbance of turbid phlegm: Yinlingquan (SP 9), Fenglong (ST 40), etc. were selected; qi and blood deficiency: Baihui (GV 20), Xuehai (SP 10), etc. were selected; liver and kidney yin deficiency: Ganshu (BL 18), Shenshu (BL 23), etc. were selected. Electric stimulation and needling manipulation were conducted on those acupoints. Ten treatments made one session. After continuous 2 sessions of treatment, the efficacy, symptom score and physical sign score were compared between two groups. Transcranial Doppler (TCD) examination was done to observe hemodynamic changes of anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) before and after treatment.

RESULTSThe total effective rate in group A was 96.7% (29/30) that was obviously better than 83.3% (25/30) in group B (P<0.05). The scores of vertigo degree, vertigo frequency, duration and accompanied symptoms after treatment were lower obviously as compared with those before treatment in two groups (all P<0.05). The improvements in group A were much significant (all P<0.05). The highest mean velocity(Vm) of bilateral MCA, ACA and PCA were apparently reduced after treatment in two groups (P< 0.05, P<0.01). The improvements in group A were much more apparently (all P<0.05).

CONCLUSIONThe penetrating needling on head points can effectively relieve vertigo caused by vertebral-basilar arterial blood-supply insufficiency, reduce the attack frequency and improve in its accompanied symptoms. Its clinical efficacy is significantly superior to that in acupuncture of syndrome division group.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Basilar Artery ; physiopathology ; Blood Circulation ; Female ; Head ; blood supply ; Humans ; Male ; Middle Aged ; Vertebral Artery ; physiopathology ; Vertebrobasilar Insufficiency ; complications ; therapy ; Vertigo ; etiology ; physiopathology ; therapy

OBJECTIVETo analyze the differences in the immediate effect of acupuncture on cervical spondylosis of vertebral artery type among three factors: needling technique, acupoint selection and time of needle retaining so as to option the best therapeutic program.

METHODSThirty-two cases were observed and randomly divided into 8 groups, 4 cases in each one. The orthogonal design of three factors and two levels was adopted. There were needling technique (electroacupuncture, reinforcing and reducing method), acupoint selection [C4-C7 Jiaji (EX-B 2) and three needles of neck: Tianzhu (BL 10), Jingbailao (EX-LHN 15), Dazhu (BL 11)] and time of needle retaining (5 min, 15 min). L8 (2(7)) orthogonal design table was arranged in the trial. The changes in mean velocity (Vm) of vertebral artery (VA) and basilar artery (BA) were observed before and after acupuncture.

RESULTSThe immediate effect of VA-BA blood flow was the most significant after electroacupuncture at C4-C7 Jiaji (EX-B 2), with continuous wave for 5 min. This method and acupoint selection greatly influenced the therapeutic results (both P<0.05).

CONCLUSIONThe optimized therapeutic program of the immediate effect of acupuncture for cervical spondylosis of vertebral artery type is electroacupuncture + C4-C7 Jiaji (EX-B 2) + 5 min. The importance of different factors for the immediate effect in acupuncture treatment of cervical spondylosis of vertebral artery type is: acupoint selection > needling technique > time of needle retaining.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Regional Blood Flow ; Spondylosis ; physiopathology ; therapy ; Vertebral Artery ; physiopathology ; Young Adult

OBJECTIVETo compare the therapeutic effects of routine acupuncture, the electroacupuncture and the combined therapy of electroacupuncture and acupoint injection.

METHODSNinety-one cases were randomly divided into a routine acupuncture group (30 cases), an electroacupuncture group (31 cases), and a combined therapy of electroacupuncture and acupoint injection group (30 cases). Zusanli (ST 36), Fengchi (GB 20), Anmian (Extra), Taiyang (EX-HN 5), Hegu (LI 4), Yintang (EX-HN 3), Baihui (GV 20) and Sishengcong (EX-HN 1) were selected among 3 groups. Even manipulation was applied in routine acupuncture group; G 6805 electroacupuncture apparatus was added in electroacupuncture group; in combined therapy of electroacupuncture and acupoint injection group, electroacupuncture was applied, besides, Vitamin B12 0.5 mg and 0.2%/ Lidocaine 2 mL were injected at Fengchi (GB 20) and Anmian (Extra). Twenty treatments were given in 4 weeks. The changes of average blood flow of vertebral artery and basilar artery before and after treatment were observed and graded by the cervical vertigo syndrome and function score; the therapeutic effects were evaluated as well.

RESULTSThe average blood flow of vertebral artery and basilar artery, and the cervical vertigo syndrome and function score were improved in 3 groups (all P < 0.01), in which, it was more obvious in combined therapy of electroacupuncture and acupoint injection group than in others (P < 0.05, P < 0.01), and it in electroacupuncture group was superior to that in routine acupuncture group (P < 0.05). The effective rate was 63.3% (19/30) in routine acupuncture group, 80.6% (25/31) in electroacupuncture group and 90.3% (28/30) in combined therapy of electroacupuncture and acupoint injection group, indicating the significant differences among them (P < 0.05, P < 0.01).

CONCLUSIONThe routine acupuncture, electroacupuncture, and combined therapy of electroacupuncture and acupoint injection are effective for cervical vertigo; the combined therapy is the best, and electroacupuncture comes second. It illustrates that the routine acupuncture, electroacupuncture, and combined therapy of electroacupuncture and acupoint injection have additive effects on treatment of cervical vertigo.

Acupuncture Points ; Aged ; Electroacupuncture ; Female ; Humans ; Injections ; Lidocaine ; administration & dosage ; Middle Aged ; Regional Blood Flow ; drug effects ; Treatment Outcome ; Vertebral Artery ; drug effects ; physiopathology ; Vertigo ; drug therapy ; physiopathology ; therapy ; Vitamin B 12 ; administration & dosage

OBJECTIVETo detect the velocity and viscosity of blood flow of the vertebral arteries, the apoptotic cell and apoptotic related protein in the brain in order to offer theoretical foundation for the treatment of cervical spondylopathy of the vertebral artery type with the eliminat dampness resolv phlegm method.

METHODSSixty male Japanese big ear rabbits were divided randomly into normal sodium group (A), Flunarizine group (B), low dosage Wendantang group (C), large dosage Wendantang group (D), Flunarizine group combined with large dosage Wendantang group (E), normal group (F). Each group had 10 rabbits. Xiaozhiling injection was injected around the vertebral arteries of rabbits in group A, B C, D, E to make the model of the cervical spondylopathy of the vertebral artery type. Normal sodium (20 ml x kg(-1)d(-1)) was apply through intragastric administration in group A, F; Flunarizine (0.8 mg x kg(-1)d(-1)), low dosage Wendantang (1 g x ml(-1)d(-1)), large dosage Wendantang (2 g x ml(-1)d(-1)), Flunarizine combined with large dosage Wendantang were respectively apply through intragastric administration in group B, C, D, E. The velocity and viscosity of blood flow of the vertebral arteries, the apoptotic cell and apoptotic protein in the brain were detected before and after the treatment.

RESULTSSatisfactory animal model were obtained in group A, B, C, D, E. The rabbits of group E had the most improvement of the velocity and viscosity of blood flow of the vertebral arteries while at meantime, which had the lowest apoptotic index and apoptotic related protein expression in the brain.

CONCLUSIONThe routine treatment for the cervical spondylopathy of the vertebral artery combined with eliminat dampness resolv phlegm method could improve velocity and viscosity of blood flow of the vertebral arteries, which maybe relate with reduction of apoptosis in the brain.

Animals ; Blood Flow Velocity ; drug effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Rabbits ; Random Allocation ; Spondylosis ; drug therapy ; physiopathology ; Vertebral Artery ; drug effects ; physiopathology

OBJECTIVETo compare the effects of the three manipulative methods in treating vertebral artery type of cervical spondylosis.

METHODSFrom December 2006 to December 2008, 300 patients (male 138 and female 162, the age from 18 to 76 years with an average of 38.6 years) with vertebral artery type of cervical spondylosis were randomly divided into group A, B, C (100 cases each group). Patients in group A, B were respectively treated with rotation-traction and rotation-turn manual reduction (one time per week, 30 min per time, 4 times a course of treatment; patients in group C were treated with traction (one time per day, 30 min per time, 10 times a course of treatment). Therapic time was a course of treatment in all groups. At 6 months after treatment, the clinical effects, cervical curvature, change of blood flow were respectively observed according sympotoms, X-ray, transcranial doppler sonography (TCD).

RESULTSAll patients were followed up more than 6 months. The improving average of cervical curvature (C2-C7 Cobb angle): group A, B, C was respectively 1.82 +/- 0.88, 0.12 +/- 0.06, 0.56 +/- 0.22; group A was better than group B (P < 0.01) and group C (P < 0.05). There was no significantly difference between group B and C (P > 0.05);and there was significantly difference in three groups (P < 0.05). TCD detection: LVA, RVA, BA improving significantly in group A than group B (P < 0.01) and group C (P < 0.05); there was no significantly difference between group B and C (P > 0.05) and there was significantly difference among three groups (P < 0.05). Clinical effects: in group A, 36 cases obtained curing results, 36 excellent, 20 utility, 8 ineffective, the rate of excellent and good was 92%; in group B: 6 cases obtained curing results, 20 excellent, 10 utility, 64 ineffective, the rate of excellent and good was 36%;in group C,10 cases obtained curing results, 26 excellent, 8 utility, 56 ineffective, the rate of excellent and good was 44%; there was significantly difference in three groups (P < 0.05).

CONCLUSIONAll three methods can significantly relieve headache and vertigo through improving cervical curvature and VA, BA blood flow, but its long-term effect should be observed.

Adolescent ; Adult ; Aged ; Female ; Hemodynamics ; Humans ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Spinal Curvatures ; complications ; physiopathology ; Spondylosis ; complications ; diagnostic imaging ; physiopathology ; therapy ; Treatment Outcome ; Ultrasonography ; Vertebral Artery ; pathology ; physiopathology ; Young Adult