远近配穴巨刺法治疗原发性三叉神经痛的临床研究  

Clinical Study on the Treatment of Primary Trigeminal Neuralgia by Opposing Needling at Near and Far Acupoints

作　　者：戴双燕 洪媛媛[1] 魏燕芳[1] 吴永刚[1] Dai Shuangyan;Hong Yuanyuan;Wei Yanfang;Wu Yonggang(Shenzhen Traditional Chinese Medicine Hospital,Guangdong,Shenzhen 518000,China)

机构地区：[1]广东省深圳市中医院,广东深圳518000

出　　处：《中国中医急症》2021年第7期1189-1191,1225,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20192080);深圳市科技研发资金条件与平台建设计划重点实验室(CXB201111250113A);“三名工程”中国中医科学院刘保研首席研究员中医针灸临床评价方法创新团队(SZSM201612001)。

摘　　要：目的通过观察简化McGill疼痛量表及血液中降钙素基因相关肽(CGRP)、5-羟色胺(5-HT)含量,观察远近配穴巨刺法治疗原发性三叉神经痛的临床疗效。方法选取60例原发性三叉神经痛患者,随机分为治疗组与对照组各30例,治疗组针刺健侧主穴内庭、太冲、合谷、三阴交、丘墟,再辨证选取健侧配穴。对照组针刺患侧主穴四白、下关、地仓、合谷、内庭、太冲及辨证选取患侧配穴。结果1)简化McGill量表[目测类比定级法(VAS)、疼痛分级指数(PRI)、现有疼痛强度(PPI)]比较:两组患者针刺当天及针刺后2 d VAS、PPI、PRI评分均较针刺前降低,差异有统计学意义(P<0.01)。治疗组针刺当天及针刺后2 d VAS、PPI、PRI评分均较对照组改善明显,差异有统计学意义(P<0.05)。2)血CGRP含量比较:两组患者针刺当天及针刺后2 d,血CGRP均较前下降(P<0.01),且针刺后2 d较针刺当天亦下降(P<0.01)。治疗组针刺当天及针刺后2 d均较对照组血CGRP下降,差异有统计学意义(P<0.05)。3)血5-HT比较:两组患者针刺当天及针刺后2 d,5-HT均较前上升明显(P<0.01),且针刺后2 d较针刺当天亦上升(P<0.01)。治疗组针刺当天及针刺后2 d均较对照组血5-HT上升明显,差异有统计学意义(P<0.05)。4)疗效比较:两组有效率比较,治疗组优于对照组(P<0.05)。结论远近配穴巨刺法治疗原发性三叉神经痛较普通针刺疗效更优,能明显降低致痛物质CGRP的释放,提高镇痛物质5-HT含量,起到明显的镇痛作用,该取穴方法能明显减轻三叉神经痛的疼痛强度,较普通针刺疗效更优。Objective:To observe the clinical efficacy of opposing needling at near and far acupoints on primary trigeminal neuralgia by observing the content of CGRP and 5-HT in blood and the simplified McGill pain scale.Methods:A total of 60 patients with primary trigeminal neuralgia were selected and randomly divided into the treatment group and control group,30 cases in each group.The treatment group was treated with opposing needling on the contralateral main acupoints of Neiting,Taichong,Hegu,Sanyinjiao and Qixu,along with the contralateral points according to syndrome differentiation.In the control group,Sibai,Xiaguan,Dicang,Hegu,Neiting,Taichong,along with the affected points according to syndrome differentiation were selected.Results:1)Comparison of simplified Mc Gill scales(VAS,PPI,PRI).The VAS,PPI,PRI scores of the two groups were significantly lower on the day of acupuncture and 2 days after acupuncture(P<0.01).The scores of VAS,PPI and PRI in the treatment group were significantly better than those in the control group on the same day and 2 days after acupuncture(P<0.05).2)Comparison of the content of CGRP in blood.CGRP in blood of the two groups decreased on the day of acupuncture and 2 days after acupuncture(P<0.01),and also decreased on 2 days after acupuncture(P<0.01).CGRP in blood of the treatment group decreased significantly on the day of acupuncture and 2 days after acupuncture compared with control group(P<0.05).3)Comparison of 5-HT in blood.5-HT increased significantly on the day of acupuncture and 2 days after acupuncture(P<0.01),and it also increased on 2 days after acupuncture(P<0.01).Compared with the control group,5-HT in the treatment group increased significantly on theday of acupuncture and 2 days after acupuncture(P<0.01).4)Comparison of curative effect.The effective rate ofthe treatment group was better than that of the control group(P>0.05).Conclusion:Opposing needling at nearand far acupoints is more effective than common acupuncture in the treatment of primary trigeminal neuralgia.Itcan ob

关 键 词：原发性三叉神经痛 针刺 远近配穴巨刺法 临床观察 

分 类 号：R745.11[医药卫生—神经病学与精神病学]