调神疏肝针刺法治疗紧张型头痛的临床对照研究

Clinical Controlled Trial on TTH Treated with Tiaoshen Shugan Acupuncture

目的:比较调神疏肝针刺法与传统针刺法和西药阿米替林治疗紧张型头痛的疗效差异。方法:本研究共纳入88例慢性和频发性紧张型头痛(TTH)患者,按随机数字表法随机分为调神疏肝针刺组(29例)、传统针刺组(29例)和西药组(30例),共治疗4周,治疗期间病例脱落5例,最终完成全部治疗及统计的为83例TTH患者,3组分别为28例、27例和28例。调神疏肝针刺组采用“调神疏肝,通络止痛”法;传统针刺组采用权威教材选穴方案;西药组采用阿米替林片。观察周期为4周。从头痛程度(视觉模拟评分法)、头痛发作次数、头痛持续时间和头痛指数4个方面进行头痛改善情况的观察,从焦虑自评量表(SAS)、抑郁自评量表(SDS)进行焦虑、抑郁症状的观察,通过头痛指数进行疗效评定。结果:3组患者治疗后头痛程度、头痛发作次数、头痛持续时间、头痛指数均较治疗前明显降低(P<0.05),且治疗后调神疏肝针刺组与传统针刺组和西药组比较差异有统计学意义(P<0.05);3组患者治疗后SAS、SDS评分均较治疗前明显减小(P<0.05),治疗后组间比较,调神疏肝针刺组和西药组均明显优于传统针刺组,差异有统计学意义(P<0.05),调神疏肝针刺组和西药组比较差异无统计学意义(P>0.05);调神疏肝针刺组总有效率96.4%(27/28),痊愈率60.7%(17/28),传统针刺组总有效率85.2%(23/27),痊愈率33.3%(9/27);西药组总有效率85.7%(24/28),痊愈率32.1%(9/28)。调神疏肝针刺组与传统针刺组和西药组总有效率及痊愈率比较差异均有统计学意义(P<0.05)。结论:调神疏肝针刺法治疗紧张型头痛可以取得较好疗效,在缓解头痛症状方面明显优于传统针刺法和西药阿米替林;在改善患者焦虑抑郁症状方面优于传统针刺法,并可以达到西药阿米替林的治疗效果。

Objective:To compare the clinical effect of Tiaoshen Shugan acupuncture with traditional acupuncture and Amitriptyline on tension-type headache(TTH).Methods:88 TTH cases were randomly divided into the study group(n=29),the control group(n=29)and the western medication group(n=30).The study group was treated with Tiaoshen Shugan acupuncture,the control group was treated with conventional acupuncture and the western medication group was treated with Amitriptyline.The treatment course was four weeks.Five cases were fallen off,therefore,there were 28 cases in the study group,27 cases in the control group and 28 cases in the western medication group in the end.Headache improvement were evaluated by visual analogue scale(VAS),the episodes of headache,the duration of headache and the index of headache.The depressive symptoms were evaluated by self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Results:The degree of headache,episodes of headache,duration of headache and index of headache level were significantly decreased in the three groups after the treatment compared to those before the treatment(P<0.05);of which the improvements in the study group were more significant than those in the control group and the western medication group(P<0.05).The scores of SAS and SDS were significantly decreased after the treatment in the three groups(P<0.05);of which the scores in the study group and the western medication group were lower than those in the control group(P<0.05);there were no statistical difference between the study group and the western medication group(P>0.05).The total effective rate and cured rate were 96.4%(27/28)and 60.7%(17/28)in the study group,which were significantly higher than 85.2%(23/27)and 33.3%(9/27)in the control group and 85.7%(24/28)and 32.1%(9/28)in the western medication group(P<0.05).Conclusion:Tiaoshen Shugan acupuncture has a better therapeutic effect on TTH.It can significantly alleviate the pain level of TTH,which has a better therapeutic effect than traditional acupuncture and Amitriptyline.The therapy can significantly improve the depressive symptoms,which has a better therapeutic effect than traditional acupuncture and achieves similar effect to Amitriptyline.