醒脑开窍针刺法治疗丘脑痛:随机对照研究  

Resuscitation acupuncture for thalamic pain:a randomized controlled trial

作　　者：李雅洁[1] 田浩[1] 安丽[1] 石学敏[2] 

机构地区：[1]首都医科大学附属北京朝阳医院中医科,北京100020 [2]天津中医药大学第一附属医院

出　　处：《中国针灸》2017年第1期14-18,共5页Chinese Acupuncture & Moxibustion

摘　　要：目的:比较醒脑开窍针刺法与西药普瑞巴林治疗丘脑痛的疗效差异及对患者血浆P物质(SP)及β内啡肽(β-EP)含量的影响。方法:将64例患者随机分为针刺组与西药组,每组32例。两组均在西医常规治疗基础上,西药组口服普瑞巴林胶囊75mg,每日2次;针刺组采用醒脑开窍针刺法治疗,主穴取水沟、内关、三阴交,上肢疼痛加患侧极泉、尺泽、合谷,下肢疼痛加患侧委中、足三里,头痛加双侧风池、完骨、翳风,每日2次,每周治疗6d,两组均治疗8周。观察两组治疗前、治疗4周、8周后及随访(治疗结束后3个月)时简化McGill疼痛问卷(SF-MPQ)评分、血浆SP及β-EP的变化,并评定两组临床疗效。结果:针刺组治疗4周后总有效率为50.0%(16/32),与西药组的46.9%(15/32)相当(P>0.05);治疗8周后、随访时,针刺组总有效率分别为90.6%(29/32)、84.4%(27/32),均分别优于西药组的65.6%(21/32)、40.6%(13/32,均P<0.05)。治疗4周、8周后及随访时针刺组疼痛评分均较治疗前明显降低(均P<0.05),西药组治疗4周、8周后疼痛评分亦较治疗前明显降低(均P<0.05);治疗8周后及随访时,针刺组疼痛评分均低于西药组(均P<0.05)。治疗4周、8周后,两组患者血浆SP含量均较治疗前降低(均P<0.05),血浆β-EP含量均较治疗前升高(均P<0.05),治疗8周后,针刺组血浆SP含量较西药组降低更明显(P<0.05),β-EP较西药组升高更显著(P<0.05)。结论:醒脑开窍针刺法能够明显缓解丘脑痛患者的临床症状,优于西药普瑞巴林,且疗效稳定,远期疗效明显占优,同时可以更明显地升高血浆β-EP含量,降低SP含量。Objective To compare the effects between resuscitation acupuncture and pregabalin for thalamic pain and their impacts on plasma P substance（SP）andβ-endorphin（β-EP）.Methods Sixty-four patients were randomly assigned into an acupuncture group and a western medication group,32 cases in each one.Based on conventional western methods,pregabalin capsule was used orally in the western medication group,75 mg a time,twice a day;resuscitation acupuncture was applied in the acupuncture group.The main acupoints were Shuigou（GV 26）,Neiguan（PC 6）,Sanyinjiao（SP 6）.Patients with upper limb pain were attached affected Jiquan（HT 1）,Chize（LU 5）,and Hegu（LI 4）;lower limb pain,affected Weizhong（BL 40）,Zusanli（ST 36）;headache,bilateral Fengchi（GB 20）,Wangu（GB 12）,and Yifeng（TE 17）,twice a day.Treatment was given 6 d a week for 8 weeks in the two groups.The changes of simplified McGill pain questionnaire（SF-MPQ）,plasma SP andβ-EP were observed before and after 4-week,8-week treatment,as well as at follow-up,namely,3 months after treatment.Also,clinical effects were evaluated.Results The total effective rate of the acupuncture group was50.0%（16/32）after 4-week treatment,which was similar to 46.9%（15/32）in the western medication group（P〈0.05）.While after 8-week treatment and at follow-up,the total effective rates of the acupuncture group were 90.6%（29/32）and 84.4%（27/32）,which were better than 65.6%（21/32）and 40.6%（13/32）of the western medication group correspondingly（both P〈0.05）.After 4-week,8-week treatment and at follow-up,the pain scores of the acupuncture group were lower than that before treatment（all P〈0.05）.After 4-week and 8-week treatment,the pain scores of the western medication group were lower than that before treatment（both P〈0.05）.After 8-week treatment and at follow-up,the pain scores of the acupuncture group were superior to those of the western medication group（both P〈0.05）.After 4-week and 8-week treatment,

关 键 词：丘脑痛 醒脑开窍 针刺疗法 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]