头穴扬刺为主治疗频发性紧张型头痛的疗效观察  

Observation on the efficacy of quintuple needling at scalp points as main treatment for frequent tension-type headache

作　　者：赵红旭 陈英华[2] 孙玮 ZHAO Hongxu;CHEN Yinghua;SUN Wei(Heilongjiang University of Chinese Medicine,Harbin 150040,China;First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,哈尔滨150040 [2]黑龙江中医药大学附属第一医院,哈尔滨150040

出　　处：《上海针灸杂志》2024年第10期1098-1104,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(82074530);黑龙江省自然科学基金项目(ZD2021H007)。

摘　　要：目的观察头穴扬刺为主治疗频发性紧张型头痛的临床疗效。方法将66例频发性紧张型头痛患者随机分为观察组(33例)和对照组(33例),两组均脱落2例,最终纳入每组31例。观察组予头穴扬刺为主联合常规针刺治疗,对照组予常规针刺治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、头痛频率、持续时间、头痛指数、汉密顿焦虑量表(Hamilton anxiety scale,HAMA)评分、汉密顿抑郁量表(Hamilton depression scale,HAMD)评分和生存质量测定量表简表(World Health Organization quality of life brief,WHOQOL-BREF)评分以及双侧大脑前动脉(anterior communicating artery,ACA)、大脑中动脉(middle cerebral artery,MCA)和大脑后动脉(posterior cerebral artery,PCA)血流速度的变化,比较两组临床疗效和复发情况。结果治疗后和治疗后3个月随访时,两组疼痛VAS评分、头痛频率、持续时间、头痛指数、HAMA评分和HAMD评分均降低(P<0.05),WHOQOL-BREF评分均升高(P<0.05),两侧ACA、MCA和PCA血流速度均下降(P<0.05)。观察组治疗后和治疗后3个月随访时疼痛VAS评分、头痛频率、持续时间、头痛指数、HAMA评分和HAMD评分低于对照组(P<0.05),WHOQOL-BREF评分高于对照组(P<0.05),两侧ACA、MCA和PCA血流速度低于对照组(P<0.05)。观察组总有效率为90.3%,优于对照组的77.4%(P<0.05)。观察组复发率低于对照组(P<0.05)。结论在常规针刺治疗基础上,头穴扬刺为主治疗可提高频发性紧张型头痛的临床疗效,可进一步降低脑血流速度,减轻头痛程度,减少疼痛持续时间和发作频率,缓解焦虑和抑郁状态,提高患者生活质量,降低复发率。Objective To observe the clinical efficacy of quintuple needling at scalp points as main treatment for frequent episodic tension-type headache.Method Sixty-six patients with frequent episodic tension-type headache were randomized to an observation group(33 cases)and a control group(33 cases).Two cases dropped out in each of the two groups and 31 cases were finally included in each group.The observation group received quintuple needling at scalp points as main treatment plus conventional acupuncture and the control group received conventional acupuncture alone.The visual analog scale(VAS)score,headache frequency,headache duration,headache index,the Hamilton anxiety scale(HAMA)score,the Hamilton depression scale(HAMD)score,the World Health Organization quality of life brief(WHOQOL-BREF)score,and bilateral anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA)blood flow velocities were observed in the two groups before and after treatment.The clinical therapeutic effect and the recurrence were compared between the two groups.Result At the end of treatment and the follow-up three months after treatment,the VAS score,headache frequency,headache duration,headache index,the HAMA score and the HAMD score decreased(P<0.05),the WHOQOL-BREF score increased(P<0.05)and bilateral ACA,MCA and PCA blood flow velocities fell(P<0.05)in the two groups.At the end of treatment and the follow-up three months after treatment,the VAS score,headache frequency,headache duration,headache index,the HAMA score and the HAMD score were lower(P<0.05),the WHOQOL-BREF score was higher(P<0.05)and bilateral ACA,MCA and PCA blood flow velocities were lower(P<0.05)in the observation group than those in the control group.The total efficacy rate was 90.3%in the observation group,which was higher than 77.4%in the control group(P<0.05).The recurrence rate was lower in the observation group than that in the control group(P<0.05).Conclusion On the basis of conventional acupuncture,shallow surround needling at scalp poin

关 键 词：针刺疗法 扬刺 穴位 头颈部 紧张型头痛 镇痛 焦虑 抑郁 

分 类 号：R246.1[医药卫生—针灸推拿学]