刮痧放痧联合电针治疗枕大神经痛:随机对照试验  

Guasha-fangsha therapy combined with electroacupuncture in treatment of greater occipital neuralgia:a randomized controlled trial

作　　者：雷婷 施茵[1] 李燕婷[1] 马悦 胡晓颖 LEI Ting;SHI Yin;LI Yanting;MA Yue;HU Xiaoying(Seventh People's Hospital Affiliated to Shanghai University of TCM,Shanghai 200137,China;Department of TCM,Shanghai Hongkou District Jiangwan Hospital,Shanghai 200081)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137 [2]上海市虹口区江湾医院中医科,上海200081

出　　处：《中国针灸》2024年第8期889-893,共5页Chinese Acupuncture & Moxibustion

基　　金：上海市虹口区“国医强优”三年行动计划中西医结合康复能力提升专项项目:HKGYQYXM-2022-04。

摘　　要：目的:观察刮痧放痧联合电针治疗枕大神经痛的临床疗效。方法:将90例枕大神经痛患者随机分为观察组(45例)和对照组(45例,脱落2例)。对照组采用电针治疗,穴取风府及双侧天柱、风池、完骨、玉枕、后溪,予疏密波,频率2 Hz/100 Hz,电流强度2~6 mA,每次30 min,隔日治疗1次,每周3次。观察组在对照组基础上采用刮痧放痧治疗,以头后部足太阳膀胱经、头侧部足少阳胆经循行处为主,每周治疗1次。两组均治疗3周。分别于治疗前,治疗1、2、3周后及治疗结束后3周随访观察两组患者视觉模拟量表(VAS)评分;于治疗前后及治疗结束后3周随访观察两组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)和简明生活质量量表(SF-36)评分;并于治疗后及治疗结束后3周随访评定两组临床疗效。结果:治疗1周后,观察组患者VAS评分较治疗前降低(P<0.05);治疗2、3周后及随访时,两组患者VAS评分均治疗前降低(P<0.05)。治疗后各时点,观察组VAS评分均低于对照组(P<0.05)。治疗后及随访时,两组患者SAS、SDS评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);两组患者SF-36各分项评分均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,观察组总有效率为91.1%(41/45),高于对照组的76.7%(33/43,P<0.05);随访时,观察组总有效率为91.1%(41/45),高于对照组的72.1%(31/43,P<0.05)。结论:刮痧放痧联合电针可有效治疗枕大神经痛,减轻疼痛程度,改善焦虑、抑郁情绪,提高生活质量。Objective To observe the clinical effect of guasha-fangsha(scrapping and bleeding)therapy combined with electroacupuncture(EA)on greater occipital neuralgia.Methods Ninety patients with greater occipital neuralgia were randomly divided into an observation group(45 cases)and a control group(45 cases,2 cases dropped out).In the control group,EA was delivered at Fengfu(GV 16)and bilateral Tianzhu(BL 10),Fengchi(GB 20),Wangu(GB 12),Yuzhen(BL 9)and Houxi(SI 3),with disperse-dense wave,at 2 Hz/100 Hz in frequency and 2 mA to 6 mA in intensity,for 30 min in each intervention,once every other days,3 times a week.In the observation group,on the basis of the intervention as the control group,guasha-fangsha therapy was used along the distribution of the bladder meridian of foot-taiyang on the occipital region and that of the gallbladder meridian of foot-shaoyang on the lateral side of the head,once weekly.The duration of treatment was 3 weeks in the two groups.In the two groups,before treatment,after 1,2 and 3 weeks of treatment and in follow-up visit after 3 weeks of treatment completion,the score of visual analogue scale(VAS)was observed;before and after treatment,as well as in follow-up visit after 3 weeks of treatment completion,the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS)and 36-item short-form health survey(SF-36)were observed;after treatment and in follow-up visit after 3 weeks of treatment completion,the clinical efficacy was evaluated.Results After one week of treatment,the VAS score in the observation group decreased when compared with that before treatment(P<0.05),while the scores in 2 and 3 weeks of treatment and in follow-up visit after 3 weeks of treatment completion were lower than those before treatment in the two groups(P<0.05)separately.At each time point after treatment,the VAS scores in the observation group were lower than those in the control group(P<0.05).After treatment and during the follow-up visit,the scores of SAS and SDS decreased when compared with those before

关 键 词：枕大神经痛 刮痧 放痧 电针 项丛刺 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]