小艾炷直接灸治疗慢性颈痛的量效关系研究
|
摘要
目的:评价小艾炷直接灸治疗慢性颈痛的有效性,探索不同壮数的小艾炷直接灸治疗慢性颈痛的量效关系。方法:将120例慢性颈痛患者随机分为3壮组、5壮组、7壮组和假灸组,各30例,均选取风池、天柱、颈百劳、肩中俞、肩井,分别接受小艾炷直接灸3壮、5壮、7壮及假艾灸的治疗。假灸组操作采用万花油将艾炷的下1/3(约1.5 mm)浸透。每周2次,共治疗10次。观察各组治疗前、治疗后和随访1个月的NorthwickPark颈痛量表(NPQ)评分、McGill疼痛量表(MPQ)评分及局部压痛阈值(PPT),并评定各组治疗后及随访1个月的疗效。结果:治疗后和随访1个月,3壮组、5壮组及7壮组NPQ评分、MPQ评分均较治疗前降低(均P<0.01),PPT测量值均较治疗前升高(均P<0.01),而假灸组与治疗前比较,差异均无统计学意义(均P>0.05)。治疗后和随访1个月,3壮组、5壮组及7壮组NPQ评分、MPQ评分均低于假灸组(均P<0.05),PPT测量值均高于假灸组(均P<0.05);治疗后,7壮组NPQ评分、MPQ评分低于3壮组,PPT测量值高于3壮组(均P<0.05)。3壮组、5壮组和7壮组在治疗后和随访1个月的疗效优于假灸组(均P<0.05);各艾灸组间疗效比较,差异无统计学意义(P>0.05)。结论:不同壮数的小艾炷直接灸均可以有效缓解慢性颈痛,总体趋势为随着壮数增加而疗效提高。
Objective To evaluate the effectiveness in treatment of chronic neck pain with the direct moxibustion of small moxa cone and explore the dose-effect relationship in treatment of chronic neck pain with different small moxa cones. Methods A total of 120 patients with chronic neck pain were randomized into a 3-moxa-cone group, a 5-moxacone group, a 7-moxa-cone group and a sham-moxibustion group, 30 cases in each one. Fengchi(GB 20), Tianzhu(BL 10), Jingbailao(EX-HN 15), Jianzhongshu(SI 15) and Jianjing(GB 21) were selected in each of the groups. The direct moxibustion with 3, 5 and 7 moxa cones as well as the sham-moxibustion therapy were provided successively in each of the above groups. In the sham-moxibustion group, the lower 1/3 section of moxa cone(about 1.5 mm in length) was soaked in wanhua oil before used in treatment. In each group, the treatment was given twice a week, for 10 treatments totally. Separately, before treatment, after treatment and in 1-month follow-up, the scores of the Northwick Park neck pain questionnaire(NPQ), the scores of McGill pain questionnaire(MPQ) and the local pressure pain threshold(PPT) were observed in each group. After treatment and in 1-month follow-up, the therapeutic effects were evaluated in each group. Results After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxacone group and the 7-moxa-cone group were reduced as compared with those before treatment separately(all P<0.01),PPT values were increased as compared with those before treatment(all P<0.01). But the differences were not statistically significant in the sham-moxibustion group as compared with those before treatment(all P>0.05). After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were lower as compared with the sham-moxibustion group separately(all P<0.05), PPT values were higher as compared with the sham-moxibustion group(all P<0.05). After treatment, the NPQ score and MPQ score in the 7-moxa-cone group were lower than the 3-moxa-cone group and PPT values was higher than the 3-moxa-cone group(all P<0.05). After treatment and in 1-month follow-up, the therapeutic effects in the 3-moxa-cone group, the 5-moxacone group and the 7-moxa-cone group were better than the sham-moxibustion group separately(all P<0.05). But, the therapeutic effects were not significantly different in comparison among the moxibusiton groups(P>0.05).Conclusion The direct moxibustion therapy with different small-moxa-cones effectively relieves chronic neck pain. There is a trend of improvement of the therapeutic effects with increase of the numbers of moxa cones.
Objective To evaluate the effectiveness in treatment of chronic neck pain with the direct moxibustion of small moxa cone and explore the dose-effect relationship in treatment of chronic neck pain with different small moxa cones. Methods A total of 120 patients with chronic neck pain were randomized into a 3-moxa-cone group, a 5-moxacone group, a 7-moxa-cone group and a sham-moxibustion group, 30 cases in each one. Fengchi(GB 20), Tianzhu(BL 10), Jingbailao(EX-HN 15), Jianzhongshu(SI 15) and Jianjing(GB 21) were selected in each of the groups. The direct moxibustion with 3, 5 and 7 moxa cones as well as the sham-moxibustion therapy were provided successively in each of the above groups. In the sham-moxibustion group, the lower 1/3 section of moxa cone(about 1.5 mm in length) was soaked in wanhua oil before used in treatment. In each group, the treatment was given twice a week, for 10 treatments totally. Separately, before treatment, after treatment and in 1-month follow-up, the scores of the Northwick Park neck pain questionnaire(NPQ), the scores of McGill pain questionnaire(MPQ) and the local pressure pain threshold(PPT) were observed in each group. After treatment and in 1-month follow-up, the therapeutic effects were evaluated in each group. Results After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxacone group and the 7-moxa-cone group were reduced as compared with those before treatment separately(all P<0.01),PPT values were increased as compared with those before treatment(all P<0.01). But the differences were not statistically significant in the sham-moxibustion group as compared with those before treatment(all P>0.05). After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were lower as compared with the sham-moxibustion group separately(all P<0.05), PPT values were higher as compared with the sham-moxibustion group(all P<0.05). After treatment, the NPQ score and MPQ score in the 7-moxa-cone group were lower than the 3-moxa-cone group and PPT values was higher than the 3-moxa-cone group(all P<0.05). After treatment and in 1-month follow-up, the therapeutic effects in the 3-moxa-cone group, the 5-moxacone group and the 7-moxa-cone group were better than the sham-moxibustion group separately(all P<0.05). But, the therapeutic effects were not significantly different in comparison among the moxibusiton groups(P>0.05).Conclusion The direct moxibustion therapy with different small-moxa-cones effectively relieves chronic neck pain. There is a trend of improvement of the therapeutic effects with increase of the numbers of moxa cones.
引文
[1]潘泳鸿,仲卫红,张俊新,等.肌肉疲劳与慢性颈痛的研究现状[J].中国康复理论与实践,2015,21(2):168-170.
[2]梁兆晖,杨宇华,于鹏,等.针刺治疗颈椎病颈痛疗效及影响因素的Logistic回归分析[J].中国针灸,2009,29(3):173-176.
[3]中华医学会.临床诊疗指南-疼痛学分册[M].北京:人民卫生出版社,2007.
[4]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[5]沈雪勇.经络腧穴学[M].北京:中国中医药出版社,2002.
[6]Vernon H,Mior S.The Northwick Park Neck Pain Questionnaire,devised to measure neck pain and disability[J].Br J Rheumatol,1994,33(5):469.
[7]罗跃嘉.简化McGill疼痛评分表的临床应用评价[J].中国康复,1992,7(4):160-164.
[8]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:378-380.
[9]王玲玲.麦粒灸传薪集[M].北京:人民卫生出版社,2012.
[10]韩济生.疼痛学[M].北京:北京大学医学出版社,2012.
[11]杨华元,肖元春,刘堂义,等.隔物灸的近红外光谱辐射特性测定[J].上海针灸杂志,2003,22(9):15-17.
[12]Zhou EH,Liu HR,Wu HG,et al.Herb-partition moxibustion relieves chronic visceral hyperalgesia and 5-HT concentration in colon mucosa of rats[J].Neurol Res,2009,31(7):734-737.
[13]朱丽霞,黎春元,吉长福,等.灸法镇痛中突触后抑制与生长抑素、P物质的关系[J].针刺研究,1993,18(4):290-295.
[14]Qi L,Liu HR,Yi T,et al.Warming moxibustion relieves chronic visceral hyperalgesia in rats:relations to spinal dynorphin and orphanin-FQ system[J].Evid Based Complement Alternat Med,2013,2013:920675.doi:10.1155/2013/920675.Epub2013Mar16.
[15]贺成功,龙红慧,蔡圣朝,等.影响灸法治疗效果的因素浅析[J].中医学报,2015,30(9):1373-1376.
[16]王桂英,王耀帅,王玲玲.艾灸疗法中灸感、灸温、灸量与灸效关系[J].中医杂志,2015,56(17):1519-1521.
[17]董洪英.试论影响艾灸疗效的因素[J].江苏中医药,2003,35(8):40-41.
[18]高希言,奥晓静.提高艾灸疗效的探讨[J].中国针灸,2008,28(4):277-279.
[19]王欣君,王玲玲,张建斌.麦粒灸的灸量调控[J].上海针灸杂志,2013,32(6):426-429.
[20]王新卷.安慰艾炷的研制及其安慰效果的临床评价[D].北京:北京中医药大学,2005.
[21]卢璐.精灸治疗颈椎病颈痛量效关系的临床研究[D].广州:广州中医药大学,2017.
[22]张慧丽,高明明,郭华珍,等.正常成人躯干皮肤温度觉阈值测定[J].中国康复理论与实践,2015,21(7):804-806.
[2]梁兆晖,杨宇华,于鹏,等.针刺治疗颈椎病颈痛疗效及影响因素的Logistic回归分析[J].中国针灸,2009,29(3):173-176.
[3]中华医学会.临床诊疗指南-疼痛学分册[M].北京:人民卫生出版社,2007.
[4]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[5]沈雪勇.经络腧穴学[M].北京:中国中医药出版社,2002.
[6]Vernon H,Mior S.The Northwick Park Neck Pain Questionnaire,devised to measure neck pain and disability[J].Br J Rheumatol,1994,33(5):469.
[7]罗跃嘉.简化McGill疼痛评分表的临床应用评价[J].中国康复,1992,7(4):160-164.
[8]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:378-380.
[9]王玲玲.麦粒灸传薪集[M].北京:人民卫生出版社,2012.
[10]韩济生.疼痛学[M].北京:北京大学医学出版社,2012.
[11]杨华元,肖元春,刘堂义,等.隔物灸的近红外光谱辐射特性测定[J].上海针灸杂志,2003,22(9):15-17.
[12]Zhou EH,Liu HR,Wu HG,et al.Herb-partition moxibustion relieves chronic visceral hyperalgesia and 5-HT concentration in colon mucosa of rats[J].Neurol Res,2009,31(7):734-737.
[13]朱丽霞,黎春元,吉长福,等.灸法镇痛中突触后抑制与生长抑素、P物质的关系[J].针刺研究,1993,18(4):290-295.
[14]Qi L,Liu HR,Yi T,et al.Warming moxibustion relieves chronic visceral hyperalgesia in rats:relations to spinal dynorphin and orphanin-FQ system[J].Evid Based Complement Alternat Med,2013,2013:920675.doi:10.1155/2013/920675.Epub2013Mar16.
[15]贺成功,龙红慧,蔡圣朝,等.影响灸法治疗效果的因素浅析[J].中医学报,2015,30(9):1373-1376.
[16]王桂英,王耀帅,王玲玲.艾灸疗法中灸感、灸温、灸量与灸效关系[J].中医杂志,2015,56(17):1519-1521.
[17]董洪英.试论影响艾灸疗效的因素[J].江苏中医药,2003,35(8):40-41.
[18]高希言,奥晓静.提高艾灸疗效的探讨[J].中国针灸,2008,28(4):277-279.
[19]王欣君,王玲玲,张建斌.麦粒灸的灸量调控[J].上海针灸杂志,2013,32(6):426-429.
[20]王新卷.安慰艾炷的研制及其安慰效果的临床评价[D].北京:北京中医药大学,2005.
[21]卢璐.精灸治疗颈椎病颈痛量效关系的临床研究[D].广州:广州中医药大学,2017.
[22]张慧丽,高明明,郭华珍,等.正常成人躯干皮肤温度觉阈值测定[J].中国康复理论与实践,2015,21(7):804-806.