针刺联合梅花针循经叩刺治疗偏头痛的疗效观察及弥散张量成像的应用  

Efficacy Observation of Treating Migraine with Acupuncture and Plum-blossom Needle Tapping Along Meridians and the Application of Diffusion Tensor Imaging

作　　者：王菲菲 韩伟 张虎 WANG Feifei;HAN Wei;ZHANG Hu(Shunyi Hospital,Beijing Hospital of Traditional Chinese Medicine,Beijing 101300,China)

机构地区：[1]北京中医医院顺义医院,北京101300

出　　处：《上海针灸杂志》2022年第12期1161-1165,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：北京市科技计划课题首都特色项目(Z171100001017150);北京市优秀人才培养资助青年骨干个人项目(2018000092582G363)。

摘　　要：目的观察针刺联合梅花针循经叩刺治疗偏头痛的临床疗效,并评估应用弥散张量成像(DTI)参数预测疗效的可能性。方法选取偏头痛患者120例,根据住院病号末位数的奇偶分为观察组(63例)和对照组(57例)。观察组予针刺联合梅花针循经叩刺治疗,对照组予单纯梅花针循经叩刺治疗。比较两组临床疗效和不良反应发生情况。观察两组治疗前后偏头痛特异性生活品质量表(MSQ)评分的变化。比较两组有效患者和无效患者的DTI参数差异。结果观察组总有效率为92.1%,高于对照组的84.2%,差异具有统计学意义(P<0.05)。治疗后3个月,观察组MSQ评分低于对照组(P<0.05)。观察组不良反应发生率为3.2%,低于对照组的8.8%,但差异无统计学意义(P>0.05)。所有患者中有效106例,无效14例;有效患者胼胝体体部、内囊前肢和皮质脊髓束部分各向异性指数(FA)均高于无效患者(P<0.05);有效患者胼胝体膝部平均扩散率(MD)低于无效患者(P<0.05);胼胝体体部、内囊前肢和皮质脊髓束FA值、胼胝体膝部MD值预测治疗无效的ROC曲线下面积分别为0.815、0.679、0.780和0.675,其中胼胝体体部和皮质脊髓束FA值有预测疗效的价值(P<0.05)。结论针刺联合梅花针循经叩刺治疗偏头痛的临床疗效优于单纯梅花针循经叩刺治疗,可降低不良反应发生率,DTI中胼胝体体部和皮质脊髓束FA值可能有预测疗效的价值。Objective To observe the clinical efficacy of treating migraine with acupuncture plus plum-blossom needle tapping and assess the possibility of using diffusion tensor imaging(DTI)parameters to predict efficacy.Method A total of 120 migraine patients were divided into an observation group(63 cases)and a control group(57cases)based on the parity of the last number of their admission number.The observation group was treated with acupuncture plus plum-blossom needle tapping along meridians,and the control group only received plum-blossom needle tapping along meridians.Clinical efficacy and adverse reactions were compared between the two groups.The migraine-specific quality of life questionnaire(MSQ)score was observed before and after the treatment.The differences in the DTI parameters between the effective and invalid cases were also measured.Result The total effective rate was 92.1% in the observation group,higher than 84.2% in the control group,and the difference was statistically significant(P<0.05).After 3-month treatment,the MSQ score in the observation group was lower than that in the control group(P<0.05).The adverse reaction rate was 3.2% in the observation group,lower than 8.8% in the control group,and the between-group difference was not statistically significant(P>0.05).Of all subjects,there were 106 effective cases and 14 invalid cases.The fractional anisotropy(FA)of the corpus callosum body,the anterior limb of internal capsule,and corticospinal tract was higher in the effective cases than in the invalid cases(P<0.05);the mean diffusion(MD)rate of the genu of corpus callosum was lower in the effective cases than in the invalid cases(P<0.05);the area under the receiver operating characteristic(ROC)curve of the FA of the corpus callosum body,the anterior limb of internal capsule,and corticospinal tract and the corpus callosum genu’s MD rate for predicting ineffectiveness was 0.815,0.679,0.780,and 0.675,respectively.Among them,the FA of corpus callosum body and corticospinal tract had value for predicting

关 键 词：梅花针疗法 针刺疗法 偏头痛 弥散张量成像 核磁共振 

分 类 号：R246.6[医药卫生—针灸推拿学]