触发点针刺疗法对无先兆偏头痛患者心率变异性的影响

Effect of Trigger Point Acupuncture on Heart Rate Variability in Migraine Patients without Aura

目的:观察触发点针刺疗法对无先兆偏头痛患者心率变异性(HRV)的影响。方法:将60例无先兆偏头痛患者,随机分为治疗组和对照组各30例。治疗组患者在胸锁乳突肌、斜方肌、颈夹肌及枕下肌群触发点行2次针刺治疗,对照组患者在相同触发点部位行2次假针刺治疗,观察两组患者治疗后即刻和1个月时视觉模拟评分法(VAS)评分、头痛积分、焦虑评分量表(SAS)评分、抑郁自评量表(SDS)评分和HRV指标变化情况。结果:治疗组患者治疗后即刻VAS评分、头痛积分显著降低,HRV指标低频(LF)、高频(HF)、总功率(TP)显著升高,低频/高频(LF/HF)降低,差异有统计学意义(P<0.05),治疗后1个月头痛积分、SAS、SDS和LF/HF较治疗前下降(P<0.05),余指标变化不明显,差异无统计学意义(P>0.05)。结论:触发点针刺不仅可以有效缓解偏头痛症状,改善情绪障碍,而且能够调节自主神经功能紊乱,提高整体自主神经活性,且HRV相关指标和VAS、SAS、SDS具有相关性。HRV有助于对偏头痛患者进行综合评估。

Objective:To observe the effect of trigger point acupuncture on heart rate variability(HRV)of migraine patients without aura.Methods:Totally 60 patients of migraine without aura were randomly assigned to treatment and control groups,30 patients in each group.Patients were treated by acupuncture twice at the trigger points of sternocleidomastoid muscle,trapezius muscle,splenius cervicis and suboccipital muscle in treatment group,while sham acupuncture twice at the same trigger point in control group.The changes of visual analogue scale(VAS),headache score,self-rating anxiety scale(SAS),self-rating depression scale(SDS)and HRV indexes were recorded in the two groups immediately and one month after treatment.Results:The VAS and headache score decreased in treatment group,and HRV indexes,low frequency(LF),high frequency(HF)and total power(TP)increased in treatment group,while low frequency/high frequency(LF/HF)decreased in treatment group immediately after treatment,with statistically significant differences(P<0.05).The headache score,SAS,SDS and LF/HF decreased in treatment group one month after treatment(P<0.05),while the change of other indexes were not obvious,without statistically significant differences(P>0.05).Conclusion:Trigger point acupuncture can not only effectively relieve migraine symptoms and improve mood disorders,but also regulate autonomic nerve dysfunction and improve overall autonomic nerve activity.And HRV index is correlated with VAS,SAS and SDS.Therefore,HRV is helpful for the comprehensive evaluation of migraine patients.