埋针治疗偏头痛的疗效观察及对患者脑血流动力学的影响

Efficacy Observation of Needle Embedding for Migraine and Its Effect on Cerebral Hemodynamics

目的观察穴位埋针治疗偏头痛的临床疗效及对患者脑血流动力学的影响。方法将74例肝阳上亢型偏头痛患者随机分为对照组和联合组,每组37例。对照组予口服盐酸氟桂利嗪胶囊治疗,联合组在对照组药物治疗基础上予穴位埋针治疗。观察两组治疗前后疼痛视觉模拟量表(VAS)评分、偏头痛症状积分、中医证候积分和脑血流动力学指标的变化,观察两组治疗前后血清内皮素-1(ET-1)、降钙素基因相关肽(CGRP)、一氧化氮(NO)和白介素-6(IL-6)水平的变化,比较两组临床疗效。结果治疗后,两组VAS评分、偏头痛症状积分以及中医证候积分中头胀痛积分、心烦易怒积分、口苦咽干积分和面红目赤积分均低于同组治疗前(P<0.05),且联合组均低于对照组(P<0.05)。治疗后,两组颅内血管收缩期峰流速(Vs)、平均血流速度(Vm)和脉动指数(PI)均低于同组治疗前(P<0.05),且联合组低于对照组(P<0.05)。治疗后,两组血清ET-1、NO和IL-6水平均低于同组治疗前(P<0.05),血清CGRP水平均高于同组治疗前(P<0.05);且联合组均优于对照组(P<0.05)。对照组总有效率为70.3%,低于联合组的97.3%,差异具有统计学意义(P<0.05)。结论在药物治疗基础上,埋针治疗肝阳上亢型偏头痛可缓解疼痛,改善临床症状和患者脑血流动力学指标,临床疗效优于单纯药物治疗。

Objective To observe the clinical efficacy of needle embedding in treating migraine and its effects on the patient’s cerebral hemodynamics.Method Seventy-four patients with migraine due to hyperactivity of liver Yang were randomized into a control group and a combined group,with 37 cases in each group.The control group received oral Flunarizine hydrochloride capsules,and the combined group received needle embedding at acupoints in addition to the medication offered to the control group.The visual analog scale(VAS)score,migraine symptoms score,symptom score of traditional Chinese medicine(TCM),and cerebral hemodynamic parameters were observed before and after the treatment.The levels of serum endothelin-1(ET-1),calcitonin gene-related peptide(CGRP),nitric oxide(NO),and interleukin-6(IL-6)were measured before and after the treatment.Clinical efficacy was compared between the two groups.Result The VAS score,migraine symptoms score,and TCM symptom scores of distending headache,irritation,bitter taste and dry throat,and flushed face and congested eyes dropped after the treatment in both groups(P<0.05)and were lower in the combined group than in the control group(P<0.05).The peak systolic velocity(Vs),mean velocity(Vm),and pulsatility index(PI)of intracranial vessels decreased after the treatment in the two groups(P<0.05)and were lower in the combined group than in the control group(P<0.05).The levels of serum ET-1,NO,and IL-6 dropped(P<0.05),and the serum CGRP level elevated(P<0.05)after the intervention in both groups,and the combined group was superior to the control group(P<0.05).The total effective rate was 70.3% in the control group,lower than 97.3% in the combined group,and the difference was statistically significant(P<0.05).Conclusion Needle embedding based on medication can reduce pain and improve clinical symptoms and cerebral hemodynamic parameters in treating migraine due to hyperactivity of liver Yang and produce more significant clinical efficacy than using the medication alone.