风池穴水针刀治疗颈源性头痛临床观察

Clinical Observation of the Treatment of Cervicogenic Headache with Water Needle-Knife Therapy at Fengchi

目的:观察风池穴水针刀治疗颈源性头痛(cervicogenic headache,CEH)的临床疗效。方法:选取淄博市中西医结合医院针灸科、脑病科2020年3月至2021年4月收治的CEH患者120例,按照随机数字表法分为治疗组、针刺组和西药组,每组40例。针刺组给予常规针刺治疗,西药组给予口服双氯芬酸钠肠溶缓释胶囊治疗,治疗组给予风池穴水针刀治疗。观察3组患者治疗前后颈椎活动度(cervical range of motion,ROM)评分、头痛程度评分、头痛持续时间评分、头痛指数评分变化情况,治疗后3个月随访进行远期疗效评价。结果:3组患者治疗后头痛程度评分、头痛持续时间评分、头痛指数评分均低于治疗前,差异有统计学意义(P<0.01),治疗组和西药组治疗1个疗程、2个疗程后头痛程度评分、头痛持续时间评分、头痛指数均低于针刺组,差异有统计学意义(P<0.01),但治疗组与西药组比较,差异无统计学意义(P>0.05)。3组患者治疗1个疗程、治疗2个疗程后ROM评分均低于治疗前,差异有统计学意义(P<0.01),治疗组治疗1个疗程、治疗2个疗程后ROM评分低于针刺组、西药组,差异有统计学意义(P<0.05),针刺组治疗2个疗程后ROM评分低于西药组,差异有统计学意义(P<0.05)。治疗组有效率为87.5%,针刺组有效率为65.0%,西药组有效率为47.5%,治疗组有效率高于西药组、针刺组,差异具有统计学意义(P<0.01)。结论:水针刀风池穴治疗颈源性头痛即时镇痛效果好,远期临床疗效高,能改善患者颈椎活动度。

Objective:To observe the clinical efficacy of water needle-knife therapy at Fengchi(GB 20)on cervicogenic headache(CEH).Methods:A total of 120 CEH patients were selected from The Acupuncture and Moxibustion Department and The Brain Disease Department of Zibo Integrated Hospital of Traditional Chinese and Western Medicine from March 2020 to April 2021,and were divided into the treatment group,the acupuncture group and the Western medicine group according to the random number table,with 40 cases in each group.The acupuncture group received routine acupuncture treatment,the Western medicine group received oral Diclofenac Sodium Enteric-Coated Sustained-Release Capsules,and the treatment group received water needle-knife therapy at Fengchi(GB 20).Then the changes in cervical range of motion(ROM)score,headache severity score,headache duration score,and headache index score of three groups before and after treatment were observed.After 3 months′treatment,the follow-up was conducted for long-term efficacy evaluation.Results:After treatment,the headache severity score,headache duration score,and headache index score of the three groups were all lower than those before treatment,and all the differences were statistically significant(P<0.01).The headache severity score,headache duration score,and headache index score of the treatment group and the Western medicine group were lower than those of the acupuncture group after one and two courses of treatment,and all the differences were statistically significant(P<0.01).However,the differences between the treatment group and the Western medicine group were not statistically significant(P<0.05).The ROM scores of the three groups after one and two courses of treatment were all lower than those before treatment,and all the differences were statistically significant(P<0.01).However,the differences between the treatment group and the Western medicine group were not statistically significant(P<0.05).The ROM scores of the treatment group after one and two courses of treatment were all lower than those of the acupuncture group and the Western medicine group,and all the differences were statistically significant(P<0.05).The ROM score of the acupuncture group after two courses of treatment was lower than that of the Western medicine group,and the difference was statistically significant(P<0.05).The effective rate of the treatment group was 87.5%,that of the acupuncture group was 65.0%,while that of the Western medicine group was 47.5%.The effective rate of the treatment group was higher than that of the Western medicine group and the acupuncture group,and all the differences were statistically significant(P<0.01).Conclusion:Water needle-knife therapy at Fengchi has a good immediate analgesic effect on CEH,and a highly long-term clinical efficacy,which can improve the patient′s cervical range of motion.