基于解剖结构的针刀治疗颈源性头痛的研究进展
|
摘要
针刀治疗颈源性头痛主要是利用针刀器具对颈枕部的肌肉、筋膜及关节突关节等进行松解,解除神经的卡压。本文归纳了针刀治疗颈源性头痛的解剖学基础及应用现状,主要从颈部解剖结构及发病机制方面探讨了针刀在颈源性头痛诊疗过程中的相关问题,梳理了治疗常用术式及靶点,明确了该病的治疗层次,旨在为提高颈源性头痛针刀治疗的术式明确性及安全性提供参考。
Acupotomy treatment in cervicogenic headache is mainly using needle knife to prick and cut the muscles,fascia, and facet joints of the cervical occipital region, so as to release the nerves entrapment. This article summarizes the anatomical basis and application status of acupotomy treatment in cervicogenic headache, analyzes the problems from anatomical structure and pathogenesis, and summarizes common operation and target of treatmentarticle, aims to provide a reference for the surgical procedure and improve safety of acupotomy treatment in cervicogenic headache.
Acupotomy treatment in cervicogenic headache is mainly using needle knife to prick and cut the muscles,fascia, and facet joints of the cervical occipital region, so as to release the nerves entrapment. This article summarizes the anatomical basis and application status of acupotomy treatment in cervicogenic headache, analyzes the problems from anatomical structure and pathogenesis, and summarizes common operation and target of treatmentarticle, aims to provide a reference for the surgical procedure and improve safety of acupotomy treatment in cervicogenic headache.
引文
[1]Shimohata K,Hasegawa K,Onodera O,et al.The Clinical Features,Risk Factors,and Surgical Treatment of Cervicogenic Headache in Patients With Cervical Spine Disorders Requiring Surgery[J].Headache,2017,57(7):1109-1117.
[2]Fredriksen TA,Antonaci F,Sjaastad O.Cervicogenic headache:too important to be left un-diagnosed[J].J Headache Pain,2015,16(1):6.
[3]何亮亮,倪家骧.颈源性头痛诊断及治疗研究进展[J].中国全科医学,2016,19(12):1392-1395.
[4]Jafari M,Bahrpeyma F,Togha M.Effect of ischemic compression for cervicogenic headache and elastic behavior of active trigger point in the sternocleidomastoid muscle us ing ultrasound imaging[J].J Bodyw Mov Ther,2017,21(4):933-939.
[5]Gellhorn AC,Katz JN,Suri P.Osteoarthritis of the spine:the facet joints[J].Nat Rev Rheumatol,2013,9(4):216.
[6]Rana MV.Managing and treating headache of cervicogenic origin[J].Med Clin North Am,2013,97(2):267-280.
[7]Narouze SN.Atlanto-axial and atlanto-occipital joints injection in the treatment of headaches and neck Pain[M]//Comprehensive Treatment of Chronic Pain by Medical,Interventional,and Integrative Approaches.Springer New York,2015:87-91.
[8]左亚忠,钟力炜,刘洪波,等.颈源性头痛病因及治疗进展[J].颈腰痛杂志,2010,31(4):297-299.
[9]Finiels PJ,Batifol D.The treatment of occipital neuralgia:Review of 111 cases[J].Neurochirurgie,2016,62(5):233-240.
[10]韩震,尹保国,刘畅,等.枕大神经卡压综合征的应用解剖学和针刀治疗研究[J].中国骨伤,2005,18(1):10-12.
[11]廖立青,李义凯,贺善礼,等.第三枕神经的解剖学观测及临床意义[J].中国中医骨伤科杂志,2017,25(2):12-14.
[12]李义凯,杨先文,查和萍.枕部神经的解剖学观测及临床意义[J].中国中医骨伤科杂志,2005,13(6):4-5.
[13]田云虎,刘亚,刘焕彩,等.手术松解治疗顽固性枕大神经痛[J].中国修复重建外科杂志,2007,21(9):967-969.
[14]李石良.针刀应用解剖与临床[M].北京:中国中医药出版社,2014:121-144.
[15]Rappaport ZH,Devor M.Experimental Pathophysiological Correlates of Clinical Symptomatology in Peripheral Neuropathie Pain Syndromes[J].Stereotact Funct Neurosurg,1990,54(8):90-95.
[16]Kallakuri S,Singh A,Lu Y,et al.Tensile stretching of cervical facet joint capsule and related axonal changes[J].Eur Spine J,2008,17(4):556-563.
[17]李义凯,徐达传.寰枕后膜挛缩症的临床思考[J].中国康复医学杂志,2008,23(10):936-939.
[18]李石良,韩峰,王全贵.枕部针刀松解治疗颈源性头痛的临床研究[J].中国骨伤,2012,25(1):22-24.
[19]游安江.小针刀联合神经阻滞法治疗颈源性头痛临床观察[J].亚太传统医药,2017,13(15):123-124.
[20]王芳,吴君瑞,吴汉卿.水针刀联合颈椎旁注射治疗颈源性头痛疗效探讨[J].中外医疗,2016,35(23):90-91.
[21]孙景涵.小针刀综合治疗对慢性颈源性头痛患者疼痛的疗效分析[J].世界最新医学信息文摘:电子版,2015,15(3):84.
[22]孙琦.极细小针刀配合手法复位对颈源性头痛患者进行治疗的效果分析[J].当代医药论丛,2017,15(3):139-140.
[23]李元平,史峰波,张旭.针刀配合头痛宁胶囊治疗颈源性头痛[J].中国民族民间医药杂志,2012,21(10):94.
[24]彭勋超.曾朝芬主任中医师针刀治疗颈源性头痛经验[J].中国中医急症,2012,21(9):1414-1415.
[25]俞伟,魏威,叶杨.针刀结合推拿治疗中青年颈肌紧张所致颈源性头痛的临床观察[J].中国中医药科技,2014,21(4):443-445.
[26]马云.针刀松解激痛点治疗颈源性头痛41例[J].中国民族民间医药杂志,2017,26(7):100-102.
[27]乔晋琳,丁宇,张秀芬,等.针刀——整脊技术治疗颈源性头痛前瞻性多中心临床研究[J].世界中医药,2017,12(6):1439-1422.
[28]孙立强.口服葛根汤配合针刀松解治疗颈源性头痛[C]//全国第二届针刀治疗膝关节病学术研讨会中国针灸学会针灸针刀科普讲座论文汇编,2012:78-80.
[29]郭建中,孙立靖,黄宪梅.针刀松解斜角肌治疗颈源性头痛例临床观察[J].河北中医,2012,34(5):720-721.
[30]田红宾.小针刀联合手法治疗颈源性头痛例临床观察[J].河北中医,2016,38(2):251-254.
[31]赖显金,李英博.针刀治疗颈源性头痛的临床疗效[J].黑龙江医药,2016,29(3):568-570.
[32]李红,刘方铭,孙小清.针刀松解“项七针”及肌肉附着点治疗颈源性头痛临床研究[J].中医学报,2016,31(5):667-669.
[33]李春霖.针刀松解颈周腧穴治疗颈源性头痛的临床研究[D].济南:山东中医药大学,2015:6.
[34]周阳辉,康忠华.神经阻滞与小针刀治疗颈源性头痛的临床观察[J].实用疼痛学杂志,2009,5(1):31-33.
[35]孟国礼.针刀治疗颈源性头痛41例[J].中国社区医师,2008,24(23):33.
[2]Fredriksen TA,Antonaci F,Sjaastad O.Cervicogenic headache:too important to be left un-diagnosed[J].J Headache Pain,2015,16(1):6.
[3]何亮亮,倪家骧.颈源性头痛诊断及治疗研究进展[J].中国全科医学,2016,19(12):1392-1395.
[4]Jafari M,Bahrpeyma F,Togha M.Effect of ischemic compression for cervicogenic headache and elastic behavior of active trigger point in the sternocleidomastoid muscle us ing ultrasound imaging[J].J Bodyw Mov Ther,2017,21(4):933-939.
[5]Gellhorn AC,Katz JN,Suri P.Osteoarthritis of the spine:the facet joints[J].Nat Rev Rheumatol,2013,9(4):216.
[6]Rana MV.Managing and treating headache of cervicogenic origin[J].Med Clin North Am,2013,97(2):267-280.
[7]Narouze SN.Atlanto-axial and atlanto-occipital joints injection in the treatment of headaches and neck Pain[M]//Comprehensive Treatment of Chronic Pain by Medical,Interventional,and Integrative Approaches.Springer New York,2015:87-91.
[8]左亚忠,钟力炜,刘洪波,等.颈源性头痛病因及治疗进展[J].颈腰痛杂志,2010,31(4):297-299.
[9]Finiels PJ,Batifol D.The treatment of occipital neuralgia:Review of 111 cases[J].Neurochirurgie,2016,62(5):233-240.
[10]韩震,尹保国,刘畅,等.枕大神经卡压综合征的应用解剖学和针刀治疗研究[J].中国骨伤,2005,18(1):10-12.
[11]廖立青,李义凯,贺善礼,等.第三枕神经的解剖学观测及临床意义[J].中国中医骨伤科杂志,2017,25(2):12-14.
[12]李义凯,杨先文,查和萍.枕部神经的解剖学观测及临床意义[J].中国中医骨伤科杂志,2005,13(6):4-5.
[13]田云虎,刘亚,刘焕彩,等.手术松解治疗顽固性枕大神经痛[J].中国修复重建外科杂志,2007,21(9):967-969.
[14]李石良.针刀应用解剖与临床[M].北京:中国中医药出版社,2014:121-144.
[15]Rappaport ZH,Devor M.Experimental Pathophysiological Correlates of Clinical Symptomatology in Peripheral Neuropathie Pain Syndromes[J].Stereotact Funct Neurosurg,1990,54(8):90-95.
[16]Kallakuri S,Singh A,Lu Y,et al.Tensile stretching of cervical facet joint capsule and related axonal changes[J].Eur Spine J,2008,17(4):556-563.
[17]李义凯,徐达传.寰枕后膜挛缩症的临床思考[J].中国康复医学杂志,2008,23(10):936-939.
[18]李石良,韩峰,王全贵.枕部针刀松解治疗颈源性头痛的临床研究[J].中国骨伤,2012,25(1):22-24.
[19]游安江.小针刀联合神经阻滞法治疗颈源性头痛临床观察[J].亚太传统医药,2017,13(15):123-124.
[20]王芳,吴君瑞,吴汉卿.水针刀联合颈椎旁注射治疗颈源性头痛疗效探讨[J].中外医疗,2016,35(23):90-91.
[21]孙景涵.小针刀综合治疗对慢性颈源性头痛患者疼痛的疗效分析[J].世界最新医学信息文摘:电子版,2015,15(3):84.
[22]孙琦.极细小针刀配合手法复位对颈源性头痛患者进行治疗的效果分析[J].当代医药论丛,2017,15(3):139-140.
[23]李元平,史峰波,张旭.针刀配合头痛宁胶囊治疗颈源性头痛[J].中国民族民间医药杂志,2012,21(10):94.
[24]彭勋超.曾朝芬主任中医师针刀治疗颈源性头痛经验[J].中国中医急症,2012,21(9):1414-1415.
[25]俞伟,魏威,叶杨.针刀结合推拿治疗中青年颈肌紧张所致颈源性头痛的临床观察[J].中国中医药科技,2014,21(4):443-445.
[26]马云.针刀松解激痛点治疗颈源性头痛41例[J].中国民族民间医药杂志,2017,26(7):100-102.
[27]乔晋琳,丁宇,张秀芬,等.针刀——整脊技术治疗颈源性头痛前瞻性多中心临床研究[J].世界中医药,2017,12(6):1439-1422.
[28]孙立强.口服葛根汤配合针刀松解治疗颈源性头痛[C]//全国第二届针刀治疗膝关节病学术研讨会中国针灸学会针灸针刀科普讲座论文汇编,2012:78-80.
[29]郭建中,孙立靖,黄宪梅.针刀松解斜角肌治疗颈源性头痛例临床观察[J].河北中医,2012,34(5):720-721.
[30]田红宾.小针刀联合手法治疗颈源性头痛例临床观察[J].河北中医,2016,38(2):251-254.
[31]赖显金,李英博.针刀治疗颈源性头痛的临床疗效[J].黑龙江医药,2016,29(3):568-570.
[32]李红,刘方铭,孙小清.针刀松解“项七针”及肌肉附着点治疗颈源性头痛临床研究[J].中医学报,2016,31(5):667-669.
[33]李春霖.针刀松解颈周腧穴治疗颈源性头痛的临床研究[D].济南:山东中医药大学,2015:6.
[34]周阳辉,康忠华.神经阻滞与小针刀治疗颈源性头痛的临床观察[J].实用疼痛学杂志,2009,5(1):31-33.
[35]孟国礼.针刀治疗颈源性头痛41例[J].中国社区医师,2008,24(23):33.