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项八穴针刺联合推拿手法治疗颈源性头痛的临床观察

徐磊 唐雨亭 蔡连芹 江勇

徐磊, 唐雨亭, 蔡连芹, 江勇. 项八穴针刺联合推拿手法治疗颈源性头痛的临床观察[J]. 中华全科医学, 2023, 21(6): 1030-1033. doi: 10.16766/j.cnki.issn.1674-4152.003042
引用本文: 徐磊, 唐雨亭, 蔡连芹, 江勇. 项八穴针刺联合推拿手法治疗颈源性头痛的临床观察[J]. 中华全科医学, 2023, 21(6): 1030-1033. doi: 10.16766/j.cnki.issn.1674-4152.003042
XU Lei, TANG Yuting, CAI Lianqin, JIANG Yong. Clinical observation of acupuncture nape eight points combined with manipulation therapy in the treatment of cervicogenic headache[J]. Chinese Journal of General Practice, 2023, 21(6): 1030-1033. doi: 10.16766/j.cnki.issn.1674-4152.003042
Citation: XU Lei, TANG Yuting, CAI Lianqin, JIANG Yong. Clinical observation of acupuncture nape eight points combined with manipulation therapy in the treatment of cervicogenic headache[J]. Chinese Journal of General Practice, 2023, 21(6): 1030-1033. doi: 10.16766/j.cnki.issn.1674-4152.003042

项八穴针刺联合推拿手法治疗颈源性头痛的临床观察

doi: 10.16766/j.cnki.issn.1674-4152.003042
基金项目: 

安徽省名中医工作室建设项目 201811

详细信息
    通讯作者:

    江勇,E-mail:498917800@qq.com

  • 中图分类号: R245.31  R244.1

Clinical observation of acupuncture nape eight points combined with manipulation therapy in the treatment of cervicogenic headache

  • 摘要:   目的  采用随机对照试验观察项八穴针刺联合推拿手法治疗颈源性头痛的临床疗效,为颈源性头痛的治疗提供高质量的临床证据。  方法  选取2020年6月—2022年5月于蚌埠医学院第一附属医院康复医学科就诊的70例颈源性头痛患者,采用随机数字表法分为治疗组(35例)和对照组(35例)。治疗组给予针刺项八穴联合推拿手法治疗;对照组给予口服布洛芬治疗。治疗结束后,观察2组治疗前后简化McGill量表评分(SF-MPQ)、颈椎功能障碍指数(NDI)的变化情况,并比较2组临床疗效。  结果  2组治疗前SF-MPQ评分中的PRI、VAS、PPI评分和NDI评分差异无统计学意义(均P>0.05);治疗后SF-MPQ评分中的PRI、VAS、PPI评分和NDI评分较治疗前差异有统计学意义(均P<0.05);治疗组治疗后SF-MPQ评分中的PRI、VAS、PPI评分和NDI评分[(5.46±0.95)分、(3.26±0.74)分、(1.34±0.48)分、(14.89±1.60)分]优于对照组[(6.43±1.01)分、(4.51±0.92)分、(2.37±0.73)分、(18.74±3.11)分,t=4.148、6.297、6.951、6.522,均P<0.05],差异有统计学意义。治疗组和对照组总有效率分别为97.1%、77.14%,2组比较差异有统计学意义(P<0.05)。  结论  项八穴针刺联合推拿手法治疗可以显著改善颈源性头痛的临床症状,改善颈椎的功能,同时减轻患者厌烦、害怕的情感障碍。

     

  • 表  1  2组颈源性头痛患者一般资料比较

    Table  1.   Comparison of general data between two groups of patients with cervicogenic headache

    组别 例数 性别(例) 年龄(x±s,岁) 病程(x±s,d)
    男性 女性
    治疗组 35 18 17 53.23±13.75 41.77±10.76
    对照组 35 16 19 52.66±14.86 39.77±11.65
    统计量 0.229a 0.167b 0.746b
    P 0.632 0.868 0.458
    注:a为χ2值,bt值。
    下载: 导出CSV

    表  2  2组颈源性头痛患者临床疗效比较[例(%)]

    Table  2.   Comparison of clinical efficacy between two groups of patients with cervicogenic headache [cases(%)]

    组别 例数 治愈 显效 好转 无效 总有效
    治疗组 35 0 12(34.29) 22(62.86) 1(2.86) 34(97.14)
    对照组 35 0 0 27(77.14) 8(22.86) 27(77.14)
    注:2组的总有效率比较,χ2=4.590,P=0.032。
    下载: 导出CSV

    表  3  2组颈源性头痛患者治疗前后疼痛程度比较(x±s,分)

    Table  3.   Comparison of pain intensity before and after treatment in the two groups of of patients with cervical headache(x±s, points)

    组别 例数 PRI VAS PPI
    治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
    治疗组 35 26.94±3.07 5.46±0.95a 6.91±1.15 3.26±0.74a 3.20±0.72 1.34±0.48a
    对照组 35 26.80±3.39 6.43±1.01a 7.00±1.21 4.51±0.92a 3.37±0.73 2.37±0.73a
    t 0.185 -4.148 -0.304 -6.297 -0.989 -6.951
    P 0.854 <0.001 0.762 <0.001 0.326 <0.001
    注:与同组治疗前比较, aP<0.05。
    下载: 导出CSV

    表  4  2组颈源性头痛患者治疗前后颈椎功能比较(x±s,分)

    Table  4.   Comparison of cervical function before and after treatment in the two groups of patients with cervicogenic headache (x±s, points)

    组别 例数 治疗前 治疗后
    治疗组 35 28.37±2.54 14.89±1.60a
    对照组 35 27.49±2.29 18.74±3.11a
    t 1.530 -6.522
    P 0.131 <0.001
    注:与同组治疗前比较, aP<0.05。
    下载: 导出CSV
  • [1] 董有康, 徐磊, 李桂平, 等. 从"筋"论刺治疗颈源性头痛思路探析[J]. 针灸临床杂志, 2019, 35(1): 75-77. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJLC201901020.htm

    DONG Y K, XU L, LI G P, et al. Exploration and Analysis of Cervicogenic Headache Treated by Acupuncture Based on Meridian Sinew Theory[J]. Journal of Clinical Acupuncture and Moxibustion, 2019, 35(1): 75-77. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJLC201901020.htm
    [2] 王正婷, 杨焕, 魏清琳. 基于"经筋理论"运用刃针治疗瘀阻脑络型颈源性头痛的临床研究[J]. 针灸临床杂志, 2022, 38(5): 19-23. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJLC202205005.htm

    WANG Z T, YANG H, WEI Q L. Clinical Study of Blade Needling in Treatment of Cervicogenic Headache Caused by Blood Stasis Obstructing Cervical Collaterals Based on 'Theory of Meridian Sinew[J]. Journal of Clinical Acupuncture and Moxibustion, 2022, 38(5): 19-23. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJLC202205005.htm
    [3] 刘腾飞, 王君, 夏卉睿. 电针配合加味葛根汤治疗颈源性头痛的临床观察[J]. 中医临床研究, 2022, 14(13): 55-58. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYLY202213014.htm

    LIU T F, WANG J, XIA H R. Clinical observation on treating cervical headache by electroacupuncture plus the Gegen decoction[J]. Clinical Journal Of Chinese Medicine, 2022, 14(13): 55-58. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYLY202213014.htm
    [4] SJAASTAD O, FREDRIKSEN T A, PFAFFENRATH V. Cervicogenic headache: diagnostic criteria[J]. Headache, 1998, 38(6): 442-445. doi: 10.1046/j.1526-4610.1998.3806442.x
    [5] 郎珈望, 郎伯旭, 罗建昌, 等. 郎伯旭教授运用"项八穴"治疗颈源性疾病临床经验[J]. 浙江中医药大学学报, 2020, 44(7): 668-672. https://www.cnki.com.cn/Article/CJFDTOTAL-BHON202007015.htm

    LANG J W, LANG B X, LUO J C, et al. Professor LANG Boxu's Clinical Experience in Treating Cervicogenic Diseases with"Eight Nape Points"[J]. Journal of Zhejiang Chinese Medical University, 2020, 44(7): 668-672. https://www.cnki.com.cn/Article/CJFDTOTAL-BHON202007015.htm
    [6] 万颖. 浮针配合悬吊运动治疗颈源性头痛临床研究[J]. 针灸临床杂志, 2019, 35(12): 18-22. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJLC201912005.htm

    WAN Y. Clinical Study of Floating Acupuncture Combined with Sling Exercise Training in Treating Cervical Headache[J]. Journal of Clinical Acupuncture and Moxibustion, 2019, 35(12): 18-22. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJLC201912005.htm
    [7] MELZACK R. The short-form mcgill pain questionnaire[J]. Pain, 1987, 30(2): 191-197. doi: 10.1016/0304-3959(87)91074-8
    [8] 伍少玲, 马超, 伍时玲, 等. 颈椎功能障碍指数量表的效度与信度研究[J]. 中国康复医学杂志, 2008, 23(7): 625-628. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGKF200807016.htm

    WU S L, MA C, WU S L, et al. Validity and reliability of the neck disability index for cervical spondylopathy patients[J]. Chinese Journal of Rehabilitation Medicine, 2008, 23(7): 625-628. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGKF200807016.htm
    [9] 皮铎波, 鲍骏侃, 朱沙利, 等. 细银针联合星状神经节阻滞治疗颈源性头痛的疗效观察[J]. 中国疼痛医学杂志, 2021, 27(9): 711-713. https://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ202109020.htm

    PI D B, BAO J K, ZHU S L, et al. Effect of fine silver needle combined with stellate ganglion block on cervical headache[J]. Chinese Journal of Pain Medicine, 2021, 27(9): 711-713. https://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ202109020.htm
    [10] 夏德鹏, 杜培学, 陈培芳, 等. 针灸治疗急性期颈源性头痛的疗效观察[J]. 中国中医急症, 2022, 31(3): 466-468. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJZ202203025.htm

    XIA D P, DU P X, CHEN P F, et al. Efficacy Observations of Acupuncture and Moxibustion in Treating Cervicogenic Headache[J]. Journal of Emergency in Traditional Chinese Medicine, 2022, 31(3): 466-468. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJZ202203025.htm
    [11] 胡正喜, 陈莉秋, 李新伟, 等. 浮针疗法配合再灌注活动治疗椎动脉型颈椎病的疗效观察[J]. 中华全科医学, 2018, 16(6): 1001-1003. doi: 10.16766/j.cnki.issn.1674-4152.000274

    HU Z X, CHEN L Q, LI X W, et al. Efficacy observation on cervical spondylosis of vertebral artery type treated by Fu's subcutaneous needling combined with reperfusion activity[J]. Chinese Journal of General Practice, 2018, 16(6): 1001-1003. doi: 10.16766/j.cnki.issn.1674-4152.000274
    [12] 彭志华, 杨丽霞, 胡翀妮, 等. 关刺法配合压痛点推拿治疗颈源性头痛临床疗效观察[J]. 贵州中医药大学学报, 2021, 43(6): 36-40, 45. https://www.cnki.com.cn/Article/CJFDTOTAL-GYZX202106009.htm

    PENG Z H, YANG L X, HU C N, et al. Clinical observation on the treatment of cervical headache by fascial acupuncture combined with massage of tender point[J]. Journal of Guizhou University of Traditional Chinese Medicine, 2021, 43(6): 36-40, 45. https://www.cnki.com.cn/Article/CJFDTOTAL-GYZX202106009.htm
    [13] 陈泽林, 何洪英, 李伟利, 等. 龙氏正骨手法配合浮针治疗颈源性头痛[J]. 广州医药, 2022, 53(4): 89-91, 95. https://www.cnki.com.cn/Article/CJFDTOTAL-GZYY202204020.htm

    CHEN Z L, HE H Y, LI W L, et al. Long's bone-setting manipulation combined with floating acupuncture therapy in the treatment of cervicogenic headache[J]. Guangzhou Medical Journal, 2022, 53(4): 89-91, 95. https://www.cnki.com.cn/Article/CJFDTOTAL-GZYY202204020.htm
    [14] 杨艳芳, 刘步平, 张美娟, 等. 并针疗法治疗颈源性头痛的临床疗效观察[J]. 广州中医药大学学报, 2022, 39(10): 2309-2314. https://www.cnki.com.cn/Article/CJFDTOTAL-REST202210016.htm

    YANG Y F, LIU B P, ZHANG M J, et al. Observation on Clinical Efficacy of Simultaneous Double-needle Acupuncture for the Treatment of Cervicogenic Headache[J]. Journal of Guangzhou University of Traditional Chinese Medicine, 2022, 39(10): 2309-2314. https://www.cnki.com.cn/Article/CJFDTOTAL-REST202210016.htm
    [15] 罗建昌, 郎伯旭. 针刺项八穴治疗枕大神经痛56例[J]. 中国针灸, 2020, 40(10): 1052-1054. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE202010008.htm

    LUO J C, LANG B X. Acupuncture at eight nape acupoints for 56 cases of greater occipital neuralgia[J]. Chinese Acupuncture & Moxibustion, 2020, 40(10): 1052-1054. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE202010008.htm
    [16] 黄英, 杜炜杰, 周东辉, 等. 中医综合方案治疗神经根型颈椎病的疗效及远期效果分析[J]. 中华全科医学, 2019, 17(11): 1914-1917. doi: 10.16766/j.cnki.issn.1674-4152.001089

    HUANG Y, DU W J, ZHOU D H, et al. Analysis of effect and long-term results of traditional Chinese medicine comprehensive treatment for cervical spondylotic radiculopathy[J]. Chinese Journal of General Practice, 2019, 17(11): 1914-1917. doi: 10.16766/j.cnki.issn.1674-4152.001089
    [17] 赵文, 张祥杰, 刘彬. 拔伸、点压手法配合针灸治疗颈源性头痛30例临床观察[J]. 中国民族民间医药, 2019, 28(22): 108-110. https://www.cnki.com.cn/Article/CJFDTOTAL-MZMJ201922031.htm

    ZHAO W, ZHANG X J, LIU B. Clinical Observation on 30 cases of Cervicogenic Headache Treated by Extubation, Point Pressing Manipulation and Acupuncture[J]. Chinese Journal of Ethnomedicine and Ethnopharmacy, 2019, 28(22): 108-110. https://www.cnki.com.cn/Article/CJFDTOTAL-MZMJ201922031.htm
    [18] 李志红. 颈椎手法复位与中频治疗颈源性头痛的疗效对比研究[J]. 实用中西医结合临床, 2019, 19(4): 121-122, 150. https://www.cnki.com.cn/Article/CJFDTOTAL-SZXL201904063.htm

    LI Z H. Comparative study on the efficacy of cervical manual reduction and intermediate frequency in the treatment of cervicogenic headache[J]. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine, 2019, 19(4): 121-122, 150. https://www.cnki.com.cn/Article/CJFDTOTAL-SZXL201904063.htm
    [19] 王少崭, 王国建, 李冰, 等. 针刺联合清宫正骨手法治疗颈源性头痛的临床研究[J]. 世界中西医结合杂志, 2020, 15(7): 1330-1333. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX202007037.htm

    WANG S Z, WANG G J, LI B, et al. Clinical Study of Acupuncture Combined with Qinggong Bone Setting Manipulation for Cervical Headache[J]. World Journal of Integrated Traditional and Western Medicine, 2020, 15(7): 1330-1333. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX202007037.htm
    [20] 衡墩前, 周卫星. 手法治疗颈源性头痛临床研究[J]. 按摩与康复医学, 2018, 9(14): 27-29. https://www.cnki.com.cn/Article/CJFDTOTAL-AMYD201814015.htm

    HENG D Q, ZHOU W X. Manipulative therapy for cervicogenic headache[J]. Chinese Manipulation and Rehabilitation Medicine, 2018, 9(14): 27-29. https://www.cnki.com.cn/Article/CJFDTOTAL-AMYD201814015.htm
    [21] 李志海, 韦建深, 刘洋, 等. 韦氏颈椎整复手法联合运动针法治疗颈源性头痛疗效观察[J]. 广西中医药, 2018, 41(4): 55-57. https://www.cnki.com.cn/Article/CJFDTOTAL-GXZY201804025.htm

    LI Z H, WEI J S, LIU Y, et al. Therapeutic Observation on Treatment for cervicogenic headache with Wei's Cervical Spine Reconstruction Manipulation and Interaction Acupuncture[J]. Guangxi Journal of Traditional Chinese Medicine, 2018, 41(4): 55-57. https://www.cnki.com.cn/Article/CJFDTOTAL-GXZY201804025.htm
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  • 收稿日期:  2023-01-09
  • 网络出版日期:  2023-08-26

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