针刺防治无先兆偏头痛临床优选方案研究

Clinical study on the optimal scheme of acupuncture for preventing and treating migraine without aura

目的:筛选无先兆偏头痛针刺防治的优选方案。方法:80例纳入研究的无先兆偏头痛患者,按析因设计方案随机分为8组,分别采用穴位组合(A)、针刺频率(B)、刺激形式(C)3个因素及相应的2个水平进行12次治疗,并在治疗结束后进行随访。观察治疗前后头痛天数、程度、头痛影响测试问卷、偏头痛残疾程度评估问卷分值的改变,并进行安全性评价。结果:对于减少头痛天数、缓解头痛程度、改善失能状态而言,主穴+辨证辨经配穴、有电针的治疗组合对无先兆偏头痛患者能起到最佳的改善效果。针刺频率的两个水平在本次试验中的各项指标上均未提示有单独效应或是交互效应。结论:针刺预防性治疗无先兆偏头痛的初步优选方案为:主穴和辨证辨经配穴,配合电针,可获得相对最佳的疗效。

Objective: To screen the optimal regimen for acupuncture prevention and treatment of migraine without aura.Methods: Eighty migraine patients without aura were randomly divided into 8 groups according to the factorial design. They were treated with acupoint combination(A), acupuncture frequency(B), electroacupuncture(C) 3 factors and corresponding 2 levels. A total of 12 treatments were performed, and follow-up was performed after the end of treatment. Each group was scored by using the headache days, headache degree, the Headache Impact Test and the Migraine Disability Assessment questionnaire before and after the treatment, and the safety was also evaluated. Results: For reducing the days of headache, relieving the degree of headache, and improving the disabled state, the treatment combination of main points+identification of meridians with syndrome differentiation and electroacupuncture could play the best improvement effect for migraine patients without aura. The two levels of acupuncture frequency did not suggest a separate effect or an interaction effect on each index in this trial. Conclusion: The main acupoints and the acupoints based on syndrome differentiation and meridian differentiation, combined with electro-acupuncture are the initial preferred solutions for the preventive treatment of migraine without aura with acupuncture, which can obtain relatively best curative effects.