目的：观察推拿联合针灸治疗椎动脉型颈椎病的临床疗效及对患者血流动力学、生活质量的影响。方法：选择88 例椎动脉型颈椎病患者，按随机数字表法分为观察组和对照组各44 例。对照组给予针灸疗法，观察组在对照组基础上给予推拿治疗。评价2 组临床疗效，比较2 组治疗前后临床症状评分、血流动力学指标及生活质量评定问卷（GQOL-74） 评分的变化。结果：观察组总有效率为93.18%，高于对照组79.55%，差异有统计学意义（P＜0.05）。治疗后，2 组肩颈痛、眩晕、头痛评分较治疗前升高（P＜0.05），且观察组各项评分高于对照组（P＜0.05）。治疗后，2 组椎动脉-基底动脉平均血流速度（TMFV）、收缩期峰值血流速度（PSV） 较治疗前升高，血管搏动指数（PI）、阻力指数（RI） 较治疗前降低（P＜0.05）；且观察组椎动脉-基底动脉TMFV、PSV 高于对照组，PI、RI 低于对照组（P＜0.05）。治疗后，2 组生活质量评定问卷（GQOL-74）中各项生活质量评分较治疗前升高（P＜0.05），且观察组各项评分高于对照组（P＜0.05）。结论：推拿联合针灸治疗椎动脉型颈椎病疗效较好，可以缓解患者临床症状，改善血流动力学指标，提高生活质量。
Abstract：Objective：To observe the clinical effect of the therapy of Chinese massage combined with acupuncture and moxibustion on cervical spondylosis of vertebral artery type and its influence on hemodynamics and quality of life of patients. Methods：A total of 88 patients with cervical spondylosis of vertebral artery type were divided into the observation group and the control group according to the random number table method，with 44 cases in each group. The control group was treated with acupuncture and moxibustion， and the observation group was additionally treated with Chinese massage based on the treatment of the control group. The clinical effects in the two groups were evaluated. The changes of clinical symptom scores，hemodynamic indexes and the scores of Generic Quality of Life Inventory-74(GQOL-74) were compared between the two groups before and after treatment. Results：The total effective rate was 93.18% in the observation group， higher than that of 79.55% in the control group， the difference being significant(P＜0.05). After treatment， the scores of shoulder and neck pain， vertigo and headache in the two groups were increased when compared with those before treatment(P＜0.05)， and the above symptom scores in the observation group were higher than those in the control group(P＜0.05). After treatment，the temporal mean flow velocity(TMFV) and peak systolic velocity(PSV) in the vertebral artery- basilar artery in the two groups were increased when compared with those before treatment， and the pulsitility index(PI) and resistance index(RI) were decreased(P＜0.05)； the TMFV and PSV in the vertebral artery- basilar artery in the observation group were higher than those in the control group，and PI and RI were low(P＜0.05). After treatment， each score in GQOL- 74 in the two groups was increased when compared with that before treatment(P＜0.05)，and each score in the observation group was higher than that in the control group(P＜0.05). Conclusion： The therapy of Chinese massage combined with acupuncture and moxibustion has a great therapeutic effect on the treatment of cervical spondylosis of vertebral artery type， which can relieve the clinical symptoms， improve the hemodynamic indexes and enhance the quality of life.