针刺对卒中恢复期相关性头痛患者血浆内源性阿片肽的影响  

Effects of acupuncture on plasma endogenous opioid peptides in patients with stroke-associated headache in convalescence

作　　者：李绍康 廖伟东 赵洁[1] 曹晓雯 LI Shao-kang;LIAO Wei-dong;ZHAO Jie;CAO Xiao-wen(Department of Acupuncture,Gongli Hospital of Pudong New Area,Shanghai 200135,China;Department of Acupuncture-moxibustion and Tuina,People’s Hospital Group of Yantian District,Shenzhen 518083,Guangdong Province)

机构地区：[1]上海市浦东新区公利医院针灸科,上海200135 [2]深圳市盐田区人民医院集团盐田院区针灸推拿科,广东深圳518083

出　　处：《针刺研究》2020年第12期995-999,共5页Acupuncture Research

基　　金：浦东新区卫生系统重中之重中医重点专病建设资助项目(No.PDZY-2018-0617)。

摘　　要：目的:观察针刺治疗缺血性脑卒中恢复期相关性头痛的临床疗效并分析其相关因素。方法:将上海市浦东新区公利医院针灸科2018年10月至2019年12月收治的缺血性脑卒中恢复期相关性头痛患者116例,按照随机数字表法分为治疗组和对照组,每组58例。两组均给予控制血压、血糖、血脂及抗凝等常规治疗。治疗组患者同时给予项七针结合穴位透刺治疗,每次30 min;对照组患者给予盐酸氟桂利嗪胶囊治疗,每次1粒(5 mg);均每日治疗1次,疗程为4周。比较两组患者治疗前后疼痛视觉模拟量尺(VAS)评分,头痛积分,血浆5-羟色胺(5-HT)、多巴胺(DA)、P物质(SP)、α-内啡肽(α-EP)和β-内啡肽(β-EP)含量,并比较两组治疗的总有效率。结果:治疗前两组患者VAS评分,头痛积分,血浆5-HT、DA、SP、α-EP、β-EP含量差异均无统计学意义(P>0.05)。治疗后,两组VAS评分,头痛积分,血浆5-HT、DA、SP含量均低于本组治疗前(P<0.05),血浆α-EP、β-EP含量高于本组治疗前(P<0.05)。治疗后治疗组VAS评分,头痛积分,血浆5-HT、DA、SP含量低于对照组(P<0.05),血浆α-EP、β-EP含量高于对照组(P<0.05)。治疗组总有效率为87.9%(51/58),对照组总有效率为72.4%(42/58),治疗组临床疗效明显优于对照组(P<0.05)。结论:针刺治疗可通过增加内源性阿片肽释放,降低5-HT、DA、SP等疼痛相关因子分泌,改善卒中相关性头痛症状。Objective To observe the clinical effect of acupuncture on patients with stroke-related headache during convalescent and analyze its related factors.Methods A total of 116 stroke-related headache patients admitted to the Acupuncture Department of Gongli Hospital of Pudong New Area,Shanghai,from October 2018 to December 2019 were divided into a treatment group and a control group according to a random number table,with 58 cases in each group.Patients in both groups were given conventional treatments for control of blood pressure,blood sugar,blood lipids and anticoagulation.At the same time,patients in the treatment group were treated with"nape seven needles"(acupuncture at Fengfu[GV16],bilateral Fengchi[GB20],bilateral Tianzhu[BL10]and bilateral Wangu[GB12])combined with penetration needling for 30 min;patients in the control group were treated with Flunarizine hydrochloride capsules(5 mg).Both interventions were conducted once daily for 4 weeks.The visual analogue scale(VAS)score and integrative sores of headache,and plasma serotonin(5-HT),dopamine(DA),substance P(SP),α-endorphin(α-EP),andβ-endorphin(β-EP)levels before and after treatment were compared between the two groups.The total therapeutic effective rate of the two groups was calculated.Results There was no significant difference in VAS score,headache score,plasma 5-HT,DA,SP,α-EP,β-EP levels between the two groups before treatment(P>0.05).After treatment,both groups have significant decrease in the VAS score,integrative sores of headache,the plasma 5-HT,DA,SP levels(P<0.05),and significant increase in the plasmaα-EP andβ-EP levels(P<0.05).At the same time,the VAS score,integrative sores of headache,the plasma 5-HT,DA,SP levels of the treatment group were lower(P<0.05),and the plasmaα-EP andβ-EP levels were higher(P<0.05)than those in the control group.The total effective rate of the treatment group(51/58,87.9%)was higher than that of the control group(42/58,72.4%,P<0.05).Conclusion Acupuncture therapy can increase the release of endogenous opioid

关 键 词：针刺 缺血性脑卒中 头痛 内源性阿片肽 

分 类 号：R245.97[医药卫生—针灸推拿学]