针刺肌筋膜触发点治疗偏头痛的血流动力学分析及机制研究

Hemodynamic Analysis and Mechanism of Acupuncture at Myofascial Trigger Point in Treatment of Migraine

目的:探究针刺肌筋膜触发点治疗偏头痛的血流动力学变化及可能机制。方法:招募2020年1月到2021年6月在西南大学医院康复科门诊就诊的57名偏头痛患者为研究对象,采用随机数字表法将受试者分为药物组(n=28)和综合组(n=29),药物组只采用药物治疗,综合组采用干针针刺肌筋膜触发点联合药物治疗,共治疗2周。对比观察两组患者头痛VAS视觉模拟评分和患侧颈内动脉、眼动脉的平均血流速度(Vm)、搏动指数(PI)和阻力指数(RI)差异。结果:治疗2周后,两组患者VAS评分均明显低于治疗前(P<0.05),且综合组明显低于药物组(P<0.05);综合组患者患侧颈内动脉平均血流速度高于治疗前(P<0.05);综合组患者患侧颈内动脉PI低于药物组(P<0.05);综合组患者患侧颈内动脉RI低于治疗前(P<0.05);药物组和综合组患者的患侧眼动脉平均血流速度、PI以及RI与治疗前无显著差异(P>0.05)。结论:针刺肌筋膜触发点和药物联合治疗可以改善偏头痛患者的局部血液循环,增加大脑颅内血流灌注,减轻患者头痛程度。

Objective:To investigate the hemodynamic changes and possible mechanism of acupuncture on myofascial trigger point in the treatment of migraine.Methods:Recruiting in January 2020 to June 2021 in southwest university hospital rehabilitation clinics of 57 patients with migraine as the research object,using the random number table method the subjects were divided into the drug group(n=28)and maintaining(n=29),drug group using medication,maintaining dry needle prick myofascial trigger point and drug combination therapy,treatment 2 weeks.Visual analog scale(VAS)was used to evaluate the severity of headache before and after treatment,and the mean blood flow velocity(Vm),pulse index(PI)and resistance index(RI)of internal carotid artery and ophthalmic artery on the affected side were analyzed.Results:After 2 weeks of treatment,VAS scores in 2 groups were significantly lower than before(P<0.05),and the comprehensive group was significantly lower than the drug group(P<0.05).The mean blood flow velocity of the affected internal carotid artery in the comprehensive group was higher than that before treatment(P<0.05).The PI of the affected internal carotid artery in the comprehensive group was lower than that in the drug group(P<0.05).The RI of the affected side of the carotid artery in the comprehensive group was lower than before treatment(P<0.05).There were no significant differences in mean blood flow velocity,PI and RI of affected ocular artery between drug group and comprehensive group compared with before treatment(P>0.05).Conclusion:Acupuncture myofascial trigger point combined with drug therapy can improve local blood circulation and increase intracranial blood perfusion in migraine patients,thereby reducing the headache degree of migraine patients.