针刀不同靶点选择治疗颈源性头痛的临床效果

Clinical efficacy of different needle-knife target selection in the treatment of cervicogenic headache

目的观察针刀不同靶点选择治疗颈源性头痛的临床效果。方法选取2015年4月～2016年12月江苏省泰兴市第二人民医院针灸科、南京市中医院针灸科及南京市中医院岱山诊疗中心针灸科门诊颈源性头痛患者60例作为研究对象,按照随机数字表法将其分为针刀1组(以颈肌起止点为进针点)、针刀2组(以颈部2、3、4棘突旁开2 cm处为进针点),各30例。比较两组患者的治疗效果、视觉模拟评分(VAS)及颈痛评分。结果与治疗前比较,两组治疗2周以及3个月后VAS评分及颈痛评分均明显下降(P<0.05);针刀1组治疗3个月后VAS评分及颈痛评分均较治疗2周时明显下降(P<0.05);且针刀1组治疗3个月后患者颈痛评分显著低于针刀2组(P<0.05)。治疗2周后,针刀1组总有效率为93.3%,针刀2组为90.0%;治疗3个月后,针刀1组总有效率为83.3%,针刀2组为80.0%。两组总有效率比较差异均无统计学意义(P>0.05)。结论针刀治疗需要一定的疗程,2周时疗效更好,针刀是治疗颈源性头痛的可靠疗法,其有效性和安全性得到临床证实,值得临床推广应用。

Objective To observe the clinical effect of different needle-knife target selection in the treatment of cervicogenic headache. Methods Sixty patients with cervicogenic headache from April 2015 to December 2016 in Oupatient Department of Acupuncture and Moxibustion of the Second People′s Hospital of Taixing City, Nanjing Hospital of Chinese Medicine and Daishan Clinical Center of Nanjing Hospital of Chinese Medicine were selected as research objects. The patients were divided into needle-knife group 1（taking the starting point and dead point of the cervical muscle as the entry points） and needle-knife group 2（taking the points 2 cm away from 2, 3, 4 cervical spinous as the entry points） according to random number table method, with 30 cases in each group. The treatment effect, visual analogue scale（VAS）, neck pain score of two groups were compared. Results After treatment for 2 weeks and 3 months,the VAS scores and neck pain scores of two groups decreased significantly compared with those before treatment（P〈0.05）, and the VAS score and neck pain score of needle-knife group 1 after treatment for 3 months decreased significantly compared with those after treatment for 2 weeks（P〈0.05）. And the score of neck pain of needle-knife group 1 after treatment for 3 months was significantly lower than that of needle-knife group 2（P〈0.05）. After treatment for 2 weeks,the total effective rate of needle-knife group 1 was 93.3%, which of needle-knife group 2 was 90.0%. After treatment for 3 months, the total effective rate of needle-knife group 1 was 83.3%, which of needle-knife group 2 was 80.0%.There were no sinificant differences on the total effective rates between the two groups（P〈0.05）. Conclusion Needle-knife treatment requires a certain course of treatment, and the effect is better on 2 weeks.Needle-knife is a reliable therapy for the treatment of cervicogenic headache. Its effectiveness and safety have been clinically confirmed and it is worthy of clinical promotion and application.