局部透刺、井穴刺血法对发作期普通偏头痛患者即刻止痛疗效的对比观察
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摘要
目的:本研究采用视觉模拟评分法(VAS)、口述分级评分法(VRS),以VAS分值、VRS分值为观察指标,对比观察局部透刺、井穴刺血法对发作期普通偏头痛患者即刻止痛疗效影响的差异性,并观察两种治疗方法之间的配合应用效应,为针灸治疗偏头痛的临床优选方案提供初步研究依据。方法:将56例发作期普通偏头痛患者随机分为三组,分别采取局部透刺、井穴刺血、局部透刺配合井穴刺血,进行治疗前、治疗后30minVAS、VRS评分,并结合分值进行止痛效果评价。结果:1.三组各自治疗前后VAS分值、VRS分值比较有非常显著性差异(P<0.01);2.三组治疗前后VAS差值、VRS差值组间两两比较无显著性差异(P>0.05);3.三组止痛效果评价组间两两比较无显著性差异(P>0.05);结论:1.三法对发作期普通偏头痛患者均具有显著的即刻止痛效果;2.三法的即刻止痛效果基本没有差别;3.初步认为,局部透刺配合井穴刺血不具有协同或拮抗作用,即两法同用也不能提高或消减单一治法的疗效。
Purpose:Observe the instant effects between SJ23 Penetrating GB8,GB4 penetrating GB6 and Pricking blood therapy on the Jing-(well) points on common migraine patients who are at the stage of attack.Explore evidence for therapeutic prescription.Method:VAS and VRS served as the objective index.56 patients are involved in the trial who are arranged into 3 randomized groups.One group of patients receive penetrating therapy, another group of patients receive Jing-(well) points pricking blood therapy while the last group of patients receive the combination the above two treatments.Scores before and 30 minutes after the treatments are recorded and processed. Result:First,pre-after self- comparision shows significant difference in three groups(sig<0.01).Second, comparision among groups before and after treatment shows no significant difference(sig>0.05). Third,there is no significant difference in analgesic effects among three groups(sig>0.05). Conclusion:First,all the three therapies have excellent instant analgesic effects.Second, there is no significant difference among the three therapies.Third,there is no cooperative or antergic effects between penetrating method and Jing- well acupoints pricking blood therapy.
Purpose:Observe the instant effects between SJ23 Penetrating GB8,GB4 penetrating GB6 and Pricking blood therapy on the Jing-(well) points on common migraine patients who are at the stage of attack.Explore evidence for therapeutic prescription.Method:VAS and VRS served as the objective index.56 patients are involved in the trial who are arranged into 3 randomized groups.One group of patients receive penetrating therapy, another group of patients receive Jing-(well) points pricking blood therapy while the last group of patients receive the combination the above two treatments.Scores before and 30 minutes after the treatments are recorded and processed. Result:First,pre-after self- comparision shows significant difference in three groups(sig<0.01).Second, comparision among groups before and after treatment shows no significant difference(sig>0.05). Third,there is no significant difference in analgesic effects among three groups(sig>0.05). Conclusion:First,all the three therapies have excellent instant analgesic effects.Second, there is no significant difference among the three therapies.Third,there is no cooperative or antergic effects between penetrating method and Jing- well acupoints pricking blood therapy.
引文
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[30]李青,王欣,任焕忠,郭义,杨秀梅.手十二井穴刺络放血对脑血流的影响[J].中国中医药信息杂志,2000,7(3):51.
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[32]范刚启.目前针灸临床研究存在的问题及对策[J].医学与哲学,1995,16(7): 344.
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[3]邓伟哲.深刺风池穴为主治疗偏头痛临床观察[J].中国针灸,2002,22(1O):661～662.
[4]周忠亮.少阳三针刺法治疗偏头痛42例观察[J].针灸临床杂志,2003,19(6):33.
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[2]边连防.偏头痛的诊断及治疗[J].现代医院,2004,5(4):10～13.
[3]于生元.偏头痛的诊治进展—最新偏头痛分类及诊断标准[J].医师进修杂志, 2005,4(28):1～3.
[4]王维治.神经病学[M].北京:人民卫生出版社,2004:253.
[5]程伟进,胡红玲等.偏头痛患者的情绪状况研究[J].浙江医学,2005,27(4):284.
[6]薛广渡.现代疾病预防学[M].北京:人民军医出版社,1996:1015.
[7] Goadsby PJ.Pathophysiology of migraine:A disease of the brain.In:Goadsby PJ,Silberstein SD,eds.Headache.New York:Butterworth-Heine mann Press, 1997,5～18.
[8] Amelito Malapira,Jorge Mendizabal著;王玉洁,付峻,蔺慕慧,张瑞君译.偏头痛[J].国外医学脑血管疾病分册,2004,1(12):19.
[9]刘丽,姚震,蒋祖勋.循环内皮细胞与高血压[J].美国中华内科学杂志,2001,3(2) :126.
[10]李月华,张大方,魏振林.偏头痛的中西医诊断与治疗[M].北京:中国中医药出版社,1999,第1版:11.
[11] Russell MB,Olesen J.A nosograpbic analysis of the migraine aura in a general population.Brain,1996,119:355～361.
[12] Lauritzen M.Pathophysiology of the migraine aura:the spreading depression theory,Brain,1994,117:199～210
[13] Blan JN.Lineet.1992,339:1202.
[14]阎海.偏头痛诊治大全[M].北京:学苑出版社,1996,第1版:45～222.
[15] Stephen JP,Ferrari MD.Genetics lf primary headaches.Curr Opin Neurol. 1999,12:249～254.
[16] Huskisson EC.Rheumatology Phyo Med,1970,Suppl:98.
[17] Clarke P R F et.al Bull Br Psychol Soc,1964,17,55:18A.
[18] Huskisson EC.Lancet.1974,Nov9:1127.
[19] Deloach LJ,Higgins MS,Caplan AB,etal.The Visual Analogue Scale in the immediate postoperative period:intrasubject variability and correlatio n with a numeric scale[J].Anesth Analg,1998,86(1):102～106.
[20] Breivik EK,Bjornsson GA,Skovlund E.A comparison of pain rating scales by sampling from clinical trial data[J].Clin J Pain,2000,16(1):22～28.
[21]吕晨,邹建玲,沈淑华,张芳芳.视觉模拟量表和语言评价量表用于术后疼痛评估的比较[J].全科医学临床与教育,2004,2(4):215.
[22]李鼎.经络学[M].上海科学技术出版社,1995:115～119.
[23]印会河,张伯讷.中医基础理论[M].上海科技出版社,1984,第1版:54.
[24]王启才.针灸治疗学[M].北京:中国中医药出版社,2003,第1版:6.
[25]范爱新.针刺吸氧疗法在急性心肌梗塞救治中的应用[J].中国针灸,1999,19(4) :213.
[26]唐文中.头皮针治疗头痛50例临床观察[J].针灸临床杂志,2001,17(7):41.
[27]卢林,李继臣,张鹏博.穴位透刺治疗偏头痛90例临床观察[J].牡丹江医学院学报,2002,23(1):24.
[28]牛晓军,储开博,杨李旺.丝竹空透率谷的穴周解剖关系及治疗偏头痛的机理探讨[J].江西中医学院学报,2005,17(5):32.
[29]袁晓军,郝喜书,赖仲平等.针刺风池穴对脑血流的影响[J].中医杂志,1996,37(5):285.
[30]李青,王欣,任焕忠,郭义,杨秀梅.手十二井穴刺络放血对脑血流的影响[J].中国中医药信息杂志,2000,7(3):51.
[31]武和平,必联阳,沈平等.自制耳穴按压丸应用于术后阵痛的临床观察和机理研究[J].上海针灸杂志,1987,6(I):11.
[32]范刚启.目前针灸临床研究存在的问题及对策[J].医学与哲学,1995,16(7): 344.
[1]窦国栋,崔召东.针刺治疗偏头痛56例临床观察[J].针灸临床杂志,1999,15(6): 12～13.
[2]余靖.缪刺法治疗偏头痛的临床疗效观察[J].上海针灸杂志,2000,19(2):17～18.
[3]邓伟哲.深刺风池穴为主治疗偏头痛临床观察[J].中国针灸,2002,22(1O):661～662.
[4]周忠亮.少阳三针刺法治疗偏头痛42例观察[J].针灸临床杂志,2003,19(6):33.
[5]陈仲新.上下配穴针刺治疗偏头痛43例[J].陕西中医,2004,25(2):155.
[6]薛梅芝.针刺治疗偏头痛[J].上海针灸杂志,2002,(20)8:25～27.
[7]袁胜.率谷透天冲治疗偏头痛[J].中国针灸,2001,21(3):190.
[8]冯亚玲.针灸透穴为主治疗偏头痛28例[J].长春中医学院学报,2002,18(3):6.
[9]王顺,蔡玉颖.透刺疗法治疗偏头痛的临床疗效与机理探讨[J].上海针灸杂志, 2003,22(2):19
[10]王秋月.针刺治疗偏头痛46例[J].吉林中医药,2004,24(7):46
[11]王峥,郭泽新,马雯.三棱针刺血治疗偏头痛的临床观察[J].上海针灸杂志, 2002,21(3):11～12.
[12]叶青青.刺血疗法治疗偏头痛50例观察[J].实用中医药杂志,1999,15(7):31.
[13]李昌生.挑络放血法治疗偏头痛疗效观察[J].辽宁中医药杂志,2005,32(12): 1299.
[14]武志鹏.头皮针治疗偏头痛39例[J].陕西中医,1998,(1):29.
[15]张丽霞.针刺头穴治疗血管神经性头痛58例[J].临床针灸临床杂志,1998,(2):14.
[16]赵丽君,刘永立.运动头针治疗偏头痛50例[J].中国中医药信息杂志.2002, 9(11):64.
[17]李梅,葛建立,张敬文.针刺治疗偏头痛51例[J].河北中医,2004,26(6):454
[18]宋志娥.针刺治疗偏头痛78例临床观察[J].中华临床新医学,2002,2(1O):992～993.
[19]张敏尚,王秋景,王山.针灸治疗偏头痛30例[J].四川中医,2005,23(1):91～92.
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