脉动负压疗法对慢性非特异性颈痛患者即刻镇痛效应及其对局部血流灌注量的影响  

Immediate analgesic effect of pulsating cupping therapy on neck pain and skin microcirculation blood perfusion in patients with chronic nonspecific neck pain

作　　者：杨洋[1] 马良宵[1] 牛婷立[2] 芦煜 王俊翔 杨学智[1] 牛欣[1] YANG Yang;MA Liang-xiao;NIU Ting-li;LU Ytl;WANG Jun-xiang;YANG Xue-zhi;NIU Xin(Beijing University of Chinese Medicine, Beijing 100029, China;Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《中华中医药杂志》2018年第4期1557-1561,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：2015年北京中医药大学新奥奖励基金课题~~

摘　　要：目的:观察脉动负压疗法对慢性非特异性颈痛患者的即刻镇痛效应,并观察其对局部血流灌注量的影响。方法:70例患者随机分为低频脉动罐组20例(30次/min)和高频脉动罐组20例(80次/min),抽气罐组20例,休息对照组10例。3个治疗组于两侧肩中俞穴区拔罐10min,以疼痛视觉模拟量表(VAS)评分为镇痛效应指标,同时应用激光散斑成像系统监测拔罐前后局部血流灌注量的变化。结果:干预前后自身对照结果显示,3个治疗组均可显著降低VAS分值(P<0.01)。与休息对照组比较,3个治疗组均显著降低VAS评分(P<0.01,P<0.05);与抽气罐组比较,低频脉动罐组与高频脉动罐组的VAS评分均显著降低(P<0.05),但两组之间并无显著差异。肩中俞穴区血流灌注量变化率显示,3个治疗组均显著高于休息对照组(P<0.01)。大椎穴区血流量变化率显示,低频脉动罐组及高频脉动罐组均显著高于抽气罐组和休息对照组(P<0.01)。身柱穴区血流量变化率显示,低频脉动罐组显著高于高频脉动罐组、抽气罐组及休息对照组(P<0.01,P<0.05)。VAS评分与各穴区的血流灌注量变化率均呈负向直线相关(P<0.05)。结论:脉动负压疗法及抽气罐疗法对慢性非特异性颈痛患者均具有较好的即刻镇痛效应,脉动负压疗法疗效更佳,可能与其更好地改善局部血流量有关。Objective： To investigate immediate analgesic effects of pulsating cupping therapy on chronic nonspecific neck pain, and observe its influence on local skin microcirculation blood perfusion. Methods： A total of 70 participants were randomized to low frequency （LF, 20 participants） and high frequency pulsating cupping （HF, 20 participants） groups, vacuum cupping （VC, 20 participants） group or waiting list （WL, 10 participonts） group. The LF, HF and VC received 1 session of cupping therapy at SI15. VAS （0-100mm） was measured before and after the intervention, and skin microcirculation blood perfusion was monitored by Pericam Perfusion Speckle Imager （PSI）. Results： Compared with baseline, the 3 treatment groups significantly reduced the VAS scores （P〈0.01）. The LF, HF and VC groups had significant reduction in VAS scores compared with WL group （P〈0.01, P〈0.05）. Compared to VC group, a significant reduction in VAS scores was found in both LF and HF groups （P〈0,05）. However, there was no significant difference between LF and HF groups. At SI15 area, all treatment groups significantly improved the blood perfusion change ration （P〈0.01） compared with WL group. At GV14 area, both LF and HF significantly improved the blood perfusion change ration compared with VC and WL respectively （P〈0.01）. At GV12 area, the blood perfusion change ratio in LF was significantly higher than HF, VC and WL （P〈0.01, P〈0.05）. There were linear correlation between VAS scores and the blood perfusion change ration at each acupoint areas （P〈0.05）. Conclusion： This study showes both pulsating cupping and vacuum cupping have satisfied immediate analgesic effects on chronic nonspecific neck pain, and pulsating cupping has more favorable effect, which may be related to its better effect on improving the local skin blood perfusion.

关 键 词：脉动负压疗法 慢性非特异性颈痛 激光散斑成像 疼痛视觉模拟评分量表 血流灌注量 即刻镇痛效应 

分 类 号：R274.9[医药卫生—中西医结合]