刺络放血结合耳穴贴压治疗偏头痛的临床研究

发布时间：2018-05-08 20:02

本文选题：偏头痛 + 放血疗法　；参考：《黑龙江中医药大学》2016年硕士论文

【摘要】：目的：通过刺络放血结合耳穴贴压疗法与常规针刺疗法治疗偏头痛的临床疗效对比研究,评价两种方法治疗偏头痛的即时镇痛效应及远期疗效的差异,探索临床治疗偏头痛的有效方法,为偏头痛的治疗提供一种新的治疗手段。方法：采用单盲、随机、对照的研究方法,将符合纳入标准的实证型偏头痛患者60例随机分为治疗组和对照组。治疗组30例接受刺络放血结合耳穴贴压治疗,放血取穴：印堂、阳白、太阳,每次出血量为3-5滴；耳穴贴压选穴：颞(枕)、神门、交感、肝、皮质下、内分泌,贴压在一侧的相应耳穴,停留3天,嘱病人每日自行按压2-3次,每次2分钟,3天后换贴另一侧,两侧耳穴交替贴压。治疗每3天一次,每周2次,共治疗3周。对照组30例采用常规针刺治疗,取穴：百会、太阳、率谷、风池、内关、太冲、阿是穴,平补平泻,待各穴得气后,连接KWD-808 II型多功能脉冲电疗仪,连续波,频率为2Hz,强度以患者能够耐受且舒适为度,每次30min。每周治疗6次,休息1天,共治疗3周。通过视觉模拟评分法(VAS)比较两组患者首次治疗前与治疗后1h的VAS分值,比较两组的即时镇痛疗效；采用电话、邮件访问或门诊等方式随访两组患者治疗前与治疗后第3个月头痛积分量表积分、总疗效,比较两组的远期疗效。结果：1.基线资料：两组患者的性别、年龄、病程、头痛严重程度及中医证型比较,结果显示差异无统计学意义(P0.05),两组间一般资料具有可比性。2.即时镇痛效果：两组患者首次治疗前VAS评分比较差异无统计学意义(P＞0.05),具有可比性。两组患者首次治疗1h后与治疗前的VAS值比较均具有非常显著性差异(P0.01)。两组首次治疗前后VAS值之差进行比较有非常显著性差异(P0.01),说明治疗组优于对照组。3.远期疗效：两组患者治疗前头痛积分比较差异无统计学意义(P0.05),具有可比性。两组患者治疗结束3月后与治疗前头痛积分值比较均具有非常显著性差异(P0.01)。治疗组临床疗效总有效率82.14%,对照组临床疗效总有效率75.00%,两组疗效对比,经秩和检验具有显著性差异(Z=-2.276,P0.05),说明治疗组疗效优于对照组。结论：1.刺络放血结合耳穴贴压疗法与常规针刺疗法对发作期实证型偏头痛患者均具有即时镇痛作用,治疗效果前者明显优于后者。2.刺络放血结合耳穴贴压疗法与常规针刺疗法对实证型偏头痛患者均具有远期治疗作用,治疗效果前者优于后者。
[Abstract]:Objective: to evaluate the difference of immediate analgesic effect and long-term curative effect of the two methods in treating migraine by comparing the clinical efficacy of pricking collaterals and bleeding combined with auricular acupoint plaster pressing therapy and routine acupuncture therapy in the treatment of migraine. To explore an effective method for the treatment of migraine and to provide a new method for the treatment of migraine. Methods: 60 patients with migraine were randomly divided into treatment group and control group. In the treatment group, 30 cases were treated with pricking collaterals and bleeding combined with auricular acupoint pressing, the points of bloodletting: Yin Tang, Yang Bai, Sun, each time bleeding volume was 3-5 drops, auricular points sticking and pressing selected points: temporal (occipital, Shenmen, sympathetic, liver, subcortical, endocrine, Press the corresponding auricular points on one side for 3 days and ask the patient to press 2-3 times a day for 2 minutes and 3 days each time to change the application to the other side, and the auricular points on both sides will be pressed alternately. Treatment every 3 days, twice a week, a total of 3 weeks. In the control group, 30 cases were treated with routine acupuncture. The acupoints were taken as follows: Baihui, Sun, rate Valley, Fengchi, Neiguan, Taochong, Ashi, Ping Buping Xiu, after each acupoint got qi, connected with KWD-808 II multi-function pulse electrotherapy instrument, continuous wave, The frequency is 2 Hz, the intensity is tolerable and comfortable, 30 mins each time. Treatment 6 times a week, rest 1 day, a total of 3 weeks treatment. Visual analogue score (VAS) was used to compare the VAS scores of the two groups before and 1 hour after the first treatment, and to compare the immediate analgesic efficacy of the two groups. The patients in the two groups were followed up by mail visit or outpatient service before treatment and 3 months after treatment. The total curative effect of the two groups was compared. The result is 1: 1. Baseline data: sex, age, course of disease, headache severity and TCM syndromes were compared between the two groups. The results showed that there was no significant difference between the two groups (P 0.05), and the general data between the two groups were comparable. 2. Immediate analgesic effect: there was no significant difference in VAS scores between the two groups before the first treatment (P > 0.05), which was comparable. There were significant differences in VAS values between the two groups after 1 hour of first treatment and before treatment (P 0.01). The difference of VAS between the two groups before and after the first treatment was very significant difference (P 0.01), which indicated that the treatment group was better than the control group. 3. Long-term curative effect: there was no significant difference in headache score between the two groups before treatment (P 0.05), which was comparable. There were significant differences in headache score between the two groups 3 months after treatment and before treatment (P 0.01). The total effective rate was 82.14% in the treatment group and 75.00% in the control group. There was a significant difference between the two groups by rank sum test, indicating that the curative effect of the treatment group was superior to that of the control group. Conclusion 1. Pricking collaterals and bleeding combined with auricular point plaster therapy and routine acupuncture therapy have immediate analgesic effect on migraine patients in attack stage, the former is obviously better than the latter. 2. Both pricking collaterals and bleeding combined with auricular point plaster therapy and routine acupuncture therapy have long-term therapeutic effect on migraine patients with empirical type, the former is better than the latter.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

【相似文献】