小针刀联合氟桂利嗪治疗前庭性偏头痛临床研究  

Clinical study of small needle-knife combined with flunarizine in the treatment of vestibular migraine

作　　者：李歌 张晓明[3] 李敬伟[1] LI Ge;ZHANG Xiaoming;LI Jingwei(Gulou Clinical Medical College,Nanjing Medical University,Nanjing,Jiangsu 210000,China;Department of Neurology,Nanjing Tongren Hospital,Nanjing,Jiangsu 210000,China;Department of Acupuncture and Knife,BenQ Medical Center Affiliated to Nanjing Medical Uni-versity,Nanjing,Jiangsu 210000,China)

机构地区：[1]南京医科大学鼓楼临床医学院,江苏南京210000 [2]南京同仁医院神经内科,江苏南京210000 [3]南京医科大学附属明基医院针刀科,江苏南京210000

出　　处：《安徽医药》2024年第10期1947-1951,共5页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金项目(82101396)。

摘　　要：目的探究小针刀联合氟桂利嗪治疗前庭性偏头痛临床疗效。方法研究对象选取2020年10月至2022年10月南京同仁医院收治的90例前庭性偏头痛病人,按就诊顺序抽签随机分为三组,分别为对照组(30例,氟桂利嗪治疗)、小针刀组(30例,小针刀治疗)、联合组[30例,小针刀(每周进行1次针刀治疗)联合氟桂利嗪治疗]。比较三组病人治疗效果、眩晕残障量表(DHI)评分、视觉模拟评分法(VAS)评分和不良反应发生情况。结果与对照组(56.67%)、小针刀组(66.67%)相比,联合组(90.00%)总改善率显著提高。同一时间点两组DHI评分比较差异有统计学意义,随治疗时间增加而减少(P<0.05);两组DHI评分组间与时点有交互效应(P<0.05),治疗2、3 d后,联合组、小针刀组和对照组DHI评分较治疗前降低(P<0.05),与对照组、小针刀组相比,联合组治疗2、3 d后DHI评分显著降低(P<0.05)。同一时间点两组VAS评分比较差异有统计学意义,随治疗时间增加而减少(P<0.05);两组VAS评分组间与时点有交互效应(P<0.05),治疗2、3 d后,联合组[(2.01±0.65)分、(1.15±0.35)分]、小针刀组[(2.43±0.71)分、(1.45±0.46)分]和对照组[(3.11±0.77)分、(2.05±0.51)分]VAS评分较治疗前[(5.72±1.25)分、(5.69±1.23)分、(5.65±1.21)分]降低(P<0.05),与对照组、小针刀组相比,联合组治疗2、3 d后VAS评分显著降低(P<0.05)。三组不良反应发生率比较,差异有统计学意义(P<0.05)。联合组不良反应发生率(13.33%,4/30)高于小针刀组(0.00%,0/30),低于对照组(30.00%,9/30)。治疗后,联合组(0.82±0.17)次/月、小针刀组(1.55±0.41)次/月和对照组(1.66±0.55)次/月,头痛发作频率较治疗前[(4.35±1.03)次/月、(4.55±1.17)次/月、(4.75±1.23)次/月]降低,与对照组、小针刀组相比,联合组治疗后头痛发作频率显著降低(P<0.05)。结论小针刀联合氟桂利嗪治疗前庭性偏头痛效果显著,可减轻病人头痛及眩晕程度,并且快速、安全Objective To explore the clinical effect of small needle-knife combined with flunarizine in the treatment of vestibular migraine.Methods A total of 90 patients with vestibular migraine admitted to Nanjing Tongren Hospital from October 2020 to October 2022 were randomly assigned into three groups according to the order of treatment by lot:control group(30 cases,flunarizine treatment),small needle-knife group(30 cases,small needle-knife treatment),and combination group(30 cases,small acupotomy(acupotomy once a week)combined with flunarizine therapy.The therapeutic effect,vertigo Disability Scale(DHI)score,visual analogue scale(VAS)score and the occurrence of adverse reactions were compared among the 3 groups.Results Compared with the control group(56.67%)and the small needle knife group(66.67%),the total improvement rate of the combined group(90.00%)was significantly increased.The DHI score of the two groups at the same time point was significantly different,and decreased with the increase of treatment time(P<0.05).DHI scores of the two groups had interaction effects between groups and time points(P<0.05).After 2 and 3 days of treatment,DHI scores of the combined group,the small acupotomy group and the control group were lower than those before treatment(P<0.05),and DHI scores of the combined group were significantly lower than those of the control group and the small acupotomy group(P<0.05).The VAS scores of the two groups at the same time point were significantly different,and decreased with the increase of treatment time(P<0.05).There was interaction effect between the two groups(P<0.05).After 2 and 3 days of treatment,VAS scores in combination group(2.01±0.65)scores,(1.15±0.35)scores,small acupotomy group(2.43±0.71)scores,(1.45±0.46)scores and control group(3.11±0.77)scores,(2.05±0.51)scores were lower than those before treatment[(5.72±1.25)scores,(5.69±1.23)scores,(5.65±1.21)scores](P<0.05).The VAS score of the combined group was significantly decreased after 2 and 3 days of treatment(P<0.05).The inci

关 键 词：偏头痛 小针刀 疗效 氟桂利嗪 内耳前庭 

分 类 号：R747.2[医药卫生—神经病学与精神病学]