星状神经节阻滞联合改良颈部椎旁神经阻滞治疗颈源性头痛

Treatment of cervicogenic headache by stellate ganglion block combined with modified cervical paravertebral nerve block

目的探讨星状神经节阻滞联合改良颈部椎旁神经阻滞治疗颈源性头痛的临床疗效。方法136例颈源性头痛患者随机分为星状神经节阻滞联合改良颈部椎旁神经阻滞(A组)和星状神经节阻滞联合外周神经阻滞(B组),每组68例。两组均以每2天治疗一次,4次为一疗程。治疗前后采用简化McGill疼痛问卷表评估疼痛程度,并结合颈椎活动度(ROM)评分来评定临床疗效。结果与治疗前比较,两组治疗后疼痛评估指数(PRI)、疼痛强度指数(PPI)、VAS、ROM评分均降低(P<0.05)。治疗后,A组PRI、PPI、VAS、ROM评分均较B组为低,治愈率较B组为高(P<0.05)结论星状神经节阻滞联合改良颈部椎旁神经阻滞治疗颈源性头痛的临床疗效优于联合外周神经阻滞。

Objective To compare the clinical efficacy of stellate ganglion block （SGB） combined with modified cervical paravertebral nerve block（CPNB） and SGB combined with peripheral nerve block（PNB） in the treatment of cervicogenic headache. Methods A total of 136 patients with cervicogenic headache was randomly divided into two groups with 68 cases each. The patients in group A received SGB combined with CPNB and those in group B received SGB combined with PNB. All patients were treated every other day for four times as a course of treatment. The short-form McGill Pain Questionnaire and reduced range of the motion in the neck （ROM） score were evaluated before and after treatment. Results Compared to before, the pain rating index （PRI）, the present pain index （PPI）, visual analogue scale（VAS）, ROM scores were lower after treatment （P〈 0.05） in two groups. PRI, PPI,VAS, ROM scores were lower and the cure rate was higher in group A than those in group B after treatment （ P 〈 0.05 ）. Conclusion SGB combined with CPNB is better than SGB combined with PNB in the treatment of cervicogenic headache.