侧卧交叉按压微调法治疗颈源性头痛的临床研究

Study on the clinical effect of the massage method of micro-regulating with vertical cross pressing lying on one side in treating cervicogenic headache

目的 ：评价侧卧交叉按压微调法治疗颈源性头痛的临床疗效。方法 ：从2012年8月至2014年4月门诊患者中选取136例颈源性头痛患者,通过随机数字表法将其随机分为两组。69例采用侧卧交叉按压微调法治疗（按压微调组）,其中男29例,女40例,平均年龄（50.55±11.38）岁;67例采用传统推拿法治疗（传统推拿组）,其中男28例,女39例,平均年龄（51.20±11.90）岁。参照国家中医药管理局制定的疗效标准对两组患者进行整体疗效评估;采用颈部残障指数（NDI评分）对两组患者的颈椎功能状态以及由其所引起的全身状况进行评定;比较两组患者治疗前后VAS疼痛评分、头痛频率及持续时间。结果 ：治疗后所有患者无不良反应,全部获得随访,时间1~6个月,平均3.1个月。整体疗效评估结果,按压微调组痊愈25例,显效26例,有效14例,无效4例;传统推拿组痊愈12例,显效21例,有效22例,无效12例,按压微调组明显优于传统推拿组（P〈0.01）。NDI评分评定结果,按压微调组由治疗前的13.48±4.83改善至治疗后的6.23±3.76,传统推拿组由治疗前的13.82±5.78改善至治疗后8.25±4.75,按压微调组改善更为显著（P〈0.01）;VAS疼痛评分比较,按压微调组由治疗前的4.75±0.97降至治疗后的1.88±1.78,传统推拿组由治疗前的4.78±0.98降至治疗后的2.84±1.94,按压微调组改善更为显著（P〈0.01）;每周头痛次数,按压微调组由治疗前的（5.38±1.96）次降至治疗后的（1.71±2.04）次,传统推拿组由治疗前的（5.22±1.81）次降至治疗后的（2.81±2.42）次,按压微调组减少更为显著（P〈0.01）;头痛持续时间,按压微调组由治疗前的（6.87±3.67）h缩短至治疗后的（0.97±1.74）h,传统推拿组由治疗前的（6.90±3.79）h缩短至治疗后的（1.83±2.21）h,按压微调组头痛持续时间缩短更为显著（P〈0.05）。结论：侧卧交叉按压微调法治疗颈源性头痛可明显改善患者颈部及全身功能状态、减轻疼痛强度、减少头痛频率及头痛持续时间,且具有安全性高、操作轻巧、疗效显著的特点,推荐应用此法治疗颈源性头痛。

Objective：To evaluate the clinical effects of the massage method of micro regulating with vertical cross pressing lying on one side in treating cervicogenic headache（CEH）. Methods：Total 136 patients with CEH were collected in the study from August 2012 to April 2014. They were divided randomly into two groups according to random digits table. Sixty nine patients accepted the treatment of micro regulating with vertical cross pressing lying on one side（pressing micro regulating group）,including 29 males and 40 females with an average age of（50.55±11.38） years old; 67 patients received the treatment of traditional massage（traditional massage group）,including 28 males and 39 females with an average age of（51.20±11.90）years old. Clinical effect was observed according to the standard of curative effect of State Administration of Traditional Chinese Medicine;the function of cervical vertebra and all body status were evaluated according to NDI score. VAS score,frequency and time of headache were recorded and compared before and after treatment. Results：No adverse reactions were found after treatment,all patients were followed up from 1 to 6 months with an average of 3.1 months. In pressing micro regulating group,25 cases got fully recover,26 excellence,14 effectiveness and 4 inefficiency;and in traditional massage group,the results were12,21,22,12;clinical effect of pressing micro regulating group was better than that of traditional massage group（P〈0.01）.NDI score in pressing micro regulating group decreased from preoperative 13.48±4.83 to postoperative 6.23±3.76;in traditional massage group also decreased from preoperative 13.82±5.78 to postoperative 8.25±4.75;the improvement of the pressing micro regulating group was obviously better than that of traditional massage group（P〈0.01）. VAS score in pressing micro regulating group decreased from preoperative 4.75±0.97 to postoperative 1.88±1.78;and in traditional massage group decreased from preoperative 4.78±0.98 to postoperative 2.84±1.94;pressing micro regulating group was more notable than that of traditional massage group（P〈0.01）. The frequency per week,the pain time in pressing micro regulating group decreased from preoperative（5.38±1.96） times and（6.87±3.67） hours to postoperative（1.71±2.04） times and（0.97±1.74） hours,respectively,in traditional massage group the above parameters decreased from preoperative（5.22±1.81） times and（6.90±3.79） hours to postoperative（2.81±2.42） times and（1.83±2.21） hours;pressing micr regulating group was more notable than that of traditional massage group（P〈0.01 or P〈0.05）. Conclusion：Using the tuina method of micro regulating with vertical cross pressing lying on one side to treat CEH can improve function of cervical vertebra and all body status,lessen the intensity,frequency,duration time of pain,and had advantage of higher security,simple operation,and evident effect.