目的:研究针刀结合手法复位治疗对颈椎病患者椎动脉血液动力学及X线影像学的影响,探讨针刀治疗颈椎病的机理。方法:1．用彩色多普勒血流显像（CDFI）检测患者双侧椎动脉针刀治疗前后收缩峰值血流速度（VP）,平均血流速度（Vm）,搏动指数（PI）和阻力指数（RI）的变化:2．用X线开口位平片检测针刀治疗前后患者的寰椎轴线与枢椎齿突轴线差值,枢椎齿突与侧块差值的减少程度和颈椎X线平片显示双边影、双突影或椎间隙变窄、骨质增生、颈椎曲度变直、韧带钙化、椎间孔变化来评估疗效。结果:1．CDFI与治疗前相比,治疗后患者左右椎动脉的VP、Vm均有显著提高（P< 0．01）,RI有了明显降低（P<0．05）;2．X线影像学治疗前后寰椎轴线与枢椎齿突轴线差值具有高度显著性（P<0．01）枢椎齿突与侧块差值也具有显著性,（P<0．05）。因此,无论是颈椎生理曲度、双边影、双突影、还是齿突、棘突偏歪等病理改变均有了显著改善。结论:椎动脉血液动力学状况明显改善及X线影像学治疗前后的改变,消除或减轻神经、椎动脉受到的压迫、牵拉、扭曲等刺激,纠正了颈椎的力平衡失调,这是治疗颈椎病的主要机理之一。我们认为,针刀结合手法是治疗该病的一种值得推广的有效方法．

Objective: To study the mechanism of acupotomy on cervical spondylopathy and its relative diseases by observing the hemodynamics of blood flow in the cervical vertebral artery and roentgenographic signs in cervical vertebral . Methods: The Vp、Vm、PI and RI were measured by Transcranial Color Doppler before and after acupotomy treatment; Furthermore, the roentgenographic variations such as the difference of the space of odontoid process-lateral mass、he difference between axial process and axes of odontoid process、double contour sign、the narrowness of interveterbral space、osseous hyperplasia、abnormal cervical curvature、the narrowness of interveterbral foramen , were also observed and measured before and after acupotomy treatment. Conclusion: Both Vp and Vm in the vertebral arteries were faster than that of before treatment（P<0.01）,and RI were lower significantly （P<0.05） compared with before treatment; According to roentgenographic results , the difference between axial process and axes of odontoid process were significantly decreased （P<0.01）, and the difference of the space of odontoid process-lateral mass were also significantly decreased （P<0.05） ,compared with before treatment . Results: The recover of biomechanics in cervical vertebral and the improving blood supply of vertebral artery are the main mechanism of treating cervical spondylopathy and its relative diseases by acupotomy.