[Efficacy of Modified Acupuncture Method at Renying (ST 9) for Patients with Cervical Spondylosis of Vertebral Artery Type and Its Impact on Velocity of Cervical Blood Flow].

OBJECTIVE: To observe the clinical efficacy of modified acupuncture at Renying point (ST 9) for patients with cervical spondylosis of vertebral artery type and its influence on velocity of cervical blood flow. METHODS: Fifty-nine cases of vertebral artery type cervical spondylosis were randomly divided into control group (n=30) and treatment group (n=29). Both groups were acupunctured at ST 9, with routine acupuncture technique used in the control group and modified technique in the treatment group, respectively. All cases received two courses of treatment, each course covered consecutive 6 once-per-day treatments. Before and after treatment, transcranial Doppler (TCD) was used to measure the systolic peak blood flow velocity (Vs) of left vertebral artery (LVA), right vertebral artery (RVA) and basilar artery (BA), and the scores of "cervical vertigo symptoms and functional assessment scale" (CVSFAS) were also assessed, separately. RESULTS: CVSFAS scoring, Vs of LVA, RVA and BA after treatment showed significant improvement compared with those before treatment (P<0.01, P<0.05). The efficacy of the treatment group in the above mentioned indexes was superior to that of the control group (P<0.05). The total effective rate of the treatment group was 93.1% (27/29), superior to 70.0% (21/30) of the control group (P<0.05). CONCLUSIONS: The modified acupuncture method at ST 9 is clinically effective in the treatment of cervical spondylosis of vertebral artery type via increasing the Vs of vertebral-basilar artery, improving the local blood circulation and relieving pain.

Evaluation of a granulated formula for the nerve root type and vertebral artery type of cervical spondylosis: a multicenter, single-blind, randomized, controlled, phase â ¢ clinical trial.

OBJECTIVE: To evaluate the effectiveness and safety of cervical spondylosis formula granules in reducing the symptoms of patients with the nerve root type and the vertebral artery type of cervical spondylosis. METHODS: This was a multicenter, single-blind, randomized, controlled trial. From April 2002 to November 2003, 499 patients were randomly assigned to either the treatment or the control group. The treatment group was orally administered granules prepared with a formula for cervical spondylosis, while the control group was given Jingfukang granules. The treatment course was 1 month for both groups. RESULTS: In patients with the nerve root type of cervical spondylosis, the total effect rate in the treatment group (87.21% ) was significantly higher than that in the control group (80.70%, P < 0.01). After the treatment period in both groups, the treatment group had a significantly greater rate of resolution of pain, numbness of the upper limbs, muscle strength of the upper limbs, and fatigue than the control group (all P < 0.05). In patients with the vertebral artery type of cervical spondylosis, the total effect rate in the treatment group (82.07%) was similar to that in the control group (71.21% , P > 0.05). After the treatment period in both groups, the treatment group had a significantly greater rate of resolution of weakness of the waist and knees than the control group (P < 0.05). CONCLUSION: The cervical spondylosis formula granules significantly improve numbness, muscle strength, and fatigue, and reduce pain in patients with the nerve root type of cervical spondylosis, and improve the weakness of the waist and knees in patients with the vertebral artery type of cervical spondylosis.

[Cervical spondylosis of vertebral artery treated with thermosensitive moxibustion with different dosages: a randomized controlled trial].

OBJECTIVE: To compare the difference in the clinical efficacy on cervical spondylosis of vertebral artery type (CSA) treated with thermosensitive moxibustion at different dosages. METHODS: Sixty cases of CSA were randomized into a saturated moxa dosage group and a regular moxa dosage group, 30 cases in each one. The thermosensitive moxibustion was adopted in the two groups. The mild suspended moxibustion was applied at two acupoints with the strongest thermosensitization. In the saturated moxa dosage group, the moxibustion time was determined by the disappearance of thermosensitization. In the regular moxa dosage group, 15 min was required on each acupoint. The treatment was given twice a day for first 4 days in the two groups. Since the 5th day, the treatment was given once a day, continuously for 10 times, and totally 14 days were required. The score of symptoms and function and clinical efficacy were compared between the two groups before and after treatment as well as 6-month follow-up after treatment. RESULTS: The curative and effective rate was 56.7% (17/30) after treatment and 60.0% (18/30) in 6-month follow-up after treatment in the saturated moxa dosage group, which were superior to 26.7% (8/30) and 30.0% (9/30) in the regular moxa dosage group respectively (P < 0.01, P < 0.05). The scores of clinical symptoms and function after treatment and in follow-up were improved apparently as compared with those before treatment in both groups (all P < 0.01). The scores of clinical symptoms and function after treatment and in follow-up in the saturated moxa dosage group were increased much more apparently than those in the regular moxa dosage group (after treatment: 22.32 +/- 4.64 vs 17.43 +/- 3.21; in follow-up: 23.01 +/- 4.76 vs 18.32 +/- 2.13, both P < 0.01). CONCLUSION: The thermosensitization moxibustion of saturated dosage achieves the superior short-term and long-term efficacies in the treatment of CSA as compared with the regular moxibustion dosage.

[Impacts on vertebral arterial blood flow of cervical spondylosis of vertebral artery type treated by abdominal acupuncture].

OBJECTIVE: To explore the therapeutic effect and mechanism of abdominal acupuncture for cervical spondylosis of vertebral artery type. METHODS: Thirty cases of cervical vertigo, in which the color ultrasonography indicated vertebral arterial blood insufficiency, were treated with abdominal acupuncture therapy. The points were Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4), Xiawan (CV 10), Shangqu (KI 17) and Huaroumen (ST 24). The treatment was given once every day and five continuous treatments made one session. Separately, before treatment and in the 1st and 5th treatments, the cervical vertigo symptom and functional assessment scales were adopted for scoring. Simultaneously, the color ultrasonography was applied to observe the blood flow changes of the bilateral cervical arteries. RESULTS: Except the score for headache in the 1st treatment, the scores in cervical vertigo and function assessment scale in the 1st and 5th treatments were all improved significantly in 30 patients as compared with those before treatment (P < 0.01, P < 0.05). In the 1st and 5th treatments, on the affected side, the vertebral artery diameter, mean velocity and blood flow per minute were all improved significantly as compared with those before treatment (all P < 0.01). In one session treatment, the total effective rate was 100.0% (30/30) and the curative rate was 60.0% (18/30). CONCLUSION: Abdominal acupuncture therapy not only relieves the clinical symptoms, but also improves vertebral arterial blood supply for the patients of cervical spondylosis of vertebral artery type.

Effect of selected manual therapy interventions for mechanical neck pain on vertebral and internal carotid arterial blood flow and cerebral inflow.

BACKGROUND: Manual therapy of the cervical spine has occasionally been associated with serious adverse events involving compromise of the craniocervical arteries. Ultrasound studies have shown certain neck positions can alter craniocervical arterial blood flow velocities; however, findings are conflicting. Knowledge about the effects of neck position on blood flow may assist clinicians in avoiding potentially hazardous practices. OBJECTIVE: The purpose of this study was to examine the effects of selected manual therapeutic interventions on blood flow in the craniocervical arteries and blood supply to the brain using magnetic resonance angiography (MRA). DESIGN: This was an experimental, observational magnetic resonance imaging study. METHOD: Twenty adult participants who were healthy and had a mean age of 33 years were imaged using MRA in the following neck positions: neutral, rotation, rotation/distraction (similar to a Cyriax manipulation), C1-C2 rotation (similar to a Maitland or osteopathic manipulation), and distraction. RESULTS: The participants were imaged using 3T MRA. All participants had normal vascular anatomy. Average inflow to the brain in neutral was 6.98 mL/s and was not significantly changed by any of the test positions. There was no significant difference in flow in any of the 4 arteries in any position from neutral, despite large individual variations. LIMITATIONS: Only individuals who were asymptomatic were investigated, and a short section of the arteries only were imaged. CONCLUSIONS: Blood flow to the brain does not appear to be compromised by positions commonly used in manual therapy. Positions using end-range neck rotation and distraction do not appear to be more hazardous to cerebral circulation than more segmentally localized techniques.

Clinical effects of innovative tuina manipulations on treating cervical spondylosis of vertebral artery type and changes in cerebral blood flow.

OBJECTIVE: To determine the clinical effect, treatment times, and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations. METHODS: One hundred and twenty six cervical spondylosis patients (vertebral artery type) were randomly divided into test and control groups. Patients in the test group were treated with innovative Tuina manipulations, while those in the control group were treated with the routine Tuina manipulations according to the textbook of Chinese Massage for Acupuncture and Moxibustion majors. The clinical effects, treatment times, clinical symptoms, and cerebral blood flow were measured. RESULTS: The response to the treatment was 100% in the test group and 88.71% in the control group. Patients in the test group required (7 +/- 4) treatments before recovery, while those in the control group required (15 +/- 7) treatments before recovery (P<0.05). The clinical symptoms exhibited greater improvement in the test group compared to the control group (P<0.05). There were no differences in cerebral blood flow between the two groups. CONCLUSION: Both innovative Tuina manipulations and routine Tuina manipulations produced satisfactory therapeutic results in vertebral artery type cervical spondylosis patients. However, the innovative manipulation was more effective in improving the functional symptoms, although there were no changes in the cerebral blood flow.

[Penetrating needling on head points for vertigo caused by vertebral-basilar arterial blood-supply insufficiency].

OBJECTIVE: To observe the differences in therapeutic effect between penetrating needling on head points and acupuncture of syndrome division in the treatment of vertigo caused by vertebral-basilar arterial blood-supply insufficiency. METHODS: Sixty cases of vertigo caused by vertebral-basilar arterial blood-supply insufficiency were divided into 2 groups: a penetrating needling on head points group (group A) and an acupuncture of syndrome division group (group B), 30 cases in each one. In group A, penetrating needling technique was applied from Baihui (GV 20) towards Qianding (GV 21), Shuaigu (GB 8) towards Qubin (GB 7) and Yuzhen (BL 9) towards Tianzhu (BL 10). Electric stimulation was added. In group B, the acupoints were selected according to syndromes. For example, upper disturbance of wind yang: Ganshu (BL 18), Xingjian (LR 2),etc. were selected; upper disturbance of turbid phlegm: Yinlingquan (SP 9), Fenglong (ST 40), etc. were selected; qi and blood deficiency: Baihui (GV 20), Xuehai (SP 10), etc. were selected; liver and kidney yin deficiency: Ganshu (BL 18), Shenshu (BL 23), etc. were selected. Electric stimulation and needling manipulation were conducted on those acupoints. Ten treatments made one session. After continuous 2 sessions of treatment, the efficacy, symptom score and physical sign score were compared between two groups. Transcranial Doppler (TCD) examination was done to observe hemodynamic changes of anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) before and after treatment. RESULTS: The total effective rate in group A was 96.7% (29/30) that was obviously better than 83.3% (25/30) in group B (P<0.05). The scores of vertigo degree, vertigo frequency, duration and accompanied symptoms after treatment were lower obviously as compared with those before treatment in two groups (all P<0.05). The improvements in group A were much significant (all P<0.05). The highest mean velocity(Vm) of bilateral MCA, ACA and PCA were apparently reduced after treatment in two groups (P< 0.05, P<0.01). The improvements in group A were much more apparently (all P<0.05). CONCLUSION: The penetrating needling on head points can effectively relieve vertigo caused by vertebral-basilar arterial blood-supply insufficiency, reduce the attack frequency and improve in its accompanied symptoms. Its clinical efficacy is significantly superior to that in acupuncture of syndrome division group.

[Evaluation of the immediate effect of acupuncture on cervical spondylosis of vertebral artery type based on orthogonal design].

OBJECTIVE: To analyze the differences in the immediate effect of acupuncture on cervical spondylosis of vertebral artery type among three factors: needling technique, acupoint selection and time of needle retaining so as to option the best therapeutic program. METHODS: Thirty-two cases were observed and randomly divided into 8 groups, 4 cases in each one. The orthogonal design of three factors and two levels was adopted. There were needling technique (electroacupuncture, reinforcing and reducing method), acupoint selection [C4-C7 Jiaji (EX-B 2) and three needles of neck: Tianzhu (BL 10), Jingbailao (EX-LHN 15), Dazhu (BL 11)] and time of needle retaining (5 min, 15 min). L8 (2(7)) orthogonal design table was arranged in the trial. The changes in mean velocity (Vm) of vertebral artery (VA) and basilar artery (BA) were observed before and after acupuncture. RESULTS: The immediate effect of VA-BA blood flow was the most significant after electroacupuncture at C4-C7 Jiaji (EX-B 2), with continuous wave for 5 min. This method and acupoint selection greatly influenced the therapeutic results (both P<0.05). CONCLUSION: The optimized therapeutic program of the immediate effect of acupuncture for cervical spondylosis of vertebral artery type is electroacupuncture + C4-C7 Jiaji (EX-B 2) + 5 min. The importance of different factors for the immediate effect in acupuncture treatment of cervical spondylosis of vertebral artery type is: acupoint selection > needling technique > time of needle retaining.

[Observation of therapeutic effects on cervical vertigo treated with different methods].

OBJECTIVE: To compare the therapeutic effects of routine acupuncture, the electroacupuncture and the combined therapy of electroacupuncture and acupoint injection. METHODS: Ninety-one cases were randomly divided into a routine acupuncture group (30 cases), an electroacupuncture group (31 cases), and a combined therapy of electroacupuncture and acupoint injection group (30 cases). Zusanli (ST 36), Fengchi (GB 20), Anmian (Extra), Taiyang (EX-HN 5), Hegu (LI 4), Yintang (EX-HN 3), Baihui (GV 20) and Sishengcong (EX-HN 1) were selected among 3 groups. Even manipulation was applied in routine acupuncture group; G 6805 electroacupuncture apparatus was added in electroacupuncture group; in combined therapy of electroacupuncture and acupoint injection group, electroacupuncture was applied, besides, Vitamin B12 0.5 mg and 0.2%/ Lidocaine 2 mL were injected at Fengchi (GB 20) and Anmian (Extra). Twenty treatments were given in 4 weeks. The changes of average blood flow of vertebral artery and basilar artery before and after treatment were observed and graded by the cervical vertigo syndrome and function score; the therapeutic effects were evaluated as well. RESULTS: The average blood flow of vertebral artery and basilar artery, and the cervical vertigo syndrome and function score were improved in 3 groups (all P < 0.01), in which, it was more obvious in combined therapy of electroacupuncture and acupoint injection group than in others (P < 0.05, P < 0.01), and it in electroacupuncture group was superior to that in routine acupuncture group (P < 0.05). The effective rate was 63.3% (19/30) in routine acupuncture group, 80.6% (25/31) in electroacupuncture group and 90.3% (28/30) in combined therapy of electroacupuncture and acupoint injection group, indicating the significant differences among them (P < 0.05, P < 0.01). CONCLUSION: The routine acupuncture, electroacupuncture, and combined therapy of electroacupuncture and acupoint injection are effective for cervical vertigo; the combined therapy is the best, and electroacupuncture comes second. It illustrates that the routine acupuncture, electroacupuncture, and combined therapy of electroacupuncture and acupoint injection have additive effects on treatment of cervical vertigo.

[Observation on therapeutic effect of cervical spondylosis of vertebral artery type treated with both acupuncture and mild moxibustion].

OBJECTIVE: To observe the clinical therapeutic effects on cervical spondylosis of vertebral artery type treated with both acupuncture and mild moxibustion and investigate the mechanism of action. METHODS: Sixty cases were randomly divided into the combined therapy group of acupuncture and mild moxibustion (combined therapy group) and the acupuncture group, 30 cases for each group. In combined therapy group, Baihui (GV 20), Fengchi (GB 20) and cervical Jiaji (EX-B 2) were punctured, and Baihui(GV 20), Dazhui (GV 14), Mingmen (GV 4), Shenque (CV 8) and Guanyuan (CV 4) were treated with mild moxibustion; in acupuncture group, acupuncture was simply applied, the acupoints selection and manipulation were the same as those in the combined therapy group. The average velocity meter and the resistive index of vertebral and basal arteries were observed before and after treatment by TCD examination, the therapeutic effects and clinical symptom-sign scores were observed too. RESULTS: The total effective rate was 93.3% (28/30) in combined therapy group, and 73.3% (22/30) in acupuncture group. The therapeutic effect in combined therapy group was superior to that in acupuncture group (P < 0.05). The improvements of symptom-sign scores in two groups after treatment were more significant than that before treatment, and the score in the combined therapy group was superior to that in acupuncture group (P < 0.05). The average velocity meter and the resistive index of vertebral and basal arteries after treatment were improved in both groups, in which, the improvement in combined therapy group was more apparent (all P < 0.05). CONCLUSION: The therapeutic effects on cervical spondylosis of vertebral artery type treated with both acupuncture and mild moxibustion are preferable; by this therapy, the average velocity meter of vertebral and basal arteries are accelerated and the resistive index is decreased.

[Experimental study of eliminat dampness resolv phlegm method in treating cervical spondylopathy of the vertebral artery type].

OBJECTIVE: To detect the velocity and viscosity of blood flow of the vertebral arteries, the apoptotic cell and apoptotic related protein in the brain in order to offer theoretical foundation for the treatment of cervical spondylopathy of the vertebral artery type with the eliminat dampness resolv phlegm method. METHODS: Sixty male Japanese big ear rabbits were divided randomly into normal sodium group (A), Flunarizine group (B), low dosage Wendantang group (C), large dosage Wendantang group (D), Flunarizine group combined with large dosage Wendantang group (E), normal group (F). Each group had 10 rabbits. Xiaozhiling injection was injected around the vertebral arteries of rabbits in group A, B C, D, E to make the model of the cervical spondylopathy of the vertebral artery type. Normal sodium (20 ml x kg(-1)d(-1)) was apply through intragastric administration in group A, F; Flunarizine (0.8 mg x kg(-1)d(-1)), low dosage Wendantang (1 g x ml(-1)d(-1)), large dosage Wendantang (2 g x ml(-1)d(-1)), Flunarizine combined with large dosage Wendantang were respectively apply through intragastric administration in group B, C, D, E. The velocity and viscosity of blood flow of the vertebral arteries, the apoptotic cell and apoptotic protein in the brain were detected before and after the treatment. RESULTS: Satisfactory animal model were obtained in group A, B, C, D, E. The rabbits of group E had the most improvement of the velocity and viscosity of blood flow of the vertebral arteries while at meantime, which had the lowest apoptotic index and apoptotic related protein expression in the brain. CONCLUSION: The routine treatment for the cervical spondylopathy of the vertebral artery combined with eliminat dampness resolv phlegm method could improve velocity and viscosity of blood flow of the vertebral arteries, which maybe relate with reduction of apoptosis in the brain.

[Evaluation of the efficacy of therapeutic physical training in patients with osteochondrosis according to rheoencephalography data].

This paper reports results of clinical and rheoencephalographic examination of 40 middle-age women with cervical osteochondrosis and symptoms of insufficiency of vertebrobasiliar blood circulation. A system of methods for therapeutic physical training has beendeveloped to normalize hemodynamics in the basin of vertebral arteries. The system was tested on 20 patients during a year. It included special physical exercises, massage, and automobilization. The efficiency of therapeutic physical training was evaluated by rheoencephalography. The women involved in the testing reported a marked improvement of the health status. Their rheoencephalograms suggested diminishing of the asymmetry coefficient and beneficial effect of therapeutic physical training on the elastic properties of vertebral arteries. No such changes were documented in a control group of women with osteochondrosis.

[Influence of manipulation on arteria vertebralis morphology and blood flow speed of cervical vertigo].

OBJECTIVE: To discuss the influence of manipulation on cervical vertigo arteria vertebralis morphology and blood flow speed. METHODS: Forty-five patients with cervical vertigo included 27 males and 18 females with an average age of 41.6 years old ranging from 25 to 60. The course of disease was from 2 weeks to 5 years. TCD were applied to test arteria vertebralis blood flow speed and 3D-CTA applied to inspect arteria vertebralis morphology as the observation targets. According to the morphology change different stage localization, the 3-step manipulation were adopt to observe the arteria vertebralis blood flow speed and the morphology influence. RESULTS: After cervical manipulation, the scoring of vertigo symptoms were improved remarkable (P<0.001); Among the patients of blood flow speed reduced and the patients of blood flow speed increased, the Vm before treament compared with after treament, there were statistical difference (P<0.01). The arteria vertebralis morphology partial patient had changed. CONCLUSION: The cervical manipulation exceptionally has the bidirectional control action to arteria vertebralis morphology change and blood flow speed in the cervical vertigo, and can cause the partial blood tubular-shaped condition to have the reversal changed.

[Influence of needle-pricking bleeding combined with pulling-rotating manipulation on blood rheology in patients with vertebral artery type cervical spondylosis].

OBJECTIVE: To observe the effect of needle-pricking bleeding combined with pulling-rotating manipulation and simple manipulation on blood rheology in vertebral artery type cervical spondylosis (VATCS) patients, so as to analyze their mechanisms in relieving VATCS. METHODS: A total of 198 VATCS patients were randomly divided into treatment group (n=101) which was treated with needle-pricking plus pulling-rotating manipulation, and control group (n=97) which was treated with simple pulling-rotating manipulation, according to the random number table. The treatment was given once every 7 days, 9 times altogether. The peak systolic blood flow velocity (Vpeak), end-diastolic blood velocity (Vmin), pulsatility index (PI) and resistent index (RI) of bilateral vertebral arteries (VA) and basilar artery (BA) were detected by transcranial doppler sonography (TCD). Whole blood apparent viscosity and the plasma viscosity in the treatment group were determined by using a blood viscosimeter. RESULTS: Of the 101 and 97 VATCS cases in the treatment and control groups, 62 (61.38%) and 12 (12.37%) were cured basically, 23 (22.77%) and 26 (26.80%) experienced marked improvement, 14 (13.86%) and 41 (42.27%) were improved. 2 (1.98%) and 18 (18.55%) failed in the treatment, with the total effective rates being 98.01% and 81.44% separately. The effective rate of the treatment group was significantly higher than that of control group (P<0.05). Compared with pretreatment, Vpeak and Vmin of the bilateral VA and BA in the treatment group, and Vpeak of the right VA in the control group increased significantly (P<0.01, P<0.05), PI and RI of the bilateral VA and BA in the treatment group, and PI and RI of the right VA in the control group decreased significantly (P<0.01, P<0.05), suggesting a marked reduction of the vascular resistance and an apparent increase of the cerebral blood supply after the treatment. The therapeutic effects of the above-mentioned indexes of treatment group were significantly superior to those of the control group (P<0.05). In comparison with pre-treatment, the whole blood apparent viscosity (high, medium and low shear rates) and plasma viscosity of the treatment group post-treatment were obviously reduced (P<0.01, P<0.05). CONCLUSION: Needle-pricking therapy combined with pulling-rotating manipulation can significantly improve VATCS patients' clinical symptoms, which may be closely related to its effects in lowering vascular blood resistance and blood viscosity and increasing cerebral blood supply.

[The vegetative status in patients with vertebrogenic vertebral artery syndrome, and its correction with health resort treatment].

According to statistics, osteochondrosis is one of the most prevalent diseases resulting in changes in the musculoskeletal, nervous, and cardiovascular systems. In vertebral artery syndrome, the irritation of sympathetic plexuses around this artery results in vasomotor changes in the vertebrobasilar system and determines the clinical picture of the syndrome, i.e. its vegetalgic and angiodystonic components. Pathology of central regulatory mechanisms and suprasegmental divisions of the vegetative nervous system appears.

Forty-six cases of vertebrobasilar insufficiency treated by acupuncture plus intravenous infusion of ligustrazine.

OBJECTIVE: To observe the therapeutic effect of acupuncture plus Ligustrazine on vertebrobasilar insufficiency (VBI) by transcranial Doppler (TCD) sonography. METHODS: 86 VBI patients including 56 cases of low flow rate velocity type (LFVT) and 30 cases of high flow velocity type (HFVT) were randomly divided into Ligustrazine group (26 LFRT and 14 HFVT) and acupuncture plus Ligustrazine group (30 LFVT and 16 HFVT). The blood flow velocity (BFV) of vertebral artery (VA) and basilar artery (BA) in systole before and after treatment was measured with TCD and therapeutic effects were evaluated after 10 days' treatment in the two groups. RESULTS: In the acupuncture plus Ligustrazine group, the total effective rate was 93.3% and 88.5% in cases of LFVT and HFVT respectively, and BFV of VA and BA increased in LFVT patients while that in HFVT patients decreased significantly (P<0.05 or P<0.01). CONCLUSION: Owing to its dual regulation on blood flow of VA and BA, the therapeutic effect of acupuncture plus Ligustrazine was better than that of simple Ligustrazine.