摘要
目的:探究火针联合平刺透穴疗法治疗偏头痛的临床疗效.方法:将符合标准的122例偏头痛患者按照随机数字表分为对照组和观察组,各61例.两组均予以常规西医治疗,对照组采用平刺透穴疗法,观察组采用火针联合平刺透穴疗法,共治疗4周.比较两组患者治疗前后中医症候积分、临床症状(发作次数、持续时间与疼痛程度)、脑血管[大脑前、中、后动脉(ACA、MCA、PCA)与椎、基底动脉(VA、BA)]血流速度、血管内皮活性物质[五羟色胺(5-HT)、内皮素(ET)与一氧化氮(NO)]和神经炎性物质[P物质(SP)、β-内啡肽(β-EP)].结果:治疗4周后,两组中医症候积分、急性发作次数、持续时间、疼痛程度、各血管血流速度及血清ET及SP水平均降低,且观察组较对照组均更低(P＜0.05),两组血清5-HT、NO及β-EP水平均升高,且观察组较对照组均更高(P＜0.05).结论:火针联合平刺透穴疗法治疗偏头痛患者可有效缓解偏头痛急性发作,调节脑血管流速,其作用机制可能是通过上调5-HT、NO、β-EP水平、抑制ET和SP水平而实现.
Abstract
Objective:To explore clinical efficacy of fire needling combined with transverse needling through points in treatment of migraine.Methods:122 patients with migraine who met the criteria were randomly divided into the control group(n=61)and the observation group(n=61).Both groups were treated with conventional Western medication;on which basis,the control group was treated with transverse needling through points,whereas the observation group was treated with fire needling combined with transverse needling through points.The treatment duration was 4 weeks.TCM symptom scores,clinical symptoms(attack frequency,pain duration,pain degree),cerebrovascular blood flow velocity(ACA,MCA,PCA,VA,BA),vascular endothelial active substances(5-HT,ET,NO),neuroinflammatory substances(SP,β-EP)were compared between before and after the treatment in the two groups.Results:After 4 weeks of treatment,the scores of TCM symptoms,the number of acute attacks,the pain duration,the pain degree,the blood flow velocity of each blood vessel and the serum levels of ET and SP were decreased in the two groups,and the above indicators in the observation group were lower than those in the control group(P＜0.05).The serum levels of 5-HT,NO and β-EP were increased after the treatment in the two groups,which were higher in the observation group than those in the control group(P＜0.05).Conclusion:The therapy of fire needling combined with transverse needling through points can effectively alleviate the acute attack of migraine and regulate the cerebral blood flow velocity in treatment of migraine,and its mechanism may be through up-regulating the levels of 5-HT,NO and β-EP and inhibiting the levels of ET and SP.
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