神经阻滞与小针刀治疗颈源性头痛的临床观察

Treatment of cervicogenic headache with nerve block and acupotomy

目的观察神经阻滞与小针刀治疗颈源性头痛的临床疗效和安全性。方法选用符合颈源性头痛诊断标准的100例患者，分为2组，治疗组行枕神经、C2横突、颈椎关节阻滞，注射镇痛液1～5ml。镇痛液含0．75％布比卡因2ml、曲安奈德5mg、维生素B12 0．5mg、加生理盐水稀释到10ml为1单位，每周1次，4次为1疗程，疼痛仍存在者行小针刀治疗；对照组为口服镇痛药尼美舒利2个月。结果治疗后半年随访，治疗组有效率为86．7％（39／45例），对照组为47．3％（26／55例），治疗组与对照组相比差异有统计学意义。结论神经阻滞与小针刀治疗颈源性头痛是一种有效方法。

Objective To observe the clinical efficacy and safety of nerve block and acupotomy for treatment of cervicogenic headache. Methods One hundred patients suffered from cervicogenic headache were divided into treatment group and control group. In former group analgesic mixture 1-5 ml （ 0.755 bupivacaine 2 ml, triamcinolone 5mg, vitamine B12 0.5 mg added normal saline to 10 ml） was injected into occipital nerve, C2 transverse process and cervical joint with acupotomy at the same time, one time per week and four times per course. In later group the patients took nimesulide for 2 months. Results At sixth months after treatment clinical efficacy was evaluated. The effective rate （86.7%, 39/45 cases） in treatment group was much better than that （47.3%, 26/55 cases） in control group （P〈0.05）. Conclusion Treatment of cervicogenic headache with nerve block and acupotomy is an effective method.