气街电针干预合脊柱调衡治疗原发性三叉神经痛临床研究  

Clinical research of primary trigeminal neuralgia treated with electroacupuncture at qi streets acupoints combined with spinal regulation therapy

作　　者：杨军雄[1,2] 张建平[1] 于建春[3] 韩景献[3,2] 

机构地区：[1]铜仁职业技术学院附属医院针灸科,贵州铜仁554300 [2]全国名老中医韩景献教授工作室 [3]天津中医药大学第一附属医院

出　　处：《中国针灸》2014年第8期763-768,共6页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学青年基金项目:30901927;铜仁市科技计划基金项目:2013trzy-1

摘　　要：目的：比较气街部穴位电针干预合脊柱调衡法与西药卡马西平治疗原发性三叉神经痛（PTN）的临床疗效差异。方法：将60例患者随机分为综合组（30例）和药物组（30例）。综合组取头气街部穴位太阳、四神聪等与胸、腹气街部穴位肾俞、中脘、关元等，得气后接电针2～4组穴位，针后行脊柱调衡法，每天1次；药物组口服卡马西平，首剂量100mg，每天2次，维持量每天400～600mg。两组均治疗1个月，于治疗前、后及随访2个月、6个月，采用疼痛量表疼痛评定指数（PRI）、生活满意度指数B量表（LSI-B）、抑郁量表（HAMD）等，综合评定两组的临床疗效，并比较两组治疗期间不良反应发生情况。结果：治疗后综合组愈显率为76．7％（23／30），优于药物组的63．3％（19／30，P〈0．01）；两组治疗后PRI病情分级差异无统计学意义（均P〉0．05），于随访2个月、6个月时，综合组PRI病情分级情况优于药物组（均P〈0．05）；两组治疗后及随访时HAMD评分均下降（均P〈0．01，P〈0．05），且于随访时综合组HAMD评分下降较药物组显著（均P〈0．05）；两组治疗后LSI-B评分均有明显上升（均P〈0．05），且综合组优于药物组（P〈0．05）；综合组不良反应发生率为16．79／6（5／30），低于药物组的30．0％（9／30，P〈0．01）。结论：气街部穴位电针干预合脊柱调衡法治疗PTN，在改善患者精神心理、镇痛、提高生活质量方面的远期疗效优于口服卡马西平，是一种安全、优效且稳定的治疗方法。Objective To compare the difference in the clinical efficacy on primary trigeminal neuralgia （PTN） between the comprehensive therapy of electroacupuncture （EA） at qi streets acupoints combined with spinal regu- lation method and medication with carbamazepine （CBZ）. Methods Sixty patients were randomized into a compre- hensive therapy group （30 cases） and a medication group （30 cases）. In the comprehensive therapy group, the acupoints at qi streets on the head such as Taiyang （EX-HN 5） and Sishencong （EX-HN 1） and those at qi streets on the chest and abdomen such as Shenshu （BL 23）, Zhongwan （CV 12） and Guanyuan （CV 4）, etc. were select- ed. After arrival of qi, EA was attached on 2 to 4 groups of acupoints. After acupuncture, the spinal regulation method was applied. This comprehensive therapy was given once a day. In the medication group, CBZ was used for oral administration, 100 mg at the first time, twice a day, and 400 to 600 mg each day as the maintenance dose. Separately, before and after treatment, in 2 and 6 months in follow-up, pain rating index （PRI）, life satis- faction index B （LSI-B） and hamilton depression scale （HAMD） were adopted to evaluate comprehensively the clinical efficacy in the two groups and compare the adverse reaction during the treatment between the two groups. Results After treatment, the curative and markedly effective rate in the comprehensive therapy group was 76.7 %（23/30）, which was better than 63.3%/oo （19/30） in the medication group （P〈0.01）. The difference in PRI was not signifi- cant after treatment between the two groups （all P〉0.05）. In 2 and 6 months follow-up, PRI grade in the comprehensive therapy group was superior to that of the medication group （both P〈0. 05）. After treatment and in follow-up, HAMD score was all reduced in the two groups （P〈0. 01 ,P〈0.05） and the result in follow-up in the comprehensive therapy group was significant as compared with that in the medication group （al

关 键 词：原发性三叉神经痛 气街 针刺 推拿 电针 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]