中医外治法治疗颈性眩晕的临床研究进展

Clinical Research Progress on the Treatment of Cervical Vertigo with Traditional Chinese Medicine External Therapies

摘要: 颈源性眩晕源于颈椎退变、力学失衡，中医病机属督脉瘀滞、经筋失和、清阳不升。中医外治法(针刺、推拿、艾灸、针刀及联合方案)通过改善椎–基底动脉血流、抗炎、调节交感神经、修复本体感觉及恢复颈椎力学平衡等多靶点协同起效，临床证实安全有效。但当前研究存在操作规范不统一、辨证标准量化不足、高质量RCT及远期随访数据缺乏等问题，未来需深化机制探索并推进规范化临床试验。

Abstract: Cervical vertigo originates from cervical degeneration and biomechanical imbalance, with a TCM pathogenesis characterized by stagnation of the Du meridian, disharmony of the collateral sinews, and failure of ascending clear yang. Traditional Chinese medicine external therapies—including acupuncture, massage, moxibustion, needling knife, and combined approaches—exert their therapeutic effects through multiple mechanisms such as improving vertebral-basilar arterial blood flow, anti-inflammatory actions, sympathetic nervous system regulation, proprioceptive recovery, and restoration of cervical biomechanical balance. Clinical evidence confirms their safety and efficacy. However, current research faces challenges, including inconsistent operational standards, insufficient quantification of syndrome differentiation criteria, and a lack of high-quality randomized controlled trials (RCTs) and long-term follow-up data. Future studies should deepen mechanistic exploration and advance standardized clinical trials.