电针少阳经穴对急性偏头痛即时镇痛作用时效规律研究

Timeliness law on the immediate analgesia on acute migraine treated with electroacupuncture at shaoyang meridian points

目的:观察少阳经循经取穴与非经非穴电针治疗急性偏头痛即时镇痛效应及时效性差异。方法:采用随机对照试验方法,将110例急性偏头痛患者随机分为两组,每组55例。观察组取少阳经经穴风池、外关等电针治疗,对照组采用非经非穴电针治疗,两组均治疗1次,留针30min。在电针前、电针后5min、10min、20min、30min(起针后即刻)、1h、2h、4h、6h、8h的镇痛效果。采用11点疼痛强度数字等级量表(NRS)对患者的疼痛程度进行评分,并记录不良反应。结果:1观察组即时镇痛有效率为87.3%(48/55),显著高于对照组的52.7%(29/55,P<0.01);2观察组及对照组患者电针后5min开始至电针后8h各时间点NRS均降低(均P<0.01);3电针后不同时间点NRS评分比较,30min时对照组明显低于观察组(P<0.05),但是2h、4h、6h及8h时观察组明显低于对照组(均P<0.01),5min、10min、20min及1h时间点两组间差异无统计学意义(均P>0.05);4电针后同时间点NRS减值幅度,电针后20 min、30min及1h时对照组明显高于观察组(均P<0.05),但是电针后2h、4h、6h及8h时观察组明显高于对照组(均P<0.05),5 min及10min时差异无统计学意义(均P>0.05);5电针后24h观察组偏头痛复发率为12.7%(7/55),明显低于对照组的34.5%(19/55,P<0.05);6两组均未出现不良反应。结论:电针少阳经穴对急性期偏头痛具有肯定的即时镇痛效应,与电针非经非穴比较镇痛作用更强且持久。

Objective To observe the differences in timely effectiveness of immediate analgesia on acute mi graine between electroaeupuncture （EA） at shaoyang meridian points and non-meridian points. Methods The randomized controlled trial method was adopted. One hundred and len cases of acute migraine were randomized into two groups, 55 cases in each one. In the observation group, EA was applied to Fengchi （GB 20）, Waiguan （TE 5）, etc. In the control group, EA was applied to non-meridian points. Only one treatment was given, and the needles were retained for 30 min in the two groups. Separately, at 10 time points, named before acupuncture, in 5 rain, 10 rain. 20 min and 30 min （at the moment of needle removal）, 1 h, 2 h, 4 h. 6 h and 8 h after acupuncture, the pain intensity numerical rating scale （PI-NRS） was adopted to evaluate the pain severity and the adverse reaction was recorded. Results （1） The effective rate of immediate analgesia was 87.3% （48/55） in the observation group, significantly higher than 52.7% （29/55） in the control group （P〈0.01）. （2） NRS of each group was reduced at each time point, from 5 min to 8 h after acupuncture （all P〈0.01）. （3） NRS score at 30 min after acupuncture in the control group was obviously lower than that in the observation group （P〈0.05）. but the scores in 2 h, 4 h, 6 h and 8 h after acupuncture in the observation group were lower apparently than those in the control group （all P〈0.01）. The differences in the scores in 5 min, 10 rain, 20 min and 1 h after acupuncture were not signifi cant （all P〈0.05）. （4） For the reducing amplitude of NRS score at the same time point after acupuncture, the results in 20 min, 30 min and 1 h in the control group were higher apparently than those in the observation group （all P〈0.05）.But, in 2 h, 4 h, 6 h and 8 h, the results in the observation group were higher apparently than those in the control group （all P〈0.05）. The differences in 5 rain and 10 min after acupuncture were not significant （both P〈0.05）. （5） In 24 h after acupuncture, the recurrence rate of migraine was 12.7% （7/55） in the observation group, which was lower obviously than 34.5% （19/55） in the control group （P〈0.05）. （6） The adverse reaction was not found in the two groups. Conclusion EA at the shaoyang meridian points achieves the definite immediate analgesia effect on acute migraine and presents the time effectiveness of analgesia.