颅底七穴加颈夹脊穴辅助加味葛根汤治疗颈源性头痛临床疗效对照研究
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摘要
目的:探究颅底七穴加颈夹脊穴辅助加味葛根汤治疗颈源性头痛的临床疗效。方法:本次研究选取99例颈源性头痛患者作为研究对象,入选患者均由我院2015年1月—2018年1月收治,采用随机数字表法将患者分为观察组及对照组,对照组患者(49例)采用加味葛根汤治疗,观察组患者(50例)采用颅底七穴加颈夹脊穴辅助加味葛根汤治疗,比较两组患者疗效及治疗前后视觉模拟疼痛量表(VAS)评分及颈椎活动度评分(ROM)、治疗后1个月、3个月、5个月患者疼痛发作次数、治疗过程中不良反应情况。结果:观察组患者治疗有效率(98. 00%)高于对照组(85. 71%)(P <0. 05);治疗前两组患者VAS及ROM评分相当(P> 0. 05),治疗后各组患者VAS及ROM评分均改善,观察组优于对照组(P <0. 05);治疗后1个月、3个月、5个月观察组患者疼痛发作次数均少于对照组(P <0. 05);观察组不良反应率(4. 00%)与对照组(4. 08%)相当(P> 0. 05),两组不良反应均较少,安全性较高。结论:颅底七穴加颈夹脊穴辅助加味葛根汤治疗颈源性头痛临床疗效显著,患者疼痛缓解,颈椎恢复良好,不良反应少,安全可靠,值得临床推广与研究。
Objective: To explore the clinical efficacy of needling seven points in the skull base and cervical Jiaji points combined with modified Gegen Decoction in the treatment of cervicogenic headache. Methods: 99 cases of cervicogenic headache were randomly divided into the observation group( n = 50) and the control group( n = 49). The control group was treated with modified Gegen Decoction; on which basis,the observation group was also treated with needling seven points in the skull base and cervical Jiaji points. The clinical efficacy,the scores of VAS and ROM before and after the treatment,pain onset after one month,three months,five months after the treatment,as well as the adverse reactions were compared between the two groups. Results: The effective rate was 98. 00% in the observation group,which was significantly higher than 85. 71% in the control group( P < 0. 05). The scores of VAS and ROM were similar in the two groups before the treatment( P >0. 05); they were both improved after the treatment in the two groups( P < 0. 05),of which the observation group was superior to the control group( P < 0. 05). The pain onsets after one month,three months,five months after the treatment were less in the observation group than those in the control group( P < 0. 05). The adverse reaction rate was 4. 00% in the observation group,which was similar to 4. 08% in the control group( P >0. 05); the treatments had less adverse reactions and higher safety in the both groups. Conclusion: Needling seven points in the skull base and cervical Jiaji points combined with modified Gegen Decoction has remarkable clinical efficacy for cervicogenic headache,it can relieve the pain and recover the cervical spine with less adverse reactions and high safety,which is worthy of clinical promotion.
Objective: To explore the clinical efficacy of needling seven points in the skull base and cervical Jiaji points combined with modified Gegen Decoction in the treatment of cervicogenic headache. Methods: 99 cases of cervicogenic headache were randomly divided into the observation group( n = 50) and the control group( n = 49). The control group was treated with modified Gegen Decoction; on which basis,the observation group was also treated with needling seven points in the skull base and cervical Jiaji points. The clinical efficacy,the scores of VAS and ROM before and after the treatment,pain onset after one month,three months,five months after the treatment,as well as the adverse reactions were compared between the two groups. Results: The effective rate was 98. 00% in the observation group,which was significantly higher than 85. 71% in the control group( P < 0. 05). The scores of VAS and ROM were similar in the two groups before the treatment( P >0. 05); they were both improved after the treatment in the two groups( P < 0. 05),of which the observation group was superior to the control group( P < 0. 05). The pain onsets after one month,three months,five months after the treatment were less in the observation group than those in the control group( P < 0. 05). The adverse reaction rate was 4. 00% in the observation group,which was similar to 4. 08% in the control group( P >0. 05); the treatments had less adverse reactions and higher safety in the both groups. Conclusion: Needling seven points in the skull base and cervical Jiaji points combined with modified Gegen Decoction has remarkable clinical efficacy for cervicogenic headache,it can relieve the pain and recover the cervical spine with less adverse reactions and high safety,which is worthy of clinical promotion.
引文
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[3]金建慧,刘延青,范愈燕,等.度洛西汀联合神经阻滞治疗颈源性头痛的疗效[J].中国疼痛医学杂志,2017,23(9):678-681.
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[8]王红娟,吕晓云.耳穴贴压配合养血疏肝止痛汤加减治疗颈源性头痛疗效及对颈部血流动力学影响[J].现代中西医结合杂志,2017,26(4):375-377.
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[12]申毅锋,周俏吟,李石良,等.基于解剖结构的针刀治疗颈源性头痛的研究进展[J].中国医药导报,2018,15(15):150-153.
[13]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):1439-1442.
[14]王风波,魏晓霏,唐明薇,等.悬吊运动疗法联合盐酸乙哌立松治疗颈源性头痛的临床效果[J].广西医学,2017,39(10):1580-1581,1587.
[15]张振华,罗晶.中西医结合治疗颈源性头痛疗效观察[J].实用中医药杂志,2013,29(3):179-180.
[16]唐旭,任路影,李亦梅,等.针刺治疗颈源性头痛疗效:更新的系统评价[J].中国疼痛医学杂志,2017,23(11):830-836.
[17]曾惠群,王珍,曾玉鳞.谈谈穴位的命名[J].江苏中医,1961(4):1-2,9.
[18]张晟星.经穴释义汇解[M].上海:上海翻译出版公司,1984.
[19]陆强益,洪文.温针灸联合川芎葛根汤治疗颈源性头痛33例临床观察[J].河北中医,2010,32(9):1382-1383.
[2]严伟,杨立强,郭玉娜,等.脉冲射频联合硬膜外腔阻滞治疗颈源性头痛的疗效观察[J].重庆医学,2017,46(12):1621-1623.
[3]金建慧,刘延青,范愈燕,等.度洛西汀联合神经阻滞治疗颈源性头痛的疗效[J].中国疼痛医学杂志,2017,23(9):678-681.
[4]罗金寿,王勇军,徐金美,等.项八针疗法治疗颈源性头痛的疗效及预防复发分析[J].上海针灸杂志,2018,37(6):660-664.
[5]张婷,游菲,万文俊,等. Mulligan手法联合人迎穴改良针刺法治疗颈源性头痛的疗效观察[J].中华物理医学与康复杂志,2017,39(8):619-622.
[6]杜静静,孟朋民,屈亚云,等.甲氧氯普胺穴位注射联合颈椎旁神经阻滞治疗颈源性头痛临床疗效观察[J].世界中西医结合杂志,2018,13(5):674-677.
[7]杜元灏,石学敏.中华针灸临床诊疗规范[M].江苏:科学技术出版社,2007:175-176.
[8]王红娟,吕晓云.耳穴贴压配合养血疏肝止痛汤加减治疗颈源性头痛疗效及对颈部血流动力学影响[J].现代中西医结合杂志,2017,26(4):375-377.
[9]杜静.项七针配合穴位透刺为主治疗颈源性头痛的临床疗效观察[J].针灸临床杂志,2017,33(7):12-15.
[10]曲志伟,宋秋实,张一,等.颈椎椎旁神经阻滞术治疗颈源性头痛36例[J].中国中西医结合外科杂志,2017,23(3):309-311.
[11]王肯堂.证治准绳[M].上海:上海科技出版社,1957.
[12]申毅锋,周俏吟,李石良,等.基于解剖结构的针刀治疗颈源性头痛的研究进展[J].中国医药导报,2018,15(15):150-153.
[13]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):1439-1442.
[14]王风波,魏晓霏,唐明薇,等.悬吊运动疗法联合盐酸乙哌立松治疗颈源性头痛的临床效果[J].广西医学,2017,39(10):1580-1581,1587.
[15]张振华,罗晶.中西医结合治疗颈源性头痛疗效观察[J].实用中医药杂志,2013,29(3):179-180.
[16]唐旭,任路影,李亦梅,等.针刺治疗颈源性头痛疗效:更新的系统评价[J].中国疼痛医学杂志,2017,23(11):830-836.
[17]曾惠群,王珍,曾玉鳞.谈谈穴位的命名[J].江苏中医,1961(4):1-2,9.
[18]张晟星.经穴释义汇解[M].上海:上海翻译出版公司,1984.
[19]陆强益,洪文.温针灸联合川芎葛根汤治疗颈源性头痛33例临床观察[J].河北中医,2010,32(9):1382-1383.