银质针疗法联合颈2背根神经节脉冲射频治疗颈源性头痛的疗效

Efficacy of combining silver needle and pulsed radiofrequency at C2 dorsal root ganglion for the treatment of patients with cervicogenic headache

目的评价银质针疗法联合颈2(G)背根神经节脉冲射频治疗颈源性头痛的疗效。方法收集2013年10月至2015年8月于郑州大学第二附属医院就诊的颈源性头痛患者86例,年龄14~71岁,性別不限.采用随机数字表法将其随机分为射频治疗组与联合治疗组,各组43例.射频治疗组采用C:背根神经节脉冲射频进行治疗.联合治疗组采用C:背根神经节脉冲射频加颈部软组织银质针松解治疗。分别记录两组患者治疗前、治疗后1 d及治疗后3、12个月时VAS评分及压痛阈值(PPT)o结果两组患者治疗前VAS、I>PT评分比较差异无统计学意义(P>0.05);与治疗前比较,两组患者治疗后Id及治疗后3、12个月时VAS评分均降低(P<0.05);与射频治疗组比较,联合治疗组患者治疗后3、12个月时VAS评分较低(P<0.05)与治疗前比较,联合治疗组患者治疗后3、12个月时PPT评分均升高(P<0.05);与射频治疗组比较,联合治疗组治疗后3、12个月时患者PPT评分及有效率均较高(P<0.05)。结论银质针联合G背根神经节脉冲射频治疗颈源性头痛疗效确切,远期效果优于单纯C:背根神经节脉冲射频治疗。

Objective To evaluate the therapeutic effect by the combination of silver needle and pulsed radiofrequency applied to C2 dorsal root ganglion in the treatment of patients with cervicogenic headache. Methods Eighty-six patients with cervicogenic headache of both sexes, aged 14-71, from October 2013 to August 2015 in the Second Affiliated Hospital of Zhengzhou University, were randomly divided into radiofrequency group (43 cases) and combined group (43 cases). Patients were treated with pulsed radiofrequency at C2 dorsal root ganglion in the radiofrequency group. Silver needle treatment was used after the pulsed radiofrequency at C2 dorsal root ganglion in the combined group. VAS and pressure pain threshold (PPT) were evaluated at 1 day, 3 months and 12 months after the treatment. Results No differences were found in VAS and PPT before the treatment between the two groups (P>0.05). Compared with pre-treatment, VAS decreased significantly at 1 day, 3 months, 12 months after the treatment in the two groups (P<0.05). VAS was even lower significantly at 3, 12 months after the treatment in the combined group than that in the radiofrequency group (P<0.05). Compared with pre-treatmrnl. PPT increased significantly at 3. 12 months after the treatment in the two groups (P<0.05). PPT and the effective rate were even higher significantly at 3. 12 months after the treatment in the combined group than those in the radiofrequency group (P<0.05). Conclusion Silver needle and pulsed radiofrequency at C2 dorsal root ganglion is rffeclive in the treatment of patients with eervicogenic headache, and its long-term effect is better than C2 dorsal root ganglion pulse radiofrequency therapy alone.