针药结合调枢柔筋法治疗中重度颈源性头痛临床观察

Acupuncture Combined with Prescription for Regulating the Hub and Release Muscles to Severe Cervicogenic Headache

目的比较针药结合调枢柔筋法与颈2背根神经节脉冲射频治疗中重度颈源性头痛(CEH)的临床疗效。方法将68例CEH患者随机分为针药组(36例,脱落2例)与射频组(36例,脱落2例)。针药组予颅项针联合瓜芍柴胡汤,射频组予颈2背根神经节脉冲射频治疗。分别于治疗前、治疗后、随访1个月、随访2个月时观察两组VAS评分、颈椎ROM评分、不良反应发生率及临床疗效。结果针药组总有效率为82.35%,高于射频组的55.88%(P<0.05)。针药组VAS评分比较,治疗后、随访1个月、随访2个月针药组均低于射频组(P<0.05),重复测量方差分析显示,评定时间主效应显著(F=483.024,P=0.000),两组治疗后、随访1个月、随访2个月的VAS评分均较治疗前降低,评定时间组别的交互作用显著(F=35.485,P=0.000),组间效应显著(F=18.342,P=0.000)。针药组颈椎ROM评分比较,治疗后、随访1个月、随访2个月针药组均低于射频组(P<0.05),重复测量方差分析显示,评定时间主效应显著(F=353.384,P=0.000),两组治疗后、随访1个月、随访2个月的颈椎ROM评分均较治疗前降低,评定时间组别的交互作用显著(F=7.972,P=0.000),组间效应显著(F=3.453,P=0.000)。结论针药结合调枢柔筋法治疗中重度CEH疗效显著。

Objective:To compare the clinical efficacy of acupuncture combined with prescription for regulating the hub and release muscles and pulsed radiofrequency of cervical 2nd dorsal root ganglion in the treatment of moderate to severe cervicogenic headache(CEH).Methods:68 patients with CEH were randomly divided into the injection group(36 cases,2 cases loss to follow-up)and radiofrequency group(36 cases,2 cases loss to followup).The acupuncture group was given cranial neck acupuncture combined with Guashao Chaihu Decoction,and the radiofrequency(RF)group was given pulsed RF treatment with cervical 2nd dorsal root ganglion.The VAS pain score,cervical spine ROM score and clinical efficacy of the two groups were observed before and after treatment(at immediately after treatment,and at 1 month,2 months and 3 months during follow-ups).Results:The total effective rate was 82.35%in the injection group and 55.88%in the RF group,and the difference was statistically significant(P<0.05).The VAS scores in the acupuncture group at immediate after treatment,1 month and 2 months after treatment were lower than those in the RF group,and the difference was statistically significant(P<0.05);repeated measurement ANOVA showed that the main effect of the evaluation time was significant(F=483.024,P=0.000),the VAS scores of the two groups after treatment,1 month and 2 months were lower than before treatment,the interaction between the evaluation time groups was significant(F=353.384,P=0.000),and the intergroup efect was significant(F=18.342,P=0.000).The cervical spine ROM scores in the acupuncture group were lower than those in the RF group after treatment,1 month and 2 months,and the differences were statistically significant(P<0.05);repeated measurement ANOVA showed that the main effect of the evaluation time was significant(F=353.384,P=0.000),the cervical spine ROM scores of the two groups at immediately after treatment,1 month and 2 months were lower than before treatment,the interaction between the evaluation time groups was significant(F=7.972,P=0.000),and the intergroup effect was significant(F=3.453,P=0.000).Conclusion:The efficacy of acupuncture combined with prescription for regulating the hub and release muscles method in the treatment of moderate to severe CEH is remarkable,which is worthy of clinical promotion and application.