中西医结合治疗椎动脉型颈椎病的证据评估

Evidence Assessment of Integrated Traditional Chinese and Western Medicine in the Treatment of Vertebral Artery Type of Cervical Spondulicks

摘要: 椎动脉型颈椎病是因颈椎退行性变化、动力性及机械性因素等造成椎动脉受压迫或刺激并最终诱发椎–基底动脉供血不足的一类症候群在颈椎病分类体系中占有重要地位该病症发病机制较为复杂核心与颈椎结构变化对椎动脉产生的作用相关目前临床上治疗手段主要包含药物干预、手术治疗与保守疗法三类药物干预依靠扩张血管、改善脑细胞代谢等机制减轻症状手术治疗通过减压术、融合术等途径解决结构性问题保守疗法则涵盖物理治疗与康复训练。这些治疗手段在一定程度上具备效果临床诊疗仍面临诊断标准不够精准、治疗效果评估体系不够完善等难题。未来伴随基因治疗、生物材料应用等新型技术的问世加之围绕细胞生物学及分子水平展开的新疗法研究椎动脉型颈椎病治疗领域有望实现更大突破。

Abstract: Vertebral artery type cervical spondulicks refers to a type of syndrome that causes compression or irritation of the vertebral artery due to cervical degenerative changes, dynamic and mechanical factors, and ultimately induces cerebrovascular insufficiency, and it occupies an important position in the classification system of cervical spondulicks. The pathogenesis of this disease is relatively complex, and its core is related to the effect of cervical structural changes on the vertebral artery. Currently, clinical treatment methods mainly include three categories: drug intervention, surgical treatment and conservative therapy—drug intervention alleviates symptoms by means of vasodilation, improving brain cell metabolism and other mechanisms, surgical treatment solves structural problems through approaches such as decompression and fusion surgery, and conservative therapy covers physical therapy and rehabilitation training. These treatment methods are effective to a certain extent, but clinical diagnosis and treatment still face problems such as imprecise diagnostic criteria and incomplete treatment effect evaluation system. In the future, with the advent of new technologies such as gene therapy and the application of bio-materials, and the research on new therapies carried out around cell biology and molecular levels, greater breakthroughs are expected in the treatment field of vertebral artery type cervical spondulicks.