针灸合并药枕治疗面肌痉挛显微血管减压术后头痛的临床研究  

Clinical study of acupuncture combined with medicated pillow in treating headache after microvascular decompression for hemifacial spasm

作　　者：史皓威[1] 郭文昌 李洋[1] 张阔[1] 石海亮[1] 钱涛[1] SHI Haowei;GUO Wenchang;LI yang;ZHANG Kuo;SHI Hailiang;QIAN Tao(The first Department of Neurosurgery,Hebei General Hospital,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北省人民医院神经外一科,河北石家庄050000

出　　处：《湖南中医药大学学报》2023年第10期1846-1852,共7页Journal of Hunan University of Chinese Medicine

基　　金：河北省中医药管理局项目(20200206)。

摘　　要：目的探究针灸合并药枕治疗面肌痉挛显微血管减压术后头痛的疗效。方法选择2021年2月至2023年2月于河北省人民医院神经外一科因面肌痉挛行显微血管减压术后头痛的92例患者作为研究对象,随机分为对照组和观察组,每组46例。对照组采用针灸疗法治疗,观察组采用针灸合并药枕治疗,1次/d,15 d为1个疗程。比较治疗后两组患者的临床疗效,以及治疗前、治疗后1、5、10、15 d的中医证候积分、视觉模拟评分(visual analogue score,VAS)、头痛影响测试量表-6(headache impact test scale-6,HIT-6)评分、健康调查简表(the MOS item short from health survey,SF-36)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、血清白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平;采用广义估计方程评价两种治疗方法对患者上述指标的影响。结果观察组治疗总有效率较对照组明显升高(P<0.05);两组患者治疗后1、5、10、15 d的中医证候积分、VAS评分、HIT-6评分、PSQI评分以及血清IL-6、TNF-α水平均依次显著降低(P<0.05),且明显低于治疗前(P<0.05);两组患者治疗后的SF-36评分随着观察时间的延长逐渐增加(P<0.05),且明显高于治疗前(P<0.05);观察组患者治疗后5、10、15 d的中医证候积分、VAS评分、HIT-6评分、PSQI评分以及血清IL-6、TNF-α水平明显低于对照组(P<0.05),SF-36评分明显高于对照组(P<0.05);广义估计方程评价结果显示,针灸合并药枕治疗对患者上述指标的改善较单纯针灸疗法治疗显著。结论针灸合并药枕治疗能够缓解面肌痉挛显微血管减压术后头痛患者的头痛症状,降低炎症反应,改善睡眠质量和生活质量,值得临床推广应用。Objective To explore the efficacy of acupuncture combined with medicated pillow in treating headache after microvascular decompression for hemifacial spasm.Methods A total of 92 patients with headache after microvascular decompression for hemifacial spasm in the first Department of Neurosurgery of Hebei General Hospital from February 2021 to February 2023 were randomly divided into control group and observation group,with 46 cases in each group.The control group was treated with acupuncture,and the observation group with the combination of acupuncture and a medicated pillow,once a day,for 15 days as a course of treatment.The clinical efficacy was compared between the two groups after treatment,and the TCM pattern score,visual analogue score(VAS),headache impact test scale-6(HIT-6)score,MOS item short from health survey(SF-36)score,Pittsburgh sleep quality index(PSQI)score,and the serum levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were compared between the two groups before and 1,5,10,and 15 d after treatment.The generalized estimating equation was used to evaluate the effects of the two treatment methods on the above-mentioned indicators.Results The total effective rate in the observation group was significantly higher than that in the control group(P<0.05).The TCM pattern scores,VAS scores,HIT-6 scores,PSQI scores,and the serum levels of IL-6 and TNF-αin the two groups decreased significantly on 1,5,10 and 15 d after treatment sequentially(P<0.05),and were significantly lower than those before treatment(P<0.05).The SF-36 scores of the two groups increased gradually with the extension of observation time after treatment(P<0.05),and were significantly higher than those before treatment(P<0.05).The TCM pattern score,VAS score,HIT-6 score,PSQI score,and the serum levels of IL-6 and TNF-αin the observation group were significantly lower than those in the control group on 5,10 and 15 d after treatment(P<0.05),and the SF-36 score was significantly higher than that in the control group(P<0.05).The

关 键 词：面肌痉挛 显微血管减压术 头痛 针灸 药枕 广义估计方程 炎症因子 

分 类 号：R245[医药卫生—针灸推拿学] R651.3[医药卫生—中医临床基础]