下关穴合谷刺联合揿针治疗痰阻血瘀型原发性三叉神经痛伴负性情绪:随机对照试验  

Chicken-claw needling at Xiaguan(ST 7) combined with intradermal needling on negative emotions in primary trigeminal neuralgia of phlegm obstruction and blood stasis:a randomized controlled trial

作　　者：张薇薇 田书艺 唐甜甜 李崖雪[2] ZHANG Wei-wei;TIAN Shu-yi;TANG Tian-tian;LI Ya-xue(Graduate School of Heilongjiang University of CM,Harbin 150040,China;Department of Acupuncture and Moxibustion,First Afiliated 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》2022年第9期999-1003,共5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:观察下关穴合谷刺联合揿针治疗痰阻血瘀型原发性三叉神经痛(PTN)伴负性情绪的临床疗效。方法:将60例痰阻血瘀型PTN患者随机分为观察组和对照组,每组30例。观察组采用下关穴合谷刺联合揿针(穴取四白、鱼腰、合谷、太冲及耳穴心、神门、皮质下等)治疗,每天1次,6 d为一疗程,疗程间休息1 d,共治疗2个疗程;对照组口服卡马西平片,连续治疗13 d。分别于治疗前后比较两组患者疼痛视觉模拟量表(VAS)、中医证候、焦虑自评量表(SAS)评分和血清神经递质[β-内啡肽(β-EP)、P物质(SP)、5-羟色胺(5-HT)]含量,并评定临床疗效。结果:治疗后,两组患者VAS、SAS、中医证候评分及血清SP含量均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);两组患者血清β-EP和5-HT含量较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。观察组总有效率为93.3%(28/30),高于对照组的83.3%(25/30,P<0.05)。结论:下关穴合谷刺联合揿针可缓解痰阻血瘀型PTN患者疼痛症状和负性情绪,可能与调节血清神经递质水平有关。Objective To observe the clinical effect of chicken-claw needling at Xiaguan(ST 7) combined with intradermal needling on negative emotion in primary trigeminal neuralgia(PTN) of phlegm obstruction and blood stasis.Methods Sixty cases of patients with PTN of phlegm obstruction and blood stasis were randomly divided into an observation group and a control group,30 cases in each group.The observation group was treated with chicken-claw needling at Xiaguan(ST 7) combined with intradermal needling(acupoints Sibai [ST 2],Yuyao [EX-HN 4],Hegu [LI 4],Taichong [LR 3] and auricular points Xin [CO15],Shenmen [TF4],Pizhixia [AT4],etc.),once a day,6 d as a course of treatment,rest 1 d between courses,a total of 2 courses of treatment;and the control group was given oral carbamazepine tablets for 13 days.Before and after treatment,the pain visual analogue scale(VAS),TCM syndromes,self-rating anxiety scale(SAS) scores and the contents of serum neurotransmitter(β-endorphin [β-EP],substance P [SP] and 5-hydroxytryptamine [5-HT]) were compared,and the clinical efficacy was evaluated.Results After treatment,the VAS,SAS,TCM syndrome scores and the contents of serum SP in the two groups were lower than those before treatment(P<0.05),and the above indexes in the observation group was lower than those in the control group(P<0.05).The contents of serum β-EP and 5-HT in the two groups were higher than those before treatment(P<0.05),and the above indexes in the observation group were higher than those in the control group(P<0.05).The total effective rate in the observation group was 93.3%(28/30),which was higher than 83.3%(25/30) in the control group(P<0.05).Conclusion Chicken-claw needling at Xiaguan(ST 7) combined with intradermal needling can relieve pain symptoms and negative emotions in patients with primary trigeminal neuralgia of phlegm obstruction and blood stasis,which may be related to the regulation of serum neurotransmitter levels.

关 键 词：原发性三叉神经痛 合谷刺 揿针 穴 下关 疼痛 负性情绪 

分 类 号：R246.6[医药卫生—针灸推拿学]