【摘要】：目的:比較運用大接經(jīng)刺血療法及普通針刺法對血管神經(jīng)性頭痛的臨床療效差異,以期驗證大接經(jīng)刺血療法治療血管神經(jīng)性頭痛的可行性。方法:選取2014年11月至2016年12月于大連醫(yī)科大學(xué)附屬第二醫(yī)院針灸門診確定診斷為肝陽上亢型血管神經(jīng)性頭痛患者共60例,隨機分成3組,分別為普通針刺組、普通針刺聯(lián)合大接經(jīng)刺血療法組、普通針刺聯(lián)合阿是穴刺血療法組,每組均為20例,其中普通針刺組(A)入組20例,脫落1例,共19例;普通針刺聯(lián)合大接經(jīng)刺血療法組(B)入組20例,脫落3例,共17例;普通針刺聯(lián)合阿是穴刺血療法組(C)入組20例,脫落4例,共16例。普通針刺組頭部取百會、四神聰、太陽、角孫等穴位,使用捻轉(zhuǎn)平補平瀉手法;風(fēng)池穴向鼻尖方向斜刺,采用捻轉(zhuǎn)平補平瀉手法。遠端穴位如太沖、足臨泣、行間施提插捻轉(zhuǎn)瀉法;太溪行平補平瀉手法。大接經(jīng)刺血療法組和阿是穴刺血療法組針刺取穴與普通針刺組相同,大接經(jīng)刺血療法取十二井穴,按照經(jīng)絡(luò)流注順序依次刺血;阿是穴刺血療法則是在頭部選取阿是穴施刺血療法,每個穴位放血量約為3-5滴,放血結(jié)束后用消毒干棉球按壓針孔3-5min直至血液不再流出。三組患者分別于治療前后進行頭痛綜合評分,治療前后采用“視覺模擬疼痛評分”(Visual Analogue Scale,VAS)法,并分別評價疼痛程度、發(fā)作次數(shù)、持續(xù)時間、伴隨癥狀、中醫(yī)證候的變化,計算出療效指數(shù),對三組的療效予以評價。將收集的數(shù)據(jù)建立數(shù)據(jù)庫,采用SPSS20.0統(tǒng)計學(xué)軟件進行數(shù)據(jù)分析,對計量資料以均數(shù)±標(biāo)準(zhǔn)差(SX±)表示。計數(shù)資料采用x2檢驗;三組之間計量資料的比較應(yīng)用單因素方差分析,兩兩比較選用LSD-t檢驗;各組治療前后變量差異應(yīng)用配對t檢驗;對比三組治療療效采用非參數(shù)秩和檢驗,P值若0.05則表示差異具有統(tǒng)計學(xué)意義。結(jié)果:通過對三個治療組治療前后疼痛程度、發(fā)作次數(shù)、持續(xù)時間變化及中醫(yī)證候評分的變化的比較,結(jié)果表明,三組治療方法對改善血管神經(jīng)性頭痛的癥狀均有臨床療效;而大接經(jīng)刺血療法組從臨床療效上看,明顯高于其他兩組;其中阿是穴刺血療法組相比于普通針刺組療效更優(yōu)(P0.05)。大接經(jīng)刺血療法組為94.1%,阿是穴刺血療法組為56.3%,普通針刺組為15.8%。從中醫(yī)證候療效總有效率上看,大接經(jīng)刺血療法組為94.1%,阿是穴刺血療法組為87.5%,普通針刺組為84.2%,說明大接經(jīng)刺血療法組療效優(yōu)于阿是穴刺血療法組和普通針刺組(P0.05)。從治療后疼痛程度、發(fā)作次數(shù)、持續(xù)時間評分變化看,大接經(jīng)刺血療法組與阿是穴刺血療法組和普通針刺組比較,差異也有顯著性意義(P0.05)。結(jié)論:1.大接經(jīng)刺血療法治療血管神經(jīng)性頭痛的療效明顯優(yōu)于其他兩組,大接經(jīng)刺血療法能顯著減輕/緩解頭痛癥狀及減少疼痛持續(xù)時間。2.大接經(jīng)刺血療法治療血管神經(jīng)性頭痛的理論思路與形式是正確可行的。
[Abstract]:Objective: to compare the clinical curative effect of the treatment of vascular and neurotic headache with the blood acupuncture therapy and the common acupuncture method, so as to verify the feasibility of the treatment of vascular nerve headache by the blood acupuncture therapy. Methods: from November 2014 to December 2016, 60 patients diagnosed as hyperactive vascular and neurotic headache of liver yang were selected from the second affiliated Hospital of Dalian Medical University. The patients were randomly divided into 3 groups: normal acupuncture group. There were 20 cases in each group, 20 cases in each group. Among them, 20 cases were (A) in group A and 19 cases in group A (1 case). There were 20 cases of (B), 3 cases of shedding and 16 cases of (C) in the group of common acupuncture combined with Ashi-acupoint blood acupuncture, 4 cases of shedding. In the common acupuncture group, Baihui, Sishen Cong, Sun, Jiao Sun and other acupoints were taken, and the points of Fengchi were slanted in the direction of nose tip, and the techniques of twisting flat and reinforcing flat diarrhea were used. Distal points such as Taochong, sobbing feet, between the implementation of twirling and diarrhea; Taixi Pingbu flat reduction technique. The acupoints in the treatment group were the same as those in the common acupuncture group, and the twelve well points in the treatment group were pricked according to the sequence of meridian blood flow. Ashi point pricking blood therapy is to select Ashi point in the head to apply pricking blood therapy, each point bleeding volume is about 3-5 drops, after bleeding with disinfectant dry cotton ball pressing pinhole 3-5min until no blood flow out. The patients in the three groups were given headache comprehensive score before and after treatment, and before and after treatment with "visual analogue pain score" (Visual Analogue Scale,VAS) method, and to evaluate the degree of pain, attack times, duration, accompanying symptoms, changes of TCM syndromes, respectively. The curative effect index was calculated and the curative effect of the three groups was evaluated. The collected data were set up and the data were analyzed by SPSS20.0 software. The measurement data were expressed as mean 鹵standard deviation (SX 鹵). The counting data were measured by x2 test, the three groups were compared by univariate ANOVA, and by LSD-t test, the difference of variables before and after treatment was matched t test. Compared with the three groups, the nonparametric rank sum test (P = 0.05) indicated the difference was statistically significant. Results: by comparing the changes of pain degree, attack frequency, duration and TCM syndrome score before and after treatment in the three treatment groups, the results showed that the three treatment methods had clinical effect on improving the symptoms of vascular and neurotic headache. The clinical efficacy of the treatment group was significantly higher than that of the other two groups; the Ashi acupoint pricking blood therapy group was better than the common acupuncture group (P0.05). It was 94.1 in the treatment group, 56.3 in the Ashi acupoint pricking blood therapy group and 15.8in the common acupuncture group. From the point of view of the total effective rate of TCM syndromes, the treatment group was 94.1, the Ashi acupoint pricking blood therapy group was 87.5, the common acupuncture group was 84.2 points, which indicated that the treatment group was superior to the Ashi acupoint pricking blood therapy group and the common acupuncture group (P0.05). According to the changes of pain degree, attack frequency and duration after treatment, there were significant differences between the treatment group and the Ashi point pricking blood therapy group and the general acupuncture group (P0.05). Conclusion 1. The therapeutic effect of the treatment of vascular and neurogenic headache was obviously better than that of the other two groups. The theory and form of the treatment of vascular and neurotic headache by blood-acupuncture therapy are correct and feasible.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.6

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