针刺治疗卒中后中枢性疼痛的随机对照研究

Acupuncture in the treatment of central post-stroke pain: a randomized placebo-controlled trial

目的探讨针刺对卒中后中枢性疼痛的临床疗效。方法将符合纳入标准的70例卒中后中枢性疼痛病人,采用数字表法随机分为针刺组(n=35)和药物组(n=35)。针刺组给予百会为主穴的调神针刺法治疗,每周5次,共治疗4周,药物组给予口服阿米替林每次25 mg,3次/d,连续治疗28 d,治疗前后进行视觉模拟评表(Visual Analogue Scale,VAS)、简明Mc Gill疼痛量表(Short-form of Mc Gill Pain Questionnaire,SF-MPQ)评定。结果针刺组总有效率为72.9%(23/32),优于药物组的51.5%(17/33,P<0.05);2组治疗后VAS、简化SF-MPQ评分较治疗前均有降低(均P<0.05),且针刺组在感觉、情感和疼痛程度方面优于药物组(P<0.05)。结论针刺对卒中后中枢性疼痛病人的疼痛症状具有缓解作用。

Objective To observe the effects of the acupuncture on the central post-stroke pain （CPSP）. Methods Seventy cases of CPSP were randomly divided into an acupuncture group （35 cases） and a medication group （35 cases）. The basic treatment of cerebrovascular disease was applied in two groups. The acupuncture group was treated with acupuncture at Baihui （GV20） etc, five times every week, and totally 4 weeks were required, while the medication group was given Amitriptyline （25 mg each time,thrice a day）, continuously for 28 days. The scores of Visual Analogue Scale/Score （VAS）, short-form of McGill pain questionnaire （SF-MPQ） were evaluated in both groups. Results The total effective rate was 72.9%（23/32）in acupuncture group, which was better than 51.5%（17/33,P〈0.05） in the medication group. The scores of VAS and SF-MPQ after treatment were decreased as compared with those before treatment in both groups （all P〈0.05）. In terms of sensory, emotion and pain,the acupuncture group was superior to the medication group （P〈0.05）. Conclusion Acupuncture could relieve pain in treating central post-stroke pain.