颈源性头痛的病因及祛因治疗

Causes and Elimination Treatment of Cervicogenic Headache

目的探讨颈源性头痛(cervicogenic headache,CEH)的病因及采用双侧两点两次旋转复位手法治疗CHE的临床疗效。方法将63例颈椎X线检查阳性(寰枢关节移位)的CEH患者按随机数字表法分为2组:双侧两点两次旋转复位手法治疗组(观察组)32例和常规推拿治疗组(对照组)31例。观察组采用双侧两点两次旋转复位手法治疗,对照组采用常规推拿治疗。观察2组患者治疗前后头痛程度及治疗后颈椎X线检查(阴性、阳性)、临床疗效和治疗后3个月有无复发等情况。结果观察组、对照组患者治疗后VAS评分值分别为(1.4±1.3)、(4.3±1.2)分,2组比较差异有统计学意义(P<0.05);观察组、对照组患者治疗后阴性率分别为62.5%、29.0%,2组比较差异有统计学意义(P<0.05);观察组、对照组总有效率分别为100.0%、77.4%,2组比较差异有统计学意义(P<0.05);观察组、对照组患者治疗后3个月复发率分别为6.3%、54.8%,2组比较差异有统计学意义(P<0.01)。结论双侧两点两次旋转复位手法治疗CEH有较好的疗效,是一种治疗CEH较好的方法。

Objective To explore the causes of cervicogenic headache（CEH） and the clinical curative effect of manipulation therapy（two-point bilateral rotation reduction for two times）.Methods Sixty-three cervical spine X-ray positive CEH patients（displacement of atlantoaxial joint） were randomly assigned to receive either two-point bilateral rotation reduction for two times（observation group,n=32） or routine massage（control group,n=31）.The degree of headache before and after treatment,cervical spine X-ray images after treatment（negative or positive）,clinical efficacy of manipulation therapy,and recurrences after 3 months of treatment were observed in both groups.Results Visual analog scale（VAS） score after treatment was（1.4±1.3） and（4.3±1.2） in observation group and control group,respectively,and there were significant differences between the two groups（P0.05）.Compared with control group,the negative rate and total effective rate significantly increased in observation group（29.0% vs 62.5% and 77.4% vs 100.0%,respectively;all P0.05）,and the relapse rate obviously decreased in observation group（54.8% vs 6.3%,P0.01）.Conclusion The two-point bilateral rotation reduction for two times is an effective treatment for CEH.