头穴丛刺长留针法治疗持续性姿势-知觉性头晕临床研究

Clinical Study of Cluster Needling at Scalp Acupoints with Long-time Needle-retaining for Persistent Postural-perceptual Dizziness

目的观察头穴丛刺长留针法治疗持续性姿势-知觉性头晕(persistent postural-perceptual dizziness,PPPD)的临床疗效。方法选取持续性姿势-知觉性头晕患者120例,随机分为药物组、针刺组、针药组,每组40例,3组在应用前庭康复训练基础上,药物组接受氢溴酸西酞普兰治疗,针刺组应用头穴丛刺治疗,针药组采用头穴丛刺联合口服西酞普兰治疗。比较3组在入组时及治疗8 W后的眩晕残障程度评定量表(dizziness handicap inventory,DHI)评分,不良反应采用副反应量表评定。结果治疗8 W后,3组DHI评分较入组时均有改善,差异均有统计学意义(P<0.01);与药物组、针刺组比较,针药组DHI评分改善更明显,差异均有统计学意义(P<0.05);与药物组、针药组比较,针刺组副反应量表评分较低,差异均有统计学意义(P<0.05)。结论在应用前庭康复训练基础上,头穴丛刺长留针法治疗持续性姿势-知觉性头晕效果显著,与氢溴酸西酞普兰相当,避免了该药的不良反应;头穴丛刺与氢溴酸西酞普兰联合应用有协同作用,可提高临床疗效。

Objective To observe the clinical efficacy of cluster needling at scalp acupoints with long-time needle-retaining in treating persistent postural-perceptual dizziness(PPPD)and discuss the plausible mechanism.Method A total of 120 PPPD patients were recruited and randomized into a medication group,an acupuncture group and an acupuncture-medication group,with 30 cases in each group.The three groups all received vestibular rehabilitation training.In addition,the medication group received Citalopram hydrobromide,the acupuncture group was given cluster needling at scalp acupoints,and the acupuncture-medication group received cluster needling at scalp acupoints plus oral Citalopram hydrobromide.At recruitment and after 8-week treatment,the Dizziness Handicap Inventory(DHI)score was compared among the three groups,and the adverse reaction was evaluated using the Side-effect Rating Scale(SERS).Result The DHI score was improved after 8-week treatment in the three groups,and the differences were statistically significant(P<0.01);compared with the medication group and acupuncture group,the acupuncture-medication group showed more significant improvement in the DHI score,and the differences were statistically significant(P<0.05);compared with the medication group and acupuncture-medication group,the SERS score was lower in the acupuncture group,and the differences were statistically significant(P<0.05).Conclusion In addition to vestibular rehabilitation training,cluster needling at scalp acupoints with long-time needle-retaining can produce significant efficacy in treating PPPD,similar to Citalopram hydrobromide but without its adverse reactions;combination of cluster needling at scalp acupoints and Citalopram hydrobromide can produce a synergistic effect,thus enhancing the clinical efficacy.