發(fā)布時(shí)間：2018-01-02 07:04

  本文關(guān)鍵詞：偏頭痛急性期不同神經(jīng)分布區(qū)穴位的針刺鎮(zhèn)痛效應(yīng)　出處：《南京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 偏頭痛急性期 針刺鎮(zhèn)痛 神經(jīng)分布區(qū) 神經(jīng)通路

【摘要】：目的：比較三叉神經(jīng)分布區(qū)和枕神經(jīng)分布區(qū)穴位的針刺鎮(zhèn)痛效應(yīng),觀察其針刺鎮(zhèn)痛效應(yīng)的相對特異性,并探索其神經(jīng)通路機(jī)制,為偏頭痛急性期的針灸治療提供一種優(yōu)化方案。方法：將符合標(biāo)準(zhǔn)的60例患者隨機(jī)分為2組,A組采用排針平刺枕神經(jīng)分布區(qū)穴位,針刺腦空透風(fēng)池,左右各排2針,腦空透風(fēng)府左右各排1針,進(jìn)針1寸,留針2h；B組針刺三叉神經(jīng)分布區(qū)穴位,頭維透魚腰、頷厭透絲竹空、懸顱透太陽、懸厘透瞳子修、曲鬢透上關(guān)、進(jìn)針1寸,聯(lián)合常規(guī)針刺三孔穴(魚腰、四白、夾承漿),留針2h,記錄針刺前、針刺即刻、針刺后10min、20min、30min、40min、50min、1h、2h的VAS評分,以及針刺2h后頭痛緩解50%以上的部位,比較A、B兩組的疼痛緩解情況,以及疼痛部位的緩解情況,比較不同神經(jīng)分布區(qū)針刺鎮(zhèn)痛效應(yīng)的特異性。結(jié)果：A組患者針刺40min內(nèi),VAS評分與上一時(shí)點(diǎn)比較,P0.05,有統(tǒng)計(jì)學(xué)意義,40min后P0.05,無統(tǒng)計(jì)學(xué)意義；B組患者針刺50min內(nèi),VAS評分與上一時(shí)點(diǎn)比較,P0.05,有統(tǒng)計(jì)學(xué)意義,50min后P0.05,無統(tǒng)計(jì)學(xué)意義；兩組針刺頭痛緩解程度比較,只有在針刺即刻P0.05,有統(tǒng)計(jì)學(xué)意義,其后的每一個(gè)時(shí)間段內(nèi),均為P0.05,無統(tǒng)計(jì)學(xué)意義。兩組患者頭痛部位緩解情況比較,枕部、前額部、顳部、眼眶周圍為發(fā)作頻率較高的4個(gè)部位,A組針刺2h后的緩解率依次為：80%、41.7%、75%、46.4%,B組針刺2h后的緩解率依次為：0、71.4%、73.7%、81%結(jié)論：1.針刺枕神經(jīng)分布區(qū)穴位相對三叉神經(jīng)分布區(qū)穴位而言,針刺鎮(zhèn)痛效應(yīng)較快,且即刻療效較佳,針刺即刻后兩組之間的鎮(zhèn)痛療效并無明顯差異,提示枕神經(jīng)分布區(qū)穴位的上位通路相仃對較短。2.針刺不同神經(jīng)分布區(qū)穴位可以緩解相應(yīng)神經(jīng)分布區(qū)的疼痛,提示偏頭痛急性期不同神經(jīng)分布區(qū)穴位針刺鎮(zhèn)痛效應(yīng)具有特異性。
[Abstract]:Objective: to compare the acupuncture analgesia effect of trigeminal nerve distribution and occipital nerve distribution, observe the relative specificity of acupuncture analgesia effect, and explore the mechanism of nerve pathway. Methods: 60 patients with acute migraine were randomly divided into two groups: group A was treated with acupuncture at the point point of occipital nerve distribution and acupuncture at the empty-ventilated cistern of the brain. 2 needles in each row, 1 needle in each row, 1 pin in each row, and 2 hours in needle; Group B acupuncture trigeminal nerve distribution area acupoints, head through the fish waist, the chin is tired of penetrating silk bamboo empty, suspending the sun, suspending the pupil repair, curly sideburns through the Shangguan, into the needle 1 inch, combined with conventional acupuncture three holes (fish waist, four white). The VAS scores were recorded before acupuncture, immediately after acupuncture, and 10 minutes after acupuncture for 30 minutes, 40 minutes, 50 minutes and 1 hour and 2 hours after acupuncture. The pain relief and pain relief in group A and B were compared after 2 hours of acupuncture and more than 50% relief of headache. Results the score of VAS in group A was significantly higher than that in group A (P 0.05) within 40 minutes after acupuncture. After 40 minutes, P0.05 had no statistical significance. In group B, the score of VAS in 50 minutes after acupuncture was significantly higher than that at the last time point (P0.05), but there was no statistical significance after 50 min of acupuncture. Two groups acupuncture headache relief degree comparison, only in the acupuncture immediate P0.05, has the statistical significance, after each time period, is all P0.05. There was no significant difference between the two groups. The remission rate of occipital part, frontal part, temporal part and periorbital part of group A was 80% 2 hours after acupuncture. The remission rate of group B was 73.7% after acupuncture for 2 hours. Conclusion 1. The analgesic effect of acupuncture on occipital nerve distribution area is faster than that of trigeminal nerve distribution area, and the immediate effect is better. There is no significant difference in analgesic effect between the two groups immediately after acupuncture. The results suggest that the epistatic pathway of occipital nerve distribution area is shorter. 2.Acupuncture at different nerve distribution areas can relieve the pain in the corresponding nerve distribution area. The results suggest that the analgesic effect of acupuncture at different nerve distribution areas in acute stage of migraine is specific.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.6

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