头穴透刺治疗原发性三叉神经痛疗效观察

Efficacy observation of point-toward-point needling at scalp points for primary trigeminal neuralgia

目的 基于三阴三阳开阖枢理论,观察头穴透刺治疗原发性三叉神经痛(primary trigeminal neuralgia,PTN)的临床疗效。方法 将60例PTN患者随机分为观察组(30例)和对照组(30例)。对照组采用常规针刺治疗,观察组在对照组基础上加用头穴透刺。采用综合症状评分量表、简化Mc Gill疼痛问卷(short-form Mc Gill pain questionnaire,SF-MPQ)、汉密顿抑郁量表(Hamilton depression scale,HAMD)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、健康调查简表(the medical outcomes study 36-item short-form health survey,SF-36)分别于治疗前后对患者进行评定,比较两组临床疗效及治疗后1个月复发率。结果 两组治疗后综合症状评分、SF-MPQ各项评分、HAMD评分和PSQI评分均较同组治疗前显著降低(P<0.01),SF-36各项评分均显著升高(P<0.01)。观察组治疗后综合症状评分、SF-MPQ各项评分、HAMD评分和PSQI评分均明显低于对照组(P<0.05),SF-36各项评分均明显高于对照组(P<0.05)。观察组总有效率为96.7%,明显高于对照组的73.3%,两组差异具有统计学意义(P<0.01)。结论 基于三阴三阳开阖枢理论,头穴透刺治疗PTN的临床疗效优于常规针刺。

Objective To observe the clinical efficacy of point-toward-point needling at scalp points in treating primary trigeminal neuralgia(PTN) based on the San Yin San Yang Kai He Shu theory(three-Yin three-Yang opening-closing pivot theory).Method Sixty PTN patients were randomized into an observation group(30 cases) and a control group(30 cases).The control group received the conventional acupuncture treatment,and the observation group received additional scalp point acupuncture with point-toward-point needle insertion.The participants were assessed using the comprehensive symptom rating scale,short-form McGill pain questionnaire(SF-MPQ),Hamilton depression scale(HAMD),Pittsburgh sleep quality index(PSQI),and the medical outcomes study 36-item short-form health survey(SF-36) before and after the treatment.Clinical efficacy and the 1-month follow-up relapse rate were also compared between the two groups.Result The comprehensive symptom rating scale,SF-MPQ,HAMD and PSQI scores showed notable decreases(P<0.01),and the SF-36 scores showed notable increases(P<0.01) after the treatment in both groups.The comprehensive symptom rating scale,SF-MPQ,HAMD and PSQI scores were significantly lower in the observation group than in the control group(P<0.05),and the SF-36 score was markedly higher in the observation group than in the control group(P<0.05).The total effective rate was 96.7% in the observation group,significantly higher than 73.3% in the control group,showing statistical significance(P<0.01).Conclusion Point-toward-point needling at scalp points based on the San Yin San Yang Kai He Shu theory can produce more significant clinical efficacy than ordinary acupuncture treatment.