“平腕立指针刺手法”治疗肝阳上亢型偏头痛的临床研究

发布时间：2018-04-21 03:08

本文选题：“平腕立指针刺手法” + 肝阳上亢型偏头痛　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的本课题通过探讨“平腕立指针刺手法”对肝阳上亢型偏头痛的治疗效应,旨在为临床治疗肝阳上亢型偏头痛提供一种新方法。方法选取符合肝阳上亢型偏头痛纳入标准的有效病例60例,按随机数字表法,分为治疗组和对照组,每组均为30例。治疗组采用“平腕立指针刺手法”,取百会、印堂、太阳、风池、阳陵泉、丝竹空、率谷、合谷、太冲、太溪为主穴治疗;对照组采用口服阿司匹林治疗,疗程共28天。按照国家中医药管理局《头风诊断与疗效评定标准》和经颅多普勒血流动力学,记录患者治疗前、治疗后及治疗结束3个月后的各项指标,以患者治疗前与治疗后的“视觉模拟评分(VAS)”、“头痛发作次数评分”、“头痛持续时间评分”、“头痛指数”及“经颅多普勒(TCD)检测的大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)、椎动脉(VA)及基底动脉(BA)平均血流速度”为近期疗效指标;治疗结束3个月后进行电话随访,记录并观察患者的“头痛发作次数评分”、“头痛持续时间评分”、“VAS评分”的时间效应和远期疗效;对两组患者的数据进行比较分析并作出近期及远期疗效评价。结果(1)治疗前:对治疗组及对照组患者的性别、年龄、病程、病情,及两组患者治疗前的“VAS评分”、“头痛持续时间评分”、“头痛发作次数评分”、“头痛指数”、“TCD检测的MCA、ACA、PCA、VA、BA平均流速”进行组间比较,差异无统计学意义(P0.05)。(2)疗程结束后:治疗组及对照组患者的“VAS评分”、“头痛持续时间评分”、“头痛发作次数评分”、“头痛指数”、“TCD检测的MCA、ACA、PCA、VA、BA平均流速”组内比较均有改善,差异有统计学意义(P0.05);组间比较治疗组优于对照组,差异有统计学意义(P0.05)。(3)治疗结束3个月后随访:两组患者的“VAS评分”、“头痛发作次数评分”组内比较均有改善,差异有统计学意义(P0.05),且组间比较治疗组优于对照组,差异有统计学意义(P0.05);治疗组患者“头痛持续时间评分”组内比较有改善,差异有统计学意义(P0.05),但对照组患者“头痛持续时间”组内比较差异无统计学意义(P0.05),两组间比较差异有统计学意义(P0.05);两组患者“头痛指数”组内比较有改善,差异有统计学意义(P0.05),但两组患者组间比较差异无统计学意义(P0.05)。(4)临床疗效:对两组患者治疗后的疗效进行对比,治疗组总有效率为90.00%,显效率为66.67%;对照组总有效率为83.33%,显效率为50.00%,两组间差异具有统计学意义(P0.05);对两组患者治疗结束3个月后的疗效进行对比,治疗组总有效率为83.33%,显效率为53.33%;对照组总有效率为70.00%,显效率为26.67%,差异具有统计学意义(P0.05)。结论“平腕立指”针刺治疗及口服阿司匹林均能改善肝阳上亢型偏头痛患者的“头痛发作次数评分”、“头痛持续时间评分”、“头痛指数”、“视觉模拟评分(VAS)”及“TCD检测的颅内MCA、ACA、PCA、VA、BA的平均血流速度”,但“平腕立指针刺手法”的疗效优于口服阿司匹林;治疗结束3个月后随访,“平腕立指”针刺治疗组患者的“VAS评分”、“头痛发作次数评分”、“头痛持续时间评分”和“头痛指数”均有改善,口服阿司匹林组患者的“VAS评分”、“头痛发作次数评分”及“头痛指数”有改善,其中“平腕立指针刺手法”在改善肝阳上亢型偏头痛患者的“头痛发作次数”、“VAS评分”、“头痛持续时间”方面的疗效较口服阿司匹林好。
[Abstract]:Objective to explore the therapeutic effect of "flat wrist standing finger acupuncture manipulation" on migraine with hyperactivity of liver Yang, and to provide a new method for clinical treatment of migraine with hyperactivity of liver yang. Methods 60 effective cases of migraine which conforms to hyperactivity of liver Yang type are selected and divided into treatment group and control group according to random digital table method, each group is divided into each group. In the treatment group, the treatment group adopted the "flat wrist and vertical finger acupuncture manipulation", taking Baihui, printing hall, sun, wind pond, Yang Ling spring, silk and bamboo air, rate Valley, Hegu, Tai Chi, and Tai Xi as the main point treatment, and the control group was treated with oral aspirin for a total of 28 days. According to the national TCM administration of Chinese medicine administration, the standard of the diagnosis and therapeutic evaluation of the head wind and the blood flow of transcranial Doppler were in accordance with the State Administration of traditional Chinese medicine (TCM). Mechanics, records of the patients before, after treatment and 3 months after the end of the treatment of the indicators, the patient before and after the treatment of the "visual analog score (VAS)", "headache attack times score", "headache duration score", "headache index" and "transcranial Doppler (TCD) detection of the anterior cerebral artery (ACA), the middle cerebral artery (MCA), The mean blood flow velocity of the posterior cerebral artery (PCA), the vertebral artery (VA) and the basilar artery (BA) was the short-term curative effect. After 3 months of treatment, a telephone follow-up was carried out to record and observe the patient's "scores of headache attacks", "headache duration score", the time effect and long-term effect of "VAS score", and the data of the two groups of patients. Comparative analysis and evaluation of short-term and long-term effect. Results (1) before treatment: the sex, age, course of disease, condition of the patients in the treatment group and the control group, and the "VAS score" before the treatment of two groups, "headache duration score", "headache times score", "headache index", "MCA, ACA, PCA, VA, BA mean flow velocity" The difference was not statistically significant (P0.05). (2) after the course of treatment, the "VAS score" of the treatment group and the control group, "headache duration score", "headache times score", "headache index", "MCA, ACA, PCA, VA, BA mean flow rate" in the group were improved, and the difference was statistically significant (P0). .05); the comparison group was better than the control group, the difference was statistically significant (P0.05). (3) after 3 months of treatment, the two groups of patients "VAS score", "headache times score" group were improved, the difference was statistically significant (P0.05), and the group was better than the control group, the difference was statistically significant (P0.05); There was a significant difference in the group of "headache duration score" in the treatment group (P0.05), but there was no significant difference in the control group (P0.05) in the group of "headache duration" (P0.05), and there was a significant difference between the two groups (P0.05); the comparison of the "headache index" group in the group of patients was improved, and the difference was statistically significant. Significance (P0.05), but there was no significant difference between the two groups of patients (P0.05). (4) clinical efficacy: the efficacy of the two groups after treatment was compared, the total effective rate of the treatment group was 90% and the effective rate was 66.67%; the total effective rate of the control group was 83.33%, the significant efficiency was 50%, and the difference between the two groups was statistically significant (P0.05); and the treatment of two groups of patients was treated. The curative effect of 3 months after treatment was compared, the total effective rate of the treatment group was 83.33%, the effective rate was 53.33%, the total effective rate of the control group was 70%, the significant rate was 26.67%, the difference was statistically significant (P0.05). Conclusion "the acupuncture treatment and oral aspirin" can improve the "headache attacks" in patients with hyperactive liver Yang type migraine. "Score", "headache duration score", "headache index", "visual analogue scale (VAS)" and "mean blood flow velocity of MCA, ACA, PCA, VA, BA detected by TCD", but the effect of "flat wrist upright finger acupuncture manipulation" was better than that of oral aspirin; after 3 months of treatment, the "VAS" in the treatment group of "flat wrist erect finger" was "VAS". "Score", "score of headache attacks", "headache duration score" and "headache index" were improved. The "VAS score", "score of headache attacks" and "headache index" were improved in the oral aspirin group, and the "flat wrist standing finger acupuncture manipulation" was used to improve the "headache" in patients with hyperactive liver Yang type migraine. The curative effect of "attack times", "VAS score" and "duration of headache" is better than that of oral aspirin.

【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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