摘要
目的分析体外冲击波结合超声引导下星状神经节阻滞对颈源性头痛患者颈部活动及血清炎症、疼痛指标的影响。方法将2022年10月-2024年7月上海市静安区闸北中心医院收治的132例颈源性头痛患者采用随机数字表法分为超声引导下星状神经节阻滞治疗的神经节阻滞组(66例)和体外冲击波结合超声引导下星状神经节阻滞治疗的联合冲击波组(66例),均治疗1个月。统计两组治疗1个月后的疗效,比较两组治疗前和治疗1个月后血清疼痛、炎症指标水平及颈部活动、头痛、睡眠改善情况。结果治疗1个月后,联合冲击波组总有效率为92.42%,高于神经节阻滞组的80.30%(P<0.05)。两组治疗1个月后,与治疗前比较,血清一氧化氮(nitric oxide,NO)、β-内啡肽(β-endorphin,β-EP)、5-羟色胺(5-hydroxytryptamine,5-HT)水平及右侧屈、右旋转、左侧屈、左旋转、前屈、后伸活动度升高,联合冲击波组高于神经节阻滞组(P<0.05);血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)、白介素-1β(interleukin-1β,IL-1β)、白介素-4(interleukin-4,IL-4)水平、头痛发生频率及视觉模拟评分(visual analogue scale,VAS)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)降低,联合冲击波组低于神经节阻滞组(P<0.05);头痛持续时间缩短,联合冲击波组短于神经节阻滞组(P<0.05)。结论在超声引导下星状神经节阻滞的基础上,联合体外冲击波结合治疗颈源性头痛患者,能更有效降低疼痛、炎症指标水平,缓解患者头痛,改善其颈部活动度及睡眠质量,具有较好的治疗效果。
Objective To analyze the effects of extracorporeal shock wave combined with ultrasound-guided stellate ganglion block on neck activity,serum inflammation and pain indexes in patients with cervicogenic headache.Methods A total of 132 patients with cervicogenic headache treated in Zhabei Central Hospital from October 2022 to July 2024 were enrolled in this study.The patients were randomly divided into the ganglion block group(66 cases,treated by ultrasound-guided stellate ganglion block)and the combined shock wave group(66 cases,treated by extracorporeal shock wave combined with ultrasound-guided stellate ganglion block),both group were treated for 1 month.The curative effects of the two groups after 1 month of treatment were counted,and the serum pain,inflammatory index levels,neck activity,headache and sleep improvement were compared between the two groups before and 1 month after treatment.Results After 1 month of treatment,the total effective rate in the combined shock wave group was 92.42%,which was higher than that in the ganglion block group(80.30%,P<0.05).After 1 month of treatment,the levels of serum nitric oxide(NO),β-endorphin(β-EP)and 5-hydroxytryptamine(5-HT)and the activities of right flexion,right rotation,left flexion,left rotation,forward flexion and backward extension in the two groups were all increased when compared with those before treatment,and those were all higher in combined shock wave group than those in the ganglion block group(all P<0.05).Serum levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-1β(IL-1β)and interleukin-4(IL-4),headache frequency,scores of visual analogue scale(VAS)and Pittsburgh Sleep Quality Index(PSQI)were all decreased in the two groups after the treatment,and those were all lower in the combined shock wave group than those in the ganglion block group(all P<0.05)The duration of headache was shorter in the two groups after the treatment,which was shorter in the combined shock wave group than that in the ganglion block group(P<0.05).Conclusion Ultrasound-guided stellate ganglion block combined with extracorporeal shock wave for patients with cervicogenic headache can reduce the level of pain and inflammation indicators,relieve headache,improve neck mobility and sleep quality more effectively.
作者
刘美跃
王召红
张国梁
张清
LIU Meiyue;WANG Zhaohong;ZHANG Guoliang;ZHANG Qing(Department of Anesthesiology,Zhabei Central Hospital,Jing'an District,Shanghai 200070,China;Department of Orthopedics of Traditional Chinese Medicine,Zhabei Central Hospital,Jing'an District,Shanghai 200070,China)
出处
《同济大学学报(医学版)》
2025年第4期570-576,共7页
Journal of Tongji University(Medical Science)
基金
上海市静安区科委课题面上项目(2022MS06)。
关键词
颈源性头痛
冲击波
星状神经节阻滞
疼痛
cervicogenic headache
shock wave
stellate ganglion block
ache
