针刺加火针治疗颈源性头痛临床观察

Clinical observation on cervical headache treated with acupuncture and fire needling technique

目的:观察针刺加火针与单纯针刺治疗颈源性头痛的疗效差异。方法:将180例患者按就诊顺序随机分为针刺加火针组(A组)和针刺组(B组),每组90例。两组均取百会、完骨、风池、天柱、颈夹脊穴等,A组先在上述穴位行火针疗法,再取毫针针刺治疗;B组只在上述穴位用毫针进行针刺治疗,均每日1次,经20次治疗后进行疗效对比观察。结果:A组有效率为95.6%(86/90),B组有效率为84.4%(76/90),两组疗效差异有统计学意义(P<0.05)。A组治疗前后视觉模拟评分(VAS)分别为7.44±1.26、0.73±1.44,B组治疗前后VAS分别为7.56±1.07、2.56±2.99,两组治疗前后VAS评分差异均有统计学意义(P<0.01),治疗后两组间差异亦有统计学意义(P<0.01)。对A组痊愈患者分别在3个月、6个月后随访,无骨性病理改变的患者总复发率为14.8%(4/27),有骨性病理改变者总复发率为43.5%(10/23),两者差异有统计学意义(P<0.05)。结论:针刺配合火针治疗颈源性头痛可以提高疗效,特别是对于无骨性病理改变的患者治疗效果更持久。

Objective To observe the efficacy in cervical headache of acupuncture combined with fire needling and the simple acupuncture therapy. Methods One hundred and eighty cases were randomized into an acupuncture plus fire needling group （group A） and an acupuncture group （group B）, 90 cases in each one. Baihui （GV 20）, Wangu （GB 12）, Fengchi （GB 20）, Tianzhu （BL 10） and Neck-Jiaji （EX-B 2） were selected in the two groups. In group A, the fire needling technique was applied to all the above points before acupuncture with filiform needles. In group B, the acupuncture therapy was used only. The treatment was given once a day, the efficacy was compared between the two groups after 20 treatments. Results The total effective rate was 95.6% （86/90） in group A and was 84.4% （76/90） in group 13, indicating the significant difference in comparison （P〈0.05）. VAS were 7.44±1.26 and 0. 73±1. 44 before and after treatment in group A separately, those were 7.56±1.07 and 2.56±2.99 in group B, indicating the significant difference in comparison （P〈0.01）. The difference in VAS after treatment was significant between the two groups. In group A, the follow-up visit was conducted at 3 months and 6 months after treatment for the cured cases. The total recurrence rate in the patients without bony pathological changes was 14.8% （4/27） and that in the patients with bony pathological changes was 43.5% （10/23）, there was significant difference between them （P〈0.05）. Conclusion The combined therapy of fire needling technique and filiform needle acupuncture improves the efficacy and sustains the efficacy especially on cervical headache without bony pathological changing.