颈源性头痛行颈2椎旁阻滞结合针刺治疗的疗效分析

Effect of Cervical Paravertebral Block Combined with Acupuncture Intervention on Cervicogenic Headache

目的:探讨颈2椎旁阻滞+针刺治疗颈源性头痛的临床疗效。方法:60例颈源性头痛患者随机分为两组,对照组采用颈2椎旁阻滞法,1次/周,共治疗3次;针刺组除采用颈2椎旁阻滞外,配合针刺百会、风池、角孙等穴进行治疗,1次/d,1周为1个疗程,共行3个疗程。记录两组患者治疗前及治疗开始后每周的视觉模拟评分(VAS)和颈椎活动度(ROM)评分。结果:两组患者治疗后各时间点VAS和ROM评分较治疗前均有所下降,而针刺组治疗后各时间点VAS和ROM评分较对照组低,差异具有统计学意义(均P<0.05),针刺组的临床疗效优于对照组。结论:采用颈2椎旁阻滞结合针刺治疗颈源性头痛可取得较满意的临床疗效。

Objective To observe the therapeutic effect of cervical paravertebral block plus acupuncture treatment for cervicogenic headache. Methods Sixty cases of cervicogenic headache were randomly and equally divided into cervical para vertebral block （control） group and acupuncture plus cervical paravertebral block （acupuncture） group. Paravertebral block was performed by injection of 5 mL of 0.3% lidocaine solution containing triamcinolone （10 mg） into the 2d cervical paravertebral tis sue from the cross point between the posterior border of the sternomastoid muscle and the angle of jaw, once every week for three weeks. Manual acupuncture stimulation was applied to Baihui （GV 20）, unilateral Fengchi （GB 20） and Jiaosun （SJ 20）, once daily for 3 weeks. The patients＇ headache severity was assessed by visual analogue scale （VAS） and their cervical vertebral ac tivity assessed by range of motion （ROM） before and after the treatment. Results Compared with pre-treatment in the same one group, the scores of both VAS and ROM at time points of one, two and three weeks after the treatment were significantly de creased in the control and acupuncture groups （P〈0.05）, suggesting a marked improvement of both headache and cervical mo tion after the treatment. Comparison between the two groups showed that the VAS and ROM scores of the acupuncture group were evidently lower than those of the control group at each time point after the treatment （P〈0.05）, displaying a better therapeutic effect of acupuncture plus paravertebral block for cervicogenic headache. Conclusion Acupuncture combined with cervical pa ravertebral block is effective in relieving cervicogenic headache and improving cervical vertebral activity in cervicogenic headache patients, and can strengthen the therapeutic effect of simple paravertebral block.