“项四穴”微调进针点为主温针灸治疗颈源性头痛临床随机对照研究

Clinical randomized controlled research of treating cervicogenic headache with warming acupuncture and moxibustion which gave priority to fine adjustment points of ‘four nape points'

目的:评价"项四穴"微调进针点(天柱Ⅰ、风池Ⅰ、完骨Ⅰ、天牗Ⅰ)温针灸治疗颈源性头痛的临床疗效。方法:将颈源性头痛患者63例随机分为对照组30例、治疗组33例。对照组取穴为"项四穴"(天柱、风池、完骨、天牗)、合谷、太冲、足临泣,其中天柱、风池、完骨穴采用温针灸治疗,余穴位采用针刺治疗;治疗组取穴为"项四穴"微调后进针点加合谷、太冲、足临泣,其中天柱Ⅰ、风池Ⅰ、完骨Ⅰ采用温针灸治疗,余穴采用针刺治疗;两组每周治疗3次,隔日治疗1次,共计4周;比较治疗前后两组头痛持续时间、头痛频率、头痛NRS评分、颈部ROM评分及治疗后的临床疗效。结果:治疗组头痛持续时间、头痛频率、头痛程度、颈部活动度改善均优于对照组(P<0.05);治疗组总有效率为93.94%,对照组为84.33%,疗效差异具有统计学意义(P<0.05)。结论:"项四穴"微调进针点为主温针灸治疗颈源性头痛可明显改善头痛程度、头痛持续时间、头痛频率及颈部的活动受限,疗效显著。

Objective： To evaluate the clinical efficacy of treating cervicogenic headache with warming acupuncture and moxibustion therapy which gave priority to fine adjustment points of ‘four nape points＇ （Tianzhu （BL 10） Ⅰ, Fengchi （GB 20） Ⅰ, Wangu （GB 12） Ⅰ and Tianyou （SJ 16） Ⅰ ）. Methods： Sixty-three patients with cervicogenic headache were randomly divided into control group （30 cases） and treatment group （33 cases）. The acupoint selections of patients in control group were ＇four nape points＇ [Tianzhu （BL 10）, Fengchi （GB 20）, Wangu （GB 12） and Tianyou （SJ 16）], Hegu （LI 4）, Taichong （LR 3） and Zulinqi （GB 41）, of which Tianzhu （BL 10）, Fengchi （GB 20） and Wangu （GB 12） were simulated with warming acupuncture and moxibustion therapy, and the other points were simulated with acupuncture therapy. The acupoint selections of patients in treatment group were fine adjustment points of ‘four nape points＇ ＇[Tianzhu （BL 10） Ⅰ, Fengchi （GB 20） Ⅰ, Wangu （GB 12） Ⅰ and Tianyou （SJ 16） Ⅰ ]＇, Hegu （LI 4）, Taichong （LR 3） and Zulinqi （GB 41）, of which Tianzhu （BL 10） Ⅰ, Fengcbi （GB 20） Ⅰ, Wangu （GB 12） Ⅰ were simulated with warming acupuncture and moxibustion therapy, and the other points were simulated with acupuncture therapy. All the patients were treated 3 times every two weeks, and the treatment lasted for 4 weeks. To compare the duration time of headache, headache frequency, numeric rating scales （NRS）of headache, range of motion （ROM） score of nape of pretherapy and post- therapy and the curative effect after treatment of patients in the two groups. Results： The improvement in duration time of headache, headache frequency, headache seriousness and ROM of nape of patients in treatment group was superior to the patients in control group （P〈0.05）. The total effective rate of treatment and control groups was 93.94% and 84.33%, respectively, and difference in curative effect between the two groups had statistically significance （P〈0.05）. Conclusion： Treating cervicogenic headache with warming acupuncture and moxibustion which gave priority to fine adjustment points of ‘four nape points＇ could improve duration time of headache, headache frequency, headache seriousness and ROM of nape of patients with cervicogenic headache obviously.