摘要
目的观察穴位针刺治疗声带小结患者的喉镜图像、嗓音声学及喉血流动力学变化,客观评价该治疗方法的疗效并探讨其作用机理。方法选择36例声带小结患者行人迎、列缺、造海穴针刺治疗,治疗前后进行患者电子喉镜检查及嗓音声学检测,以实时二维彩色多普勒血流显像系统(real-timetwo-dimensionalcolorDopplerflowimaging,RT-2DCDFI)检查其中30例患者针刺前及取针后即刻甲状腺上动脉血流动力学参数变化。结果 36例患者治疗后喉镜检查显示,6例声带小结基本消失(治愈),28例声带小结缩小(改善),2例声带小结无明显变化。声学检测显示与治疗前比较,治疗后患者嗓音频率微扰(jitter)、振幅微扰(shimmer)及声门噪声能量(NNE)均值均下降(P<0.05)。彩色多普勒血流显像检查显示针刺取针后即刻与针刺前比较,除最大血流速度(Vmax)外其它各项血流参数值均有显著性差异,血管舒张期内径(D)增宽(P<0.01),最小血流速度(Vmin)、平均流速(Tamx)增大(P<0.05),搏动指数(PI)和阻力指数(RI)减小(P<0.01),单位时间内血流量(Q)增大(P<0.01)。结论喉镜检查及嗓音声学检测证实针刺治疗声带小结具有显著的疗效;彩色多普勒血流显像检查表明,针刺治疗可使喉部血管扩张、喉部血流量增加,此点可能是针刺治疗喉部增生性炎症的作用机制。
Objective To investigate the laryngoscopic images, acoustic characteristics and laryngeal hemodynamics of the patients with vocal nodules treated using acupuncture, and to evaluate objectively the effectiveness of acupuncture and discuss the possible mechanism of this therapy. Methods Thirty-six patients with vocal nodules received the acupuncture on three pairs Of acupoints （Renyin, Lieque and Zhaohai）. Laryngoscopic and acoustic examinations were performed before and after the treatment inall patients. A real-time two-dimensional color Doppler flow imaging （RT-2D CDFI） was used to measure the blood flow of thyroid gland arteries before acupuncture and at the moment of pulling out the needles in 30 cases. Results The laryngoscopy showed that 6 of the original 36 treated with acupuncture were cured and had normal glottal images, and 28 cases were improved in glottal images. The.acoustics analysis revealed that the acoustic parameters （jitter, shimmer and NNE） in all cases were significantly decreased after treatment when compared with the date before treatment（P 〈0.05）, There was a significant difference of hemodynamic data between before and after treatment except Vmax. At the moment of pulling out needles, the artery diameter, Vmin and Tamx were increased, PI and RI were decreased, and blood flow was increased （P 〈0.05 or P 〈0.01）. Conclusions The Laryngoscopy and acoustic analysis confirmed that acupuncture is an effective treatment for vocal noudles. CDFI suggested that acupuncture has a significant effect on improving laryngeal blood flow, which may be the mechanism of this treatment for benign vocal disorders.
出处
《中国中西医结合耳鼻咽喉科杂志》
2010年第4期208-211,共4页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
基金
江苏省中医药局科研基金(WA0101)
