摘要
目的探究超声引导下针刀松解颈神经皮支分布区软组织治疗颈源性头痛(CEH)患者的临床疗效和安全性。方法本研究为前瞻性随机对照研究。收集2017年10月—2020年1月于中日友好医院针灸科就诊的60例CEH患者为研究对象,随机分为试验组和对照组,各30例。试验组采用超声引导下针刀松解颈神经皮支分布区软组织联合伪神经阻滞,对照组采用神经阻滞联合伪针刀,比较两组患者治疗前、治疗结束、治疗结束后3个月的视觉模拟量表(VAS)、口述评分法(VRS)、简版McGill疼痛问卷-2(SF-MPQ-2)、健康调查简表(SF-36)评分变化及临床总有效率。组间符合正态分布的连续变量以x^(-)±s表示,采用t检验;非正态分布者以M(Q_(1),Q_(3))表示,采用Wilcoxon秩和检验;分类变量以例数(%)表示,采用χ^(2)检验。结果两组患者在治疗结束、治疗结束后3个月的VAS评分、VRS评级、SF-MPQ-2量表与治疗前比较均有显著改善,差异均有统计学意义(P均<0.05);两组患者治疗结束与治疗结束后3个月的上述量表评分比较,差异均无统计学意义(P均>0.05)。两组患者的临床总有效率在治疗结束与治疗结束后3个月比较,差异均无统计学意义(P均>0.05)。SF-36量表中,治疗结束后及结束3个月后,试验组患者的BP、SF较治疗前均显著改善,对照组患者的HT、RP、GH、SF、RE较治疗前均显著改善,差异均有统计学意义(P均<0.05),而组间比较差异均无统计学意义(P均>0.05)。结论超声引导下针刀松解颈神经皮支分布区软组织治疗CEH患者效果较好,值得临床参考。
Objective To investigate the clinical efficacy and safety of ultrasound-guided acupotomy release of soft tissue in the cutaneous branch distribution area of cervical nerves for treating patients with cervicogenic headache(CEH).Method This study was a prospective randomized controlled trial.A total of 60 CEH patients who visited the acupuncture department of China-Japan Friendship Hospital from October 2017 to January 2020 were enrolled and randomly divided into a treatment group and a control group,with 30 patients in each group.The treatment group received ultrasound-guided acupotomy release of soft tissue in the cutaneous branch distribution area of cervical nerves combined with sham nerve block,while the control group received nerve block combined with sham acupotomy.The changes in visual analog scale(VAS),verbal rating scale(VRS),short-form McGill pain questionnaire-2(SF-MPQ-2),and short form-36 health survey(SF-36)scores before treatment,at the end of treatment,and 3 months after treatment were compared between the two groups,along with the overall clinical effectiveness.Continuous variables conforming to a normal distribution were expressed as x^(-)±s and analyzed using t-tests;non-normally distributed variables were expressed as M(Q_(1),Q_(3))and analyzed using the Wilcoxon rank-sum test;categorical variables were expressed as counts(%)and analyzed using theχ^(2) test.Results Both groups showed significant improvements in VAS scores,VRS ratings,and SF-MPQ-2 scores at the end of treatment and 3 months after treatment compared to baseline,with statistically significant differences(all P<0.05).There were no significant differences in the above scale scores between the end of treatment and 3 months after treatment in either group(all P>0.05).There were no significant differences in the overall clinical effectiveness between the two groups at the end of treatment and 3 months after treatment(all P>0.05).In the SF-36 scale,both at the end of treatment and 3 months after treatment completion,patients in the experimental group showed significant improvements in BP and SF compared to baseline,while patients in the control group demonstrated statistically significant improvements in HT,RP,GH,SF,and RE compared to pre-treatment levels(all P<0.05).but there were no significant differences between the groups(all P>0.05).Conclusions Ultrasound-guided acupotomy release of soft tissue in the cutaneous branch distribution area of cervical nerves is effective in treating CEH patients and is worthy of clinical reference.
作者
李石良
贾雁
邱祖云
朱新月
申毅锋
周俏吟
石翀
LI Shiliang;JIA Yan;QIU Zuyun;ZHU Xinyue;SHEN Yifeng;ZHOU Qiaoyin;SHI Chong(Department of Acupuncture,China-Japan Friendship Hospital,Beijing 100029,China;Department of Pain,Shanxi Bethune Hospital,Taiyuan 030032,China;Department of Traditional Chinese Medicine Orthopedics,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Orthopedics,Chaoyang District Traditional Chinese Medicine Hospital,Beijing 100026,China;TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China;School of Traditional Chinese Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;Department of Traditional Chinese Medicine,Aerospace Center Hospital,Beijing 100049,China)
出处
《中国研究型医院》
2025年第2期13-18,共6页
Chinese Research Hospitals
关键词
头痛
颈神经
超声引导
针刀
Headache
Cervical nerve
Ultrasound guidance
Acupotomy
