针刺激痛点联合盐酸氟桂利嗪治疗偏头痛的临床研究  

Efficacy of acupuncture at myofascial trigger points combined with flunarizine hydrochloride on migraine

作　　者：张若滔 郭静[2] 王雪飞[2] 温雅丽[2] 王握瑜 刘璐[2] 赵洛鹏 王麟鹏[2] 李彬[2] 徐晓白[2] ZHANG Ruotao;GUO Jing;WANG Xuefei;WEN Yali;WANG Woyu;LIU Lu;ZHAO Luopeng;WANG Linpeng;LI Bin;XU Xiaobai(Beijing University of Chinese Medicine,Beijing 100029,China;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

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,北京100010

出　　处：《现代中西医结合杂志》2024年第14期1930-1934,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金资助项目(82004452);北京市科学技术学会青年人才托举工程(BYESS2023337);北京市医院管理局“扬帆”计划重点医学专业(重点扶持专业)-中西医结合康复(ZYLX202140)。

摘　　要：目的观察针刺激痛点联合盐酸氟桂利嗪治疗偏头痛患者的疗效及对炎症相关指标、血管活性物质的影响。方法选择2017年1月—2022年1月首都医科大学附属北京中医医院诊治的80例偏头痛患者为研究对象,根据随机数字表法按1:1比例将患者分为观察组、对照组,每组40例。对照组予以假针刺+口服盐酸氟桂利嗪治疗,观察组予以激痛点针刺+口服盐酸氟桂利嗪治疗,针刺隔天治疗1次,2组均治疗4周。比较2组治疗后头痛情况,临床疗效,血清炎症相关指标[环氧化酶-2(COX-2)、降钙素基因相关肽(CGRP)、前列腺素E 2(PGE_(2))]及血管活性物质[血管性血友病因子(vWF)、内皮素-1(ET-1)、一氧化氮(NO)]水平、脑血流速度及不良反应发生情况。结果治疗后,观察组偏头痛发生次数、头痛发作总时间、疼痛程度VAS评分均明显低于对照组(P均<0.05);观察组总有效率明显高于对照组[92.5%(37/40)比75.0%(30/40),P<0.05];观察组血清COX-2、CGRP、PGE_(2)、vWF、ET-1水平均明显低于治疗前及对照组(P均<0.05),NO水平均明显高于治疗前及对照组(P均<0.05);观察组大脑前动脉、大脑中动脉、大脑后动脉、椎动脉、基底动脉的血流速度均明显慢于治疗前及对照组(P均<0.05)。治疗期间2组不良反应发生率比较差异无统计学意义(P>0.05)。结论针刺激痛点联合盐酸氟桂利嗪治疗偏头痛疗效显著,可有效缓解患者的疼痛症状,降低炎症相关指标水平,改善血管内皮功能和脑血流动力学,且治疗安全。Objective It is to observe the efficacy of acupuncture at myofascial trigger points combined with flunarizine hydrochloride in the treatment of patients with migraine and its effects on inflammation-related indicators and vasoactive substance.Methods Eighty migraine patients treated in Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from January 2017 to January 2022 were selected for the study,and the patients were divided into observation group and control group according to the randomized numerical table method in the ratio of 1∶1,with 40 cases in each group.The control group was treated with sham acupuncture+oral administration of flunarizine hydrochloride,and the observation group was treated with acupuncture at myofascial trigger points combined with oral administration of flunarizine hydrochloride,the acupuncture was performed once every other day,and both groups were treated for 4 weeks.The headache,clinical efficacy,serum levels of inflammation-related indexes[cyclooxygenase-2(COX-2),calcitonin gene-related peptide(CGRP),prostaglandin E 2(PGE_(2))],and vasoactive substances[vascular hemophilic factor(vWF),endothelin-1(ET-1),nitric oxide(NO)],cerebral blood flow velocity after treatment,and the incidence of adverse effects were compared between the two groups.Results After treatment,the times of migraine occurrences,the total duration of headache attacks,and the VAS score of pain in the observation group were significantly lower than those in the control group(all P<0.05);the total effective rate of the observation group was significantly higher than that of the control group[92.5%(37/40)VS.75.0%(30/40),P<0.05];the serum levels of COX-2,CGRP,PGE_(2),vWF,ET-1 in the observation group were significantly lower(all P<0.05),while the level of NO was significantly higher than those before treatment and in the control groups(all P<0.05);the blood flow velocities of the anterior cerebral artery,middle cerebral artery,posterior cerebral artery,vertebral artery,and basilar

关 键 词：偏头痛 激痛点 针刺疗法 盐酸氟桂利嗪 血管活性物质 脑血流动力学 

分 类 号：R747.2[医药卫生—神经病学与精神病学]