银质针导热疗法治疗颈源性头痛的临床疗效及其机制探讨  

Clinical Efficacy and Mechanism of Silver Needle Heat Conduction Therapy in the Treatment of Cervicogenic Headache

作　　者：王明[1] 张杰[1] 杨时雨 WANG Ming;ZHANG Jie;YANG Shi-Yu(Geriatric Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430081,China)

机构地区：[1]武汉科技大学附属老年病医院,武汉430081

出　　处：《微循环学杂志》2024年第4期24-31,共8页Chinese Journal of Microcirculation

基　　金：武汉商学院博士科研基金项目(武商院科-2024-1号+2024KB021)。

摘　　要：目的:探究银质针导热疗法对颈源性头痛的临床疗效与作用机制。方法:90例颈源性头痛患者随机分为银质针非导热组(30例)、布洛芬片组(30例)和银质针导热组(30例)。银质针非导热组接受银质针非导热治疗,布洛芬片组口服布洛芬片治疗,银质针导热组采用银质针导热治疗,疗程均为1周。对比治疗前后患者的疼痛视觉模拟评分量表(VAS)评分、颈椎活动度评分(ROM)、血清促肾上腺皮质激素(ACTH)、β-内啡肽、皮质醇、一氧化氮(NO)、内皮素-1(ET-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1(IL-1)、血清前列腺素F2α(PGF2α)及血管加压素(AVP)水平,并运用血液流变学测量仪检测患者血浆黏度、红细胞压积以及纤维蛋白原水平。结果:治疗后,银质针导热组有效率(88.57%)显著高于银质针非导热组(40.00%)和布洛芬片组(66.57%)(P<0.05),银质针非导热组与布洛芬片组有效率差异无统计学意义(P>0.05)。相较于银质针非导热组和布洛芬片组,银质针导热组治疗后的VAS、ROM评分降低(P<0.05);ACTH、皮质醇水平降低(P<0.05),β-内啡肽水平升高(P<0.05);TNF-α、IL-6、IL-1水平均降低(P<0.05);血清PGF2α及AVP水平均下降(P<0.05);NO水平升高(P<0.05),ET-1水平降低(P<0.05);血浆黏度、红细胞压积、纤维蛋白原水平均下降(P<0.05)。治疗后银质针非导热组与布洛芬片组各指标差异无统计学意义(P>0.05)。结论:银质针导热疗法可改善颈源性头痛症状,其机制可能与其下调ACTH、炎性因子、提高疼痛阈值、缓解血管紧张、改善血流灌注有关。Objective:To explore the clinical efficacy and mechanism of silver needle heat conduction therapy in the treatment of cervicogenic headache.Method:90 admitted patients with cervicogenic headache were divided into the silver-needle non-heat-conduction group(30 cases),the ibuprofen-tablet group(30 cases),and the silver-needle heat-conduction group(30 cases).The silver-needle non-heat-conduction group received non-heat-conduction silver-needle therapy,the ibuprofen-tablet group was treated with oral administration of ibuprofen tablets,and the silver-needle heat-conduction group underwent silver-needle heat-conduction therapy for one consecutive week.The scores of the visual analogue scale(VAS)for pain,the cervical range of motion(ROM)score,the levels of serum adrenocorticotropic hormone(ACTH),β-endorphin,cortisol,nitric oxide(NO),endothelin-1(ET-1),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1(IL-1),serum prostaglandin F2α(PGF2α),and vasopressin(AVP)before and after treatment were compared.The levels of plasma viscosity,hematocrit,and fibrinogen were measured by a hemorheology analyzer.Results:After treatment,the effective rate of the silver-needle heat-conduction group(88.57%)was significantly higher than that of the silver-needle non--heat-conduction group(40.00%)and the ibuprofen-tablet group(66.57%).Moreover,there was no statistical significance in the effective rate between the silver-needle non-heat-conduction group and the ibuprofen-tablet group.Compared with the silver-needle non-heat-conduction group and the ibuprofen-tablet group,in the silver-needle heat-conduction group after treatment,the VAS and ROM scores were decreased(P<0.05);the levels of ACTH and cortisol were decreased(P<0.05),while the level ofβ-endorphin was increased(P<0.05);the levels of TNF-α,IL-6,and IL-1 were all decreased(P<0.05);the levels of serum PGF2αand AVP were decreased(P<0.05);the level of NO was increased(P<0.05)and the level of ET-1 was decreased(P<0.05);the levels of plasma viscosity,hematocrit,and fi

关 键 词：颈源性头痛 银质针导热疗法 机制 临床观察 

分 类 号：R245.3[医药卫生—针灸推拿学]