圆利针深刺下关穴配合梅花针叩刺治疗风热型三叉神经痛疗效观察  

Clinical observation on deep needling at Xiaguan(ST 7) with round sharp needle combined with plum-blossom needle for trigeminal neuralgia of wind and heat

作　　者：吴民民 刘小华 王利娇 陈小雨 李崖雪[2] WU Min-min;LIU Xiao-hua;WANG Li-jiao;CHEN Xiao-yu;LI Ya-xue(Graduate School of Heilongjiang University of CM,Harbin 150040,China;Department of Acupuncture and Moxibustion,First Affiliated Hospital of Heilongjiang University of CM,Harbin 150040)

机构地区：[1]黑龙江中医药大学研究生院,哈尔滨150040 [2]黑龙江中医药大学附属第一医院针灸科,哈尔滨150040

出　　处：《中国针灸》2021年第10期1089-1094,共6页Chinese Acupuncture & Moxibustion

基　　金：黑龙江省自然科学基金面上项目:H2015033;黑龙江省中医药科研项目:ZHY2020-106。

摘　　要：目的:比较圆利针深刺下关穴配合梅花针叩刺与常规针刺治疗风热型三叉神经痛(TN)的临床疗效,并探讨其作用机制。方法:将60例风热型TN患者随机分为观察组(30例)和对照组(30例)。观察组采用圆利针深刺下关穴配合梅花针叩刺患侧阳白、颧髎、地仓、四白等穴;对照组取穴同观察组,采用常规针刺治疗,均每日1次,每周5次,治疗4周。观察两组患者治疗前后简式Mc Gill疼痛问卷(SF-MPQ)评分、中医证候评分、总体印象变化(PGIC)评分、综合症状评分,检测治疗前后血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、血管活性肠肽(VIP)和β-内啡肽(β-EP)水平,并观察两组不良反应。结果:治疗后,两组患者PRI、PPI、VAS评分,中医证候评分、PGIC评分、综合症状评分及血清IL-6、TNF-α、VIP水平均较治疗前降低(P<0.05),且观察组以上指标降低幅度均大于对照组(P<0.05);治疗后,两组患者血清β-EP水平较治疗前升高(P<0.05),且观察组升高幅度大于对照组(P<0.05)。两组均未出现严重不良反应。结论:圆利针深刺下关穴配合梅花针叩刺可有效治疗风热型三叉神经痛,减轻患者疼痛症状,疗效优于常规针刺,其机制可能与调节血清IL-6、TNF-α、VIP和β-EP免疫相关细胞因子有关。Objective To compare the clinical therapeutic effect between deep needling at Xiaguan(ST 7) with round sharp needle combined with plum-blossom needle and conventional acupuncture in patients with trigeminal neuralgia(TN) of wind and heat, and explore its mechanism. Methods A total of 60 patients with TN of wind and heat were randomized into an observation group(30 cases) and a control group(30 cases). In the observation group, deep needling with round sharp needle was applied at Xiaguan(ST 7), and tapping with plum-blossom needle was applied at Yangbai(GB 14), Quanliao(SI 18), Dicang(ST 4), Sibai(ST 2), etc. of affected side. In the control group, conventional acupuncture was applied at the same acupoints selected in the observation group. The treatment was given once a day, 5 times a week for 4 weeks in the both groups. Before and after treatment, the scores of short-form Mc Gill pain questionnaire(SF-MPQ), TCM syndrome, patient global impression of change(PGIC) and comprehensive symptom were observed, the serum levels of interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), vasoactive intestinal peptide(VIP) and β-endorphin(β-EP) were detected, and the adverse reaction was observed in the both groups. Results After treatment, the scores of PRI, PPI, VAS, TCM syndrome, PGIC and comprehensive symptom and the serum levels of IL-6, TNF-α and VIP were decreased compared before treatment in the both groups(P<0.05), and the variations of above indexes in the observation group were larger than those in the control group(P<0.05). After treatment, the serum levels of β-EP were increased compared before treatment in the both groups(P<0.05), and the variation of that in the observation group was larger than the control group(P<0.05). No severe adverse reaction was observed in the both groups. Conclusion Deep needling at Xiaguan(ST 7) with round sharp needle combined with plum-blossom needle can effectively treat the trigeminal neuralgia of wind and heat and relieve pain, its therapeutic effect is superior to conventio

关 键 词：三叉神经痛 圆利针 穴 下关 梅花针 炎性细胞因子 

分 类 号：R246.6[医药卫生—针灸推拿学]