四关穴配合胆经穴针刺治疗偏头痛:随机对照研究

Acupuncture at“Siguan”combined with Gallbladder Meridian acupoints for migraine:a randomized controlled trial

目的:观察和评价针刺四关穴配合胆经穴治疗偏头痛的临床疗效。方法:采用随机对照试验设计,将87例患者随机分为观察组(42例)和对照组(45例)。观察组采用四关穴(合谷、太冲)配胆经穴(风池、率谷、丘墟、足临泣)针刺治疗;对照组采用单纯胆经穴(风池、率谷、丘墟、足临泣、阳陵泉、颔厌)针刺治疗,两组均隔日治疗1次,每周3次,共6周。观察患者治疗前后头痛强度、头痛发作频率和每次头痛持续时间,并于治疗后3个月随访,评定两组临床疗效。结果:两组治疗后疼痛评分、发作频率和持续时间均较治疗前明显降低(均P<0.01),且观察组比对照组降低更明显(均P<0.05);治疗结束时观察组总有效率为95.2%(40/42),对照组为80.0%(36/45),差异有统计学意义(P<0.05),3个月后随访,两组总有效率分别为88.1%(37/42)、75.6%(34/45),差异无统计学意义(P>0.05)。结论:四关穴配胆经穴治疗偏头痛可显著降低头痛强度、头痛发作频率及头痛持续时间,症状改善及近期疗效均优于单纯针刺胆经穴治疗。

Objective To observe and evaluate the clinical effect of acupuncture at ＂Siguan＂ combined with the Gallbladder Meridian aeupoints on migraine. Methods With randomized controlled trial design, 87 patients were randomly divided into an observation group （42 cases） and a control group （45 cases）. The observation group was treated with acupuncture at ＂Siguan＂ including Hegu （LI4） and Taichong （LR3）, combined with the Gallbladder Meridian acupoints including Fengchi （GB 20）, Shuaigu （GB 8）, Qiuxu （GB 40） and Zulinqi （GB 41）, while the control group was treated with acupuncture at the Gallbladder Meridian acupoints, including Fengchi （GB 20）, Shuaigu （GB 8）, Qiuxu （GB 40）, Zulinqi （GB 41）, Yanglingquan （GB 34） and Hanyan （GB 4）. The treatment was given every other day in two groups, 3 times per week for totally 6 weeks. The migraine intensity, migraine frequency and lasting time of each migraine were observed before and after treatment, and 3-month follow-up was performed after treatment. The clinical ef- ficacy in two groups was evaluated. Results Compared with those before treatment, the migraine intensity, frequency and lasting time were all reduced significantly after treatment in the two groups （all P〈0.01）, which were more obvious in the observation group （all P〈0. 05）. At the end of the treatment, the total effective rate was 95.2%（40/42） in the observation group and 80.0% （36/45） in the control group, which had statistical difference （P〈0. 05）. After 3-month follow-up, the total effective rate was 88.1% （37/42） in the observation group and 75.6 % （34/45） in the control group, which had no statistical difference （P〉0.05）. Conclusion The ＂Siguan＂ combined with the Gallbladder Meridian aeu- points could significantly relieve the migraine intensity, frequency and lasting time, and its improvement of symptoms and short-term efficacy are superior to those of the Gallbladder Meridian acupoints alone.