大接经刺血疗法治疗血管神经性头痛的临床疗效观察

发布时间：2018-08-24 17:13

【摘要】：目的:比较运用大接经刺血疗法及普通针刺法对血管神经性头痛的临床疗效差异,以期验证大接经刺血疗法治疗血管神经性头痛的可行性。方法:选取2014年11月至2016年12月于大连医科大学附属第二医院针灸门诊确定诊断为肝阳上亢型血管神经性头痛患者共60例,随机分成3组,分别为普通针刺组、普通针刺联合大接经刺血疗法组、普通针刺联合阿是穴刺血疗法组,每组均为20例,其中普通针刺组(A)入组20例,脱落1例,共19例;普通针刺联合大接经刺血疗法组(B)入组20例,脱落3例,共17例;普通针刺联合阿是穴刺血疗法组(C)入组20例,脱落4例,共16例。普通针刺组头部取百会、四神聪、太阳、角孙等穴位,使用捻转平补平泻手法;风池穴向鼻尖方向斜刺,采用捻转平补平泻手法。远端穴位如太冲、足临泣、行间施提插捻转泻法;太溪行平补平泻手法。大接经刺血疗法组和阿是穴刺血疗法组针刺取穴与普通针刺组相同,大接经刺血疗法取十二井穴,按照经络流注顺序依次刺血;阿是穴刺血疗法则是在头部选取阿是穴施刺血疗法,每个穴位放血量约为3-5滴,放血结束后用消毒干棉球按压针孔3-5min直至血液不再流出。三组患者分别于治疗前后进行头痛综合评分,治疗前后采用“视觉模拟疼痛评分”(Visual Analogue Scale,VAS)法,并分别评价疼痛程度、发作次数、持续时间、伴随症状、中医证候的变化,计算出疗效指数,对三组的疗效予以评价。将收集的数据建立数据库,采用SPSS20.0统计学软件进行数据分析,对计量资料以均数±标准差(SX±)表示。计数资料采用x2检验;三组之间计量资料的比较应用单因素方差分析,两两比较选用LSD-t检验;各组治疗前后变量差异应用配对t检验;对比三组治疗疗效采用非参数秩和检验,P值若0.05则表示差异具有统计学意义。结果:通过对三个治疗组治疗前后疼痛程度、发作次数、持续时间变化及中医证候评分的变化的比较,结果表明,三组治疗方法对改善血管神经性头痛的症状均有临床疗效;而大接经刺血疗法组从临床疗效上看,明显高于其他两组;其中阿是穴刺血疗法组相比于普通针刺组疗效更优(P0.05)。大接经刺血疗法组为94.1%,阿是穴刺血疗法组为56.3%,普通针刺组为15.8%。从中医证候疗效总有效率上看,大接经刺血疗法组为94.1%,阿是穴刺血疗法组为87.5%,普通针刺组为84.2%,说明大接经刺血疗法组疗效优于阿是穴刺血疗法组和普通针刺组(P0.05)。从治疗后疼痛程度、发作次数、持续时间评分变化看,大接经刺血疗法组与阿是穴刺血疗法组和普通针刺组比较,差异也有显著性意义(P0.05)。结论:1.大接经刺血疗法治疗血管神经性头痛的疗效明显优于其他两组,大接经刺血疗法能显著减轻/缓解头痛症状及减少疼痛持续时间。2.大接经刺血疗法治疗血管神经性头痛的理论思路与形式是正确可行的。
[Abstract]:Objective: to compare the clinical curative effect of the treatment of vascular and neurotic headache with the blood acupuncture therapy and the common acupuncture method, so as to verify the feasibility of the treatment of vascular nerve headache by the blood acupuncture therapy. Methods: from November 2014 to December 2016, 60 patients diagnosed as hyperactive vascular and neurotic headache of liver yang were selected from the second affiliated Hospital of Dalian Medical University. The patients were randomly divided into 3 groups: normal acupuncture group. There were 20 cases in each group, 20 cases in each group. Among them, 20 cases were (A) in group A and 19 cases in group A (1 case). There were 20 cases of (B), 3 cases of shedding and 16 cases of (C) in the group of common acupuncture combined with Ashi-acupoint blood acupuncture, 4 cases of shedding. In the common acupuncture group, Baihui, Sishen Cong, Sun, Jiao Sun and other acupoints were taken, and the points of Fengchi were slanted in the direction of nose tip, and the techniques of twisting flat and reinforcing flat diarrhea were used. Distal points such as Taochong, sobbing feet, between the implementation of twirling and diarrhea; Taixi Pingbu flat reduction technique. The acupoints in the treatment group were the same as those in the common acupuncture group, and the twelve well points in the treatment group were pricked according to the sequence of meridian blood flow. Ashi point pricking blood therapy is to select Ashi point in the head to apply pricking blood therapy, each point bleeding volume is about 3-5 drops, after bleeding with disinfectant dry cotton ball pressing pinhole 3-5min until no blood flow out. The patients in the three groups were given headache comprehensive score before and after treatment, and before and after treatment with "visual analogue pain score" (Visual Analogue Scale,VAS) method, and to evaluate the degree of pain, attack times, duration, accompanying symptoms, changes of TCM syndromes, respectively. The curative effect index was calculated and the curative effect of the three groups was evaluated. The collected data were set up and the data were analyzed by SPSS20.0 software. The measurement data were expressed as mean 卤standard deviation (SX 卤). The counting data were measured by x2 test, the three groups were compared by univariate ANOVA, and by LSD-t test, the difference of variables before and after treatment was matched t test. Compared with the three groups, the nonparametric rank sum test (P = 0.05) indicated the difference was statistically significant. Results: by comparing the changes of pain degree, attack frequency, duration and TCM syndrome score before and after treatment in the three treatment groups, the results showed that the three treatment methods had clinical effect on improving the symptoms of vascular and neurotic headache. The clinical efficacy of the treatment group was significantly higher than that of the other two groups; the Ashi acupoint pricking blood therapy group was better than the common acupuncture group (P0.05). It was 94.1 in the treatment group, 56.3 in the Ashi acupoint pricking blood therapy group and 15.8in the common acupuncture group. From the point of view of the total effective rate of TCM syndromes, the treatment group was 94.1, the Ashi acupoint pricking blood therapy group was 87.5, the common acupuncture group was 84.2 points, which indicated that the treatment group was superior to the Ashi acupoint pricking blood therapy group and the common acupuncture group (P0.05). According to the changes of pain degree, attack frequency and duration after treatment, there were significant differences between the treatment group and the Ashi point pricking blood therapy group and the general acupuncture group (P0.05). Conclusion 1. The therapeutic effect of the treatment of vascular and neurogenic headache was obviously better than that of the other two groups. The theory and form of the treatment of vascular and neurotic headache by blood-acupuncture therapy are correct and feasible.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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