摘要
目的：比较气街部穴位电针干预合脊柱调衡法与西药卡马西平治疗原发性三叉神经痛（PTN）的临床疗效差异。方法：将60例患者随机分为综合组（30例）和药物组（30例）。综合组取头气街部穴位太阳、四神聪等与胸、腹气街部穴位肾俞、中脘、关元等，得气后接电针2～4组穴位，针后行脊柱调衡法，每天1次；药物组口服卡马西平，首剂量100mg，每天2次，维持量每天400～600mg。两组均治疗1个月，于治疗前、后及随访2个月、6个月，采用疼痛量表疼痛评定指数（PRI）、生活满意度指数B量表（LSI-B）、抑郁量表（HAMD）等，综合评定两组的临床疗效，并比较两组治疗期间不良反应发生情况。结果：治疗后综合组愈显率为76．7％（23／30），优于药物组的63．3％（19／30，P〈0．01）；两组治疗后PRI病情分级差异无统计学意义（均P〉0．05），于随访2个月、6个月时，综合组PRI病情分级情况优于药物组（均P〈0．05）；两组治疗后及随访时HAMD评分均下降（均P〈0．01，P〈0．05），且于随访时综合组HAMD评分下降较药物组显著（均P〈0．05）；两组治疗后LSI-B评分均有明显上升（均P〈0．05），且综合组优于药物组（P〈0．05）；综合组不良反应发生率为16．79／6（5／30），低于药物组的30．0％（9／30，P〈0．01）。结论：气街部穴位电针干预合脊柱调衡法治疗PTN，在改善患者精神心理、镇痛、提高生活质量方面的远期疗效优于口服卡马西平，是一种安全、优效且稳定的治疗方法。
Objective To compare the difference in the clinical efficacy on primary trigeminal neuralgia （PTN） between the comprehensive therapy of electroacupuncture （EA） at qi streets acupoints combined with spinal regu- lation method and medication with carbamazepine （CBZ）. Methods Sixty patients were randomized into a compre- hensive therapy group （30 cases） and a medication group （30 cases）. In the comprehensive therapy group, the acupoints at qi streets on the head such as Taiyang （EX-HN 5） and Sishencong （EX-HN 1） and those at qi streets on the chest and abdomen such as Shenshu （BL 23）, Zhongwan （CV 12） and Guanyuan （CV 4）, etc. were select- ed. After arrival of qi, EA was attached on 2 to 4 groups of acupoints. After acupuncture, the spinal regulation method was applied. This comprehensive therapy was given once a day. In the medication group, CBZ was used for oral administration, 100 mg at the first time, twice a day, and 400 to 600 mg each day as the maintenance dose. Separately, before and after treatment, in 2 and 6 months in follow-up, pain rating index （PRI）, life satis- faction index B （LSI-B） and hamilton depression scale （HAMD） were adopted to evaluate comprehensively the clinical efficacy in the two groups and compare the adverse reaction during the treatment between the two groups. Results After treatment, the curative and markedly effective rate in the comprehensive therapy group was 76.7 %（23/30）, which was better than 63.3%/oo （19/30） in the medication group （P〈0.01）. The difference in PRI was not signifi- cant after treatment between the two groups （all P〉0.05）. In 2 and 6 months follow-up, PRI grade in the comprehensive therapy group was superior to that of the medication group （both P〈0. 05）. After treatment and in follow-up, HAMD score was all reduced in the two groups （P〈0. 01 ,P〈0.05） and the result in follow-up in the comprehensive therapy group was significant as compared with that in the medication group （all P〈0.05）. Alter treatment, LSI-B score was increased obvi- ously in the two groups （all P〈0. 05） and the result in the c0mprehensive therapy group was better than that in the medica- tion group （P〈0. 05）. The incidence of adverse reaction in the comprehensive therapy group was 16. 7%（5/30）, which was lower than 30. 0%（9/30, P〈 0. 01） in the medication group. Conclmion The comprehensive therapy of EA at qi streets acpoints combined with spinal regulation method achieves the long-term efficacy on PTN as compared with oral administration of CBZ in terms of the improvement of psychological condition, analgesia and life quality. It is the safe, effective and stable therapy. KEY WORDS primary trigeminal neuralgia; qi streets; acupuncture; tuina; electroacupuncture; randomized con- trolled trial （RCT）
出处
《中国针灸》
CAS
CSCD
北大核心
2014年第8期763-768,共6页
Chinese Acupuncture & Moxibustion
基金
国家自然科学青年基金项目:30901927
铜仁市科技计划基金项目:2013trzy-1
关键词
原发性三叉神经痛
气街
针刺
推拿
电针
随机对照试验
primary trigeminal neuralgia
qi streets
acupuncture
tuina
electroacupuncture
randomized con-trolled trial （RCT）
