摘要
目的 观察揿针合谷穴治疗脑震荡后遗头痛的临床疗效及对患者睡眠质量的影响。方法 选取脑震荡后遗头痛患者150例,随机分为对照组、按摩组和揿针组,每组50例。对照组予口服尼莫地平片和常规护理,按摩组在对照组治疗基础上予指揉法按摩合谷穴治疗,揿针组在对照组治疗基础上予揿针合谷穴治疗。观察3组中医证候积分、头痛持续时间、疼痛视觉模拟量表(visual analog scale, VAS)评分、经颅多普勒检查参数(大脑前动脉、中动脉、后动脉及基底动脉的血流速度)、血清神经损伤因子[神经元特异性烯醇化酶(neuronspecific enolase, NSE)、泛素C末端水解酶-L1(ubiquitin C-terminal hydrolase-L1, UCHL1)和髓鞘碱性蛋白(myelin basic protein, MBP)]、睡眠时间、夜间苏醒次数和匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)的变化,比较3组临床疗效和不良反应发生情况。结果 揿针组总有效率为94.0%,高于对照组的74.0%和按摩组的80.0%(P<0.05)。治疗后,揿针组头痛、头晕、恶心呕吐、失眠多梦、记忆力减退的中医证候积分、头痛持续时间和VAS评分低于对照组和按摩组(P<0.05),按摩组头痛的中医证候积分、头痛持续时间和VAS评分低于对照组(P<0.05)。治疗后,揿针组大脑前动脉、中动脉及后动脉的平均血流速度均低于对照组和按摩组(P<0.05),基底动脉的平均血流速度低于对照组(P<0.05);揿针组血清NSE、UCHL1和MBP水平均低于对照组和按摩组(P<0.05);揿针组睡眠时间多于对照组(P<0.05),夜间苏醒次数和PSQI评分均低于对照组和按摩组(P<0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 在口服尼莫地平片和常规护理基础上,揿针合谷穴治疗脑震荡后遗头痛的临床疗效优于按摩合谷穴,可有效改善患者的临床症状,缓解头痛,改善睡眠质量,延长睡眠时间,可能与降低血清NSE、UCHL1和MBP水平及改善脑血管血流速度有关。
Objective To observe the clinical efficacy of intradermal needle at Hegu(LI4)in the treatment of post-concussion headache and its effect on the sleep quality of patients.Method A total of 150 patients with post-concussion headache were selected and randomly divided into a control group,a tuina group and an intradermal needle group,with 50 patients in each group.The control group was given oral Nimodipine tablets and routine care,while the tuina group was treated with finger-kneading manipulation at Hegu on the basis of the treatment in the control group,and the intradermal needle group was treated with intradermal needle at Hegu on the basis of the treatment in the control group.The change in the Chinese medicine pattern score,headache duration,visual analog scale(VAS)score,transcranial Doppler parameters(blood flow velocity of anterior,middle,posterior and basilar arteries),serum nerve damage factors[neuron-specific enolase(NSE),ubiquitin C-terminal hydrolase-L1(UCHL1)and myelin basic protein(MBP)],sleep duration,number of nocturnal awakenings and Pittsburgh sleep quality index(PSQI)were observed in the three groups.The clinical efficacy and adverse effects of the three groups were compared.Result The total effective rate of the intradermal needle group was 94.0%,which was higher than that of the control group(74.0%)and the tuina group(80.0%)(P<0.05).After treatment,the Chinese medicine pattern scores,headache duration and VAS scores of headache,dizziness,nausea and vomiting,insomnia and dreaminess,and memory loss in the intradermal needle group were lower than those in the control group and the tuina group(P<0.05),while the Chinese medicine pattern scores,headache duration and VAS scores of headache in the tuina group were lower than those in the control group(P<0.05).After treatment,the mean blood flow rate of anterior,middle and posterior cerebral arteries in the intradermal needle group was lower than that of the control group and tuina group(P<0.05),and the mean blood flow rate of basilar artery of the intradermal needle group was lower than that of the control group(P<0.05);the levels of serum NSE,UCHL1 and MBP in the intradermal needle group were lower than that of the control group and tuina group(P<0.05);the sleep time of the intradermal needle group was more than that of the control group(P<0.05),the number of nocturnal awakenings and PSQI scores of the intradermal needle group were lower than those of the control group and tuina group(P<0.05),and the differences in the incidence of adverse reactions among the three groups were not statistically significant(P>0.05).Conclusion On the basis of oral Nimodipine tablets and routine care,the clinical efficacy of intradermal needle at Hegu in treating post-concussion headache was better than that of tuina at Hegu,which could effectively improve the clinical symptoms of the patients,alleviate the headache,improve the quality of sleep,and prolong the sleeping time,which might be related to the reduction of serum NSE,UCHL1 and MBP levels and the improvement of cerebral vascular blood flow velocity.
作者
吴梦超
吴娟
陆琴
秦洁
蒋茹
章文觉
WU Mengchao;WU Juan;LU Qin;QIN Jie;JIANG Ru;ZHANG Wenjue(Yixing Hospital of Traditional Chinese Medicine,Jiangsu Province,Yixing 214200,China)
出处
《上海针灸杂志》
2025年第4期411-417,共7页
Shanghai Journal of Acupuncture and Moxibustion
关键词
皮内针疗法
揿针
耳穴贴压
头痛
脑震荡
睡眠质量
Intradermal needle therapy
Thumbtack needle
Auricular point sticking
Headache
Concussion
Sleep quality
