温针联合颈椎旁神经阻滞治疗颈源性头痛疗效及对患者疼痛、颈部血流动力学影响  

Effects of warm acupuncture combined with treatment for cervical paravertebral nerve block on clinical efficacy pain and cervical hemodynamics in patients with cervicogenic headache

作　　者：王海慧 王素匣 陈尧华 WANG Haihui;WANG Suxia;CHEN Yaohua(Department of pain,First Affiliated Hospital of Army Medical University,Chongqing 400038)

机构地区：[1]陆军军医大学第一附属医院疼痛科,重庆400038

出　　处：《陕西中医》2020年第9期1307-1310,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：重庆市卫生健康委员会资助项目(2018JSTG022)。

摘　　要：目的:探讨温针联合颈椎旁神经阻滞治疗颈源性头痛患者临床疗效,及对患者疼痛及颈部血流动力学的影响。方法:选择68例颈源性头痛患者作为研究对象,对照组采取颈椎旁神经阻滞治疗,观察组采取温针联合颈椎旁神经阻滞治疗。对照组使用C形臂X线机引导确定进针位置,将混合药液(利多卡因、曲安奈德)推入即可。治疗后需要进行常规观察30 min,吸氧2 h。2次/周,4次为1个疗程。观察组在对照组治疗基础上加温针治疗;穴位主要有天柱、风池、完骨等。属于虚证者使用捻转补法,实证者使用捻转泻法,1次/d,4次为1个疗程。对患者治疗4周后进行观察,了解患者临床疗效、治疗前后疼痛情况、颈部血流动力学情况以及颈部关节活动度。结果:治疗后观察组的总有效率为91.17%,明显高于对照组70.58%(P<0.05)。治疗后两组患者ROM评分、NRS评分、头痛持续时间、头痛发生频率、颈部血流动力学指标均有所改善。治疗后观察组、对照组ROM评分分别为(1.16±0.33)分、(1.85±0.26)分,NRS评分分别为(3.26±2.10)分、(4.85±3.22)分,头痛持续时间分别为(3.22±2.28)h、(6.59±7.44)h,头痛发生频率分别为(3.01±1.84)次/周、(2.30±1.87)次/周,PI分别为(0.31±0.55)、(0.74±0.87),RI(0.44±0.03)、(0.61±0.47),各指标比较组间差异有统计学意义(P<0.05)。观察组Vm(31.85±4.55)cm/s高于对照组(26.35±5.44)cm/s(P<0.05)。结论:温针联合颈椎旁神经阻滞治疗颈源性头痛临床效果较好,减少了患者疼痛情况。Objective:To investigate the effects of warm acupuncture combined with the treatment for cervical paravertebral nerve block on clinical efficacy,pain and cervical hemodynamics in patients with cervicogenic headache.Method:68 patients with cervicogenic headache were selected as research objects.The control group were treatmented with cervical paravertebral nerve block.The observation group were given warm acupuncture combined with the treatment for cervical paravertebral nerve block.The control group was guided by a C-arm X-ray machine to determine the position of the inserting needle,and the mixed drug solution(lidocaine,triamcinolone acetonide)was pushed in.After treatment,they need routine observation for 30 minutes and oxygen inhalation for 2 hours.Twice a week,4 times was a course of treatment.The observation group was supplemented with warming needle therapy,main points including Tianzhu,Fengchi and Wangu.Those who belong to Xu syndrome were given the twirling supplementation method,belong to Shi syndrome were given the twirling draining method.Once a day,4 times was a course of treatment.The patients were observed 4 weeks after treatment to understand the clinical efficacy,pain before and after treatment,neck hemodynamics,and neck joint mobility.Results:After treatment,the total effective rate in the observation group was 91.17%,which was significantly higher than that of the control group 70.58%(P<0.05).ROM scores,NRS scores,headache duration,frequency of occurrence headache,hemodynamic parameters of the neck of the two patients in the two groups were improved.After treatment,the observation group and the control group of ROM score were(1.16±0.33)scores,(1.85±0.26)scores;NRS(3.26±2.10)scores,(4.85±3.22)scores;headache duration(3.22±2.28)h,(6.59±7.44)h;frequency of occurrence headache(3.01±1.84)frequency/week,(2.30±1.87)frequency/week;PI(0.31±0.55),(0.74±0.87);RI(0.44±0.03),(0.61±0.47),and both groups were statistically significant(P<0.05).The observation group of Vm was(31.85±4.55)cm/s higher

关 键 词：温针 颈椎旁神经阻滞 颈源性头痛 颈部血流动力学 

分 类 号：R259[医药卫生—中西医结合]