矩阵针法结合“五心穴”为主治疗痉挛性斜颈

Observation on the clinical efficacy of spasmodic torticollis treated with matrix needling technique and acupuncture at "Wuxin points" mainly

目的:比较矩阵针法结合"五心穴"针刺与A型肉毒毒素局部注射治疗痉挛性斜颈的疗效差异。方法:将42例患者随机分为针刺组、肉毒素组,每组21例。针刺组采用矩阵针法结合针刺治疗,取穴以风池、"五心穴"(水沟,双侧劳宫、涌泉)及局部阿是穴为主;肉毒素组采用A型肉毒毒素局部多点注射。两组均治疗1个月,比较两组每一周末的疗效及治疗后半年随访结果。结果:1周末肉毒素组愈显率、总有效率分别为42.8%(9/21)、90.5%(19/21),优于针刺组的4.8%(1/21)、28.6%(6/21)(均P<0.01);2周末肉毒素组愈显率、总有效率分别为71.4%(15/21)、95.2%(20/21),优于针刺组的19.1%(4/21)、61.9%(13/21)(均P<0.01);3周末肉毒素组愈显率、总有效率分别为66.7%(14/21)、95.2%(20/21),亦优于针刺组的38.1%(8/21)、71.4%(15/21)(均P<0.05);治疗1个月及治疗后半年随访两组愈显率与总有效率差异均无统计学意义(均P>0.05)。针刺组未见不良反应,肉毒素组出现局部不良反应14例,其中颈肌无力9例,颈部肌肉疼痛5例。结论:矩阵针法结合"五心穴"为主治疗痉挛性斜颈疗效显著,虽然在起效上不如肉毒素局部注射,但矩阵针法治疗1个月后及半年随访与肉毒素疗效相当,且无不良反应。

Objective To compare the difference in the efficacy on spasmodic torticollis between matrix needling technique combined with puncturing “Wuxin points” and the local injection of botox type A. Methods Forty-two cases were randomized into an acupuncture group and a botox group, 21 cases in each one. In the acupuncture group, the matrix needling technique was used and acupuncture was adopted at Fengchi （GB 20）, “Wuxin points” [Shuigou （GV 26）, bi- lateral Laogong （PC 8） and bilateral Yongquan （KI 1）] and local Ashi points. In the botox group, botox type A was in- jected at several spots of local region. The treatment course was 1 month in the two groups. The efficacy in each weekend and the results of follow-up visit in half a year after treatment were compared between the two groups. Results In the 1st weekend, the markedly effective rate was 42.8% （9/21） and the total effective rate was 90.5% （19/21） in the botox group, which were better than those of 4.8% （1/21） and 28.6% （6/21） respectively in the acupuncture group （both P〈0.01）. In the 2nd weekend, the markedly effective rate was 71.4% （15/21） and the total effective rate was 95.2% （20/21） in the botox group, which were better than those of 19.1% （4/21） and 61.9% （13/21） respectively in the acu- puncture group （both P〈0.01）. In the 3rd weekend, the markedly effective rate was 66.7% （14/21） and the total ef- fective rate was 95.2% （20/21） in the botox group, which were better than those of 38.1% （8/21） and 71.4% （15/21） respectively in the acupuncture group （both P〈0.05）. The markedly effective rate and the total effective rate were not different significantly between the two groups in the treatment of 1 month and the follow-up visit in half a year （all P〉 O. 05）. There was no adverse reaction in the acupuncture group. There were 14 cases of adverse reactions in the botox group, in which 9 cases of neck muscular weakness and 5 cases of neck muscular pain. Conclusion The treatment of ma- trix needling technique and combined with acupuncture at ＂Wuxin points＂ achieves the significant efficacy on spasmodic torticollis. Although the effect is not obtained as quickly as the local injection of botox, the efficacy of matrix needling technique is similar to that of botox in the treatment of 1 month and the follow-up visit in half a year. Moreover, this therapy has no adverse reaction.