针刺辅助神经阻滞治疗枕大神经痛临床研究

Effect of acupuncture assisted neuralgia in the treatment of patients with occipital neuralgia

目的:探讨针刺辅助神经阻滞对枕大神经痛患者临床疗效的影响。方法:78例确诊为枕大神经痛的患者随机分为对照组和治疗组各39例,对照组予普瑞巴林胶囊口服和行枕大神经阻滞治疗;治疗组:辅助针刺疗法余基本治疗同对照组。治疗后对比两组患者的疗效及不良反应,并对所有患者治疗前后疼痛分级以及睡眠质量进行比较。结果:经治疗后,对照组患者总有效率为72.9%,治疗组患者总有效率为100.0%,治疗组的总有效率较对照组明显高(P<0.05)。在疼痛状况评估方面,两组患者治疗前疼痛分级指数(PRI)、视觉模拟量表(VAS)、疼痛强度(PPI)评估具有可比性(P>0.05),经治疗后,治疗组的PRI、PPI、VAS改善较对照组更加明显(P<0.05)。经治疗后,两组患者的半年内复发率比较,治疗组(2.70%)明显低于对照组(21.62%,P<0.05)。经治疗后,治疗组和对照组患者睡眠质量和睡眠障碍较治疗前明显改善,且治疗组改善更明显,差异具有统计学意义(P<0.05)。结论:针刺辅助神经阻滞治疗枕大神经痛疗效较单一神经阻滞治疗疗效明显,并且能降低远期复发率,提高睡眠质量。

Objective:To investigate the effects of acupuncture assisted neuralgia in patients with occipital neuralgia.Methods:78 cases of patients diagnosed with occipital neuralgia were randomized divided into control group(39 cases)and treatment group(39 cases).Treatment group:auxiliary acupuncture therapy and basic treatment were the same as control group.The efficacy and adverse reactions and sleep quality of the two groups were compared after treatment.Results:After treatment,the total effective rate of the control group was 72.9%,the total effective rate of the treatment group was 100.0%,the total effective rate of the treatment group was significantly higher than the control group(P<0.05).In terms of pain assessment,PRI,VAS and PPI were comparable between the two groups(P>0.05).After treatment,PRI,PPI and VAS were more improved in the treatment group than in the control group(all P<0.05).After treatment,the comparison of recurrence rate within half a year between the two groups showed that the treatment group(2.70%)was significantly lower than the control group(21.62%)(P<0.05).After treatment,there are significantly improvements in sleep quality and sleep disorders between the treatment group and control group and the quality of sleep in the treatment group was more important(P<0.05).Conclusion:Acupuncture assisted nerve block for treatment of occipital great neuralgia is more effective than single nerve block,and can reduce the long-term recurrence rate and improve the quality of sleep,the reason why is to esplore more effective methods of treatment and therapeutic mechansims.