针刺少阳经特定穴治疗偏头痛患者近期疗效及脑血流速度的临床观察

Clinical observation on short-term effect and TCD in acupuncture therapy of migraine with specific acupoints on Shaoyang meridian

目的:通过观察针刺少阳经特定穴治疗偏头痛患者的近期疗效及脑血流速度的变化情况,探讨经穴效应的特异性以及针刺治疗偏头痛的作用机制。方法:采用随机、对照、单盲的研究方法,将符合入选标准的偏头痛病例59例随机分为治疗组和对照组。治疗组30例针刺少阳经特定穴,对照组29例针刺非经非穴,每次治疗30min,5次/周,共治疗4周。于治疗前和治疗后分别记录两组患者偏头痛症状评分、总体疗效、经颅多普勒(TCD)血流速度等指标变化,以判定近期疗效。结果:①治疗组头痛发作次数、持续时间、伴随症状、发作程度治疗后明显优于治疗前(P<0.05),治疗后组间比较显示,除持续时间评分外,治疗组其它各项评分均优于对照组(P<0.05);②治疗组总有效率明显高于对照组(P<0.01);③治疗组主要脑动脉收缩期最大血流速度峰值(Vp)在治疗前后自身比较双侧大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)、椎动脉(VA)和基底动脉(BA)均有改善(P<0.01),两组间各主要动脉Vp比较,除双侧ACA和RMCA、LVA外,双侧PCA、RVA和BA均有显著性差异(P<0.05)。结论:①针刺少阳经特定穴与非经非穴均有疗效,尤其是针刺少阳经特定穴治疗偏头痛,其近期疗效优于非经非穴对照组。②针刺少阳经特定穴不仅可以改善偏头痛患者的临床症状,且能调节脑血管舒缩状态,改善脑血流,对于预防偏头痛的发作,改善其发作频率和程度都有较好的疗效。

Objective： To discuss the mechanism of specific acupoints on Shaoyang meridian by observing the changes of the cerebral blood flow velocity （CBFV） and the clinical effect on migraine with specific acupoints on Shaoyang meridian. Methods： By the research methods of random, contrast and single-blind, 59 cases of patients who conformed to the standard were randomly divided into two groups： the therapy group and the control group. The therapy group included 30 cases which were inserted the specific acupoints on Shaoyang meridian, and the control group included 29 cases which were inserted the non-meridian and non-acupoint. The needles need to stay 30 minutes every time, 5 times per week, four weeks of treatment in total. One month before and after treatment, the symptom scores and the overall effects and the changes of CBFV by TCD were evaluated, which could compare the short-term effects. After treatment, the short-term effect were evaluated with symptom scores, the overall effect, the cerebral blood flow of TCD. Results： （1）after one month of treatment, the times of attack, lasting time, accompanying symptoms and the intensity of attack in treatment group were obviously better than that of before treatment （P〈0.05）. Except for the symptom scores of lasting time, the scores of others in treatment group were obviously better than that of control group （P〈0.05）. （2）The total effective rates in treatment group were much higher than that of contrast group （P〈0.01）. （3）The treatment group had significant improvement after treatment on both sides peak systolic velocity of contraction period of cerebral arteries including the VP of MCA, ACA, PCA, VA, BA （P〈0.01）. Except for the both sides peak systolic velocity of ACA, RMCA and LVA, the two sides peak systolic velocity of PCA, RVA and BA had significant difference between the two groups after treatment （P〈0.05）. Conclusion： （i）Both acupuncture with and without the specific acupoint on the meridian of Shaoyang had curative effect, especially acupuncture with specific acupoint on Shaoyang meridian had a better short-time effect in curing migraine than those without acupoints or meridian. （4）Acupuncture with the specific acupoint on the meridian of Shaoyang was not just effective for improving the clinical symptoms of migraine, but also can adjust the vasomotion state of brain, improve the cerebral blood flow, prevent migraine attack and have a good effect on modifying frequency and intensity of the attack.