偏头痛急性期不同神经分布区穴位的针刺镇痛效应

发布时间：2018-01-02 07:04

本文关键词：偏头痛急性期不同神经分布区穴位的针刺镇痛效应　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：比较三叉神经分布区和枕神经分布区穴位的针刺镇痛效应,观察其针刺镇痛效应的相对特异性,并探索其神经通路机制,为偏头痛急性期的针灸治疗提供一种优化方案。方法：将符合标准的60例患者随机分为2组,A组采用排针平刺枕神经分布区穴位,针刺脑空透风池,左右各排2针,脑空透风府左右各排1针,进针1寸,留针2h；B组针刺三叉神经分布区穴位,头维透鱼腰、颔厌透丝竹空、悬颅透太阳、悬厘透瞳子修、曲鬓透上关、进针1寸,联合常规针刺三孔穴(鱼腰、四白、夹承浆),留针2h,记录针刺前、针刺即刻、针刺后10min、20min、30min、40min、50min、1h、2h的VAS评分,以及针刺2h后头痛缓解50%以上的部位,比较A、B两组的疼痛缓解情况,以及疼痛部位的缓解情况,比较不同神经分布区针刺镇痛效应的特异性。结果：A组患者针刺40min内,VAS评分与上一时点比较,P0.05,有统计学意义,40min后P0.05,无统计学意义；B组患者针刺50min内,VAS评分与上一时点比较,P0.05,有统计学意义,50min后P0.05,无统计学意义；两组针刺头痛缓解程度比较,只有在针刺即刻P0.05,有统计学意义,其后的每一个时间段内,均为P0.05,无统计学意义。两组患者头痛部位缓解情况比较,枕部、前额部、颞部、眼眶周围为发作频率较高的4个部位,A组针刺2h后的缓解率依次为：80%、41.7%、75%、46.4%,B组针刺2h后的缓解率依次为：0、71.4%、73.7%、81%结论：1.针刺枕神经分布区穴位相对三叉神经分布区穴位而言,针刺镇痛效应较快,且即刻疗效较佳,针刺即刻后两组之间的镇痛疗效并无明显差异,提示枕神经分布区穴位的上位通路相仃对较短。2.针刺不同神经分布区穴位可以缓解相应神经分布区的疼痛,提示偏头痛急性期不同神经分布区穴位针刺镇痛效应具有特异性。
[Abstract]:Objective: to compare the acupuncture analgesia effect of trigeminal nerve distribution and occipital nerve distribution, observe the relative specificity of acupuncture analgesia effect, and explore the mechanism of nerve pathway. Methods: 60 patients with acute migraine were randomly divided into two groups: group A was treated with acupuncture at the point point of occipital nerve distribution and acupuncture at the empty-ventilated cistern of the brain. 2 needles in each row, 1 needle in each row, 1 pin in each row, and 2 hours in needle; Group B acupuncture trigeminal nerve distribution area acupoints, head through the fish waist, the chin is tired of penetrating silk bamboo empty, suspending the sun, suspending the pupil repair, curly sideburns through the Shangguan, into the needle 1 inch, combined with conventional acupuncture three holes (fish waist, four white). The VAS scores were recorded before acupuncture, immediately after acupuncture, and 10 minutes after acupuncture for 30 minutes, 40 minutes, 50 minutes and 1 hour and 2 hours after acupuncture. The pain relief and pain relief in group A and B were compared after 2 hours of acupuncture and more than 50% relief of headache. Results the score of VAS in group A was significantly higher than that in group A (P 0.05) within 40 minutes after acupuncture. After 40 minutes, P0.05 had no statistical significance. In group B, the score of VAS in 50 minutes after acupuncture was significantly higher than that at the last time point (P0.05), but there was no statistical significance after 50 min of acupuncture. Two groups acupuncture headache relief degree comparison, only in the acupuncture immediate P0.05, has the statistical significance, after each time period, is all P0.05. There was no significant difference between the two groups. The remission rate of occipital part, frontal part, temporal part and periorbital part of group A was 80% 2 hours after acupuncture. The remission rate of group B was 73.7% after acupuncture for 2 hours. Conclusion 1. The analgesic effect of acupuncture on occipital nerve distribution area is faster than that of trigeminal nerve distribution area, and the immediate effect is better. There is no significant difference in analgesic effect between the two groups immediately after acupuncture. The results suggest that the epistatic pathway of occipital nerve distribution area is shorter. 2.Acupuncture at different nerve distribution areas can relieve the pain in the corresponding nerve distribution area. The results suggest that the analgesic effect of acupuncture at different nerve distribution areas in acute stage of migraine is specific.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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