火针联合毫针治疗紧张性头痛的疗效及对颅周肌肉压痛的影响  

The curative effect of fire needling combined with filiform needling on tension-type headache and its effect on the tenderness of pericranial muscles

作　　者：高帆 邵冰 李彬[2] 刘璐[2] 游伟[2] 陈鹏[2] 王少松[2] 魏嘉[2] 张帆[2] 廖宇翔 罗煊之 刘慧林[2] GAO Fan;SHAO Bing;LI Bin;LIU Lu;YOU Wei;CHEN Peng;WANG Shao-song;WEI Jia;ZHANG Fan;LIAO Yu-xiang;LUO Xuan-zhi;LIU Hui-lin(Beijing University of Chinese Medicine,Beijing 100029,China;Acupuncture and Moxibustion Center of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University/Beijing Key Laboratory of Acupuncture Neuromodulation,Beijing 100010;China Rehabilitation Research Center,Beijing 100068)

机构地区：[1]北京中医药大学,北京100029 [2]首都医科大学附属北京中医医院针灸中心/针灸神经调控北京市重点实验室,北京100010 [3]中国康复研究中心,北京100068

出　　处：《针刺研究》2023年第11期1151-1158,共8页Acupuncture Research

基　　金：北京市医院管理局“扬帆”计划临床技术创新项目(No.XMLX201832)。

摘　　要：目的:观察火针点刺颅周压痛点联合毫针治疗紧张性头痛(TTH)的疗效及对颅周肌肉压痛的影响,探讨TTH头痛症状变化与颅周肌肉压痛之间的相关性,并分析颅周肌肉压痛对TTH的影响。方法:TTH患者经区组随机分组,试验组完成41例,对照组完成38例。试验组予火针点刺颅周压痛点联合毫针安神刺法治疗;对照组仅采用毫针安神刺法治疗;两组患者每周治疗2次,连续治疗8周。记录治疗前后的头痛发作天数、颅周肌肉压痛点数量与分布,采用视觉模拟量尺评分法记录头痛程度,测量颅周肌肉压痛阈值,分析头痛发作天数及程度变化与颅周肌肉压痛点数量和压痛阈值变化的相关性,计算治疗有效率。结果:与治疗前比较,两组患者头痛发作天数减少、程度减轻(P<0.05);试验组颅周肌肉压痛点数量减少(P<0.05),压痛阈值升高(P<0.05)。治疗后,与对照组比较,试验组头痛发作天数和程度、颅周肌肉压痛点数量均减少或减轻(P<0.05),压痛阈值升高(P<0.05)。头痛发作减少天数及减轻程度与颅周肌肉压痛点减少数量及压痛阈值升高程度均呈正相关(P<0.05)。试验组治疗有效率为87.80%(36/41),高于对照组治疗有效率57.89%(22/38,P<0.05)。受试者最常见压痛点的解剖位置是上斜方肌,其次是胸锁乳突肌、上项线、颞肌、咬肌等。结论:火针点刺颅周压痛点联合毫针安神刺法治疗TTH可明显改善临床症状、显著减轻颅周肌肉压痛,且颅周压痛可能是TTH发病的重要因素。Objective To observe the curative effect of fire needling pricking pericranial tender points com⁃bined with filiform needling on tension-type headache(TTH)and its effect on pericranial muscle tenderness,and ex⁃plore the correlation between changes of headache symptoms and pericranial muscle tenderness in TTH,to analyze the influence of pericranial muscle tenderness on TTH.Methods A total of 41 TTH patients in the treatment group and 38 TTH patients in the control group completed the study.The patients in the treatment group were treated with fire nee⁃dling at pericranial tender points combined with filiform needling at Baihui(GV20),Sishencong(EX-HN1),Shenting(GV24),Touwei(ST8)and Fengchi(GB20).The patients in the control group were only treated with the same filiform needling as the treatment group.Patients in the two groups were treated twice a week for 8 weeks.Before and after treatment,the days of headache onset,the number and distribution of pericranial muscle tender points were recorded,the degree of headache was evaluated by visual analogue scale and the threshold of pericranial muscle tender points were measured.The correlations between the changes of the days and degree of headache onset and the changes of the number and threshold of pericranial muscle tender points were analyzed.The effective rates in the two groups were calculated.Results Compared with those before treatment,the days of headache onset and the degree of headache were decreased(P<0.05)in the two groups;the number of pericranial muscle tender points was decreased(P<0.05)and the tenderness threshold was increased(P<0.05)in the treatment group.After treatment,compared with the con⁃trol group,the days of headache onset,the degree of headache,and the number of pericranial muscle tender points were decreased(P<0.05),and the tenderness threshold was increased(P<0.05)in the treatment group.The decrease of the days and degree of headache was positively correlated with the decrease of number and the increase of tender⁃ness threshold of pe

关 键 词：火针 紧张性头痛 颅周肌肉压痛 

分 类 号：R245.31[医药卫生—针灸推拿学]