针刺少阳经特定穴治疗偏头痛急性发作即时效应不同时程即时总体疗效缓解率评定的观察

目的 观察针刺刺少阳经特定穴治疗偏头痛急性发作即时效应不同时程即时总体疗效缓解率,评价其临床疗效.方法 采用随机、对照、单盲的研究方法,将符合纳入标准的90例偏头痛患者分为治疗组A组(少阳经特定穴组)、对照组B组(非经非穴1组)和对照组C组(非经非穴2组),每组各30例,均针刺治疗30 min.分别记录患者治疗前和治疗后0.5,2,4,24h的视觉模拟评分(VAS评分)和头痛强度,以判定即时疗效.结果 少阳经特定穴组24h完全缓解率明显高于非经非穴1组(P＜0.01),各时相缓解率均高于非经非穴2组(P＜0.01).结论 针刺少阳经特定穴能有效缓解偏头痛的急性发作,即时疗效明显优于非经非穴,值得进一步推广应用.     

针刺少阳经特定穴对偏头痛患者近期VAS评分头痛强度及MSQ评分的临床观察

目的 观察针刺少阳经特定穴对偏头痛患者近期视觉模拟评分(Visual analogue scale,VAS)、头痛强度及近期偏头痛生活品质问卷(Migraine specific quality of life questionnaire,MSQ)量表计分的影响.方法 将60例偏头痛患者随机分为治疗组和对照组,每组30例.治疗组针刺角孙、外关、阳陵泉、丘墟穴,对照组针刺非经非穴,每次治疗30 min,每周5次,共治疗4周,观察治疗前后两组患者偏头痛强度、VAS评分、MSQ量表计分等指标变化,判断两组近期临床疗效.结果 与对照组相比,治疗组疗效比较差异有统计学意义(P＜0.01),治疗组VAS计分、头痛强度比较差异均有统计学意义(P＜0.01),治疗组功能受限、功能障碍、情感评分比较差异均有统计学意义(P＜0.01).结论 针刺少阳经特定穴对偏头痛患者有明显近期疗效,能改善患者的临床症状及生活质量,疗效优于针刺非经非穴.     

针刺少阳经特定穴对慢性偏头痛患者脑神经元代谢影响的研究

目的:探求针刺少阳经特定穴对慢性偏头痛病人脑神经元代谢的影响。方法:慢性偏头痛病人60例,随机分为治疗组治疗组30例,针刺少阳经特定穴;对照组30例,针刺非经非穴。两组病人均在针刺治疗前后进行头痛程度评估、PAG区1H-MRS分析。结果:经针刺治疗后,治疗组较对照组头痛程度减轻,(P0.05);针刺治疗后,治疗组较对照组PAG区NAA/Cr升高,(P0.05),两组病人针刺治疗前后PAG区Cho/Cr均无明显差异(P0.05)。结论:慢性偏头痛病人经针刺少阳经特定穴后PAG区存在神经元代谢活化,可能逆转PAG区异常减弱的疼痛抑制功能。     

针刺少阳经特定穴对偏头痛患者脑动脉血流速度的影响

目的观察针刺手少阳三焦经和足少阳胆经特定穴对偏头痛患者脑血流速度的影响，并探讨其可能的作用机制。方法将60例偏头痛患者随机分为两组，少阳经特定穴组30例，非经非穴组30例，均采取同样的针刺治疗方法，进行对照观察。在TCD的显示下，分别记录针刺前后的脑动脉血流速度。结果针刺少阳经特定穴组的患者脑血流速度明显改善，而非经非穴对照组未见有明显改变，经统计学处理两组有统计学意义（P〈0．05）。结论针刺少阳经特定穴对偏头痛患者的脑动脉血流速度有较好双向调节作用。     

针刺透穴法治疗肝阳上亢型偏头痛疗效观察

目的 观察针刺透穴法治疗肝阳上亢型偏头痛的临床疗效.方法 将60例患者随机分为针刺透穴组和常规针刺组各30例.2组治疗前后分别进行头痛综合评分,比较2种治疗方法对肝阳上亢型偏头痛患者各个治疗阶段头痛综合评分的影响,分析2种方法对肝阳上亢型偏头痛的疗效.结果 针刺透穴组和常规针刺组治疗后偏头痛综合评分较治疗前均有明显改善(P＜0.05),2组间疗效分别为93.33％和83.33％,经统计学处理疗效无显著性差异(P＞0.05);但2组在治疗5次和10次后对偏头痛综合评分的改善程度比较,差异具有统计学意义(P＜0.05),均是针刺透穴组优于常规针刺组;2组治疗结束后3个月随访偏头痛综合评分与疗程刚结束时比较差异无统计学意义(P＞0.05),即治疗结束后3个月2组的患者情况稳定.结论 针刺透穴法和常规针刺法均可有效治疗肝阳上亢型偏头痛,而且远期疗效稳定.但治疗初期针刺透穴法疗效更明显.     

本经取穴治疗肝阳上亢型无先兆偏头痛的疗效评价研究

目的评价本经取穴及非经非穴治疗肝阳上亢型无先兆偏头痛的疗效差异。方法将28例肝阳上亢型无先兆偏头痛患者随机分成两组,经穴组14例,针刺患侧角孙、外关、阳陵泉及丘墟四穴,非经非穴组14例,针刺患侧四个非经非穴点,两组均每天治疗1次,共10次,治疗前后及入组3个月分别以视觉/直观模拟量表(Visual Analogue Scale,VAS)及偏头痛患者生活品质问卷(MSQ)评价。结果 (l)近期疗效:两组头痛VAS计分、MSQ计分治疗后明显优于治疗前(P<0.05),治疗后两组间比较显示,经穴组VAS计分、MSQ计分均优于非经非穴组(P<0.05);(2)远期疗效:入组3个月随访经穴组VAS计分、MSQ计分均优于治疗前(P<0.05),非经非穴组则与治疗前无差异(P>0.05)。结论该经取穴治疗肝阳上亢型无先兆偏头痛的即时、远期疗效均优于非经非穴组。     

针刺少阳经特定穴治疗偏头痛的临床疗效观察

目的:评估针刺少阳经特定穴治疗无先兆偏头痛的临床疗效。方法:将符合纳入标准的90名无先兆偏头痛受试者,随机分为少阳经特定穴组(真穴组)、非经非穴组(假穴组)和等待治疗组(等待组),分别给予真穴组和假穴组为期4周20次针刺治疗,而等待组观察4周不予治疗,以头痛天数为主要评价指标,以头痛对生活质量、情绪影响为次要指标,评估针刺镇痛的临床疗效和安全性。结果:头痛天数真穴组明显减少(4.11±2.24)天,假穴组无显著改善(0.53±3.16)天,等待组增加(-4.40±4.38)天,真穴组对头痛天数的改善优于假穴组与等待组。偏头痛生活品质问卷评分(MSQ)与抑郁情绪的改善,真穴组优于假穴组与等待组。结论:针刺少阳经特定穴治疗偏头痛的临床疗效优于非经非穴和等待治疗。     

电针针刺锥体区治疗偏头痛临床研究

目的观察电针针刺锥体区治疗偏头痛的临床疗效。方法采用随机数字表法将120例偏头痛患者分为锥体区组、常规针灸组、西药组、非经非穴组各30例。锥体区组针刺锥体区(玉枕至天柱连线),常规针灸组双侧常规取穴,非经非穴组针刺锥体区旁开2寸,均予电针,8~20 m A,2/100 Hz疏密波,每次30 min,每日1次;西药组予双氯芬酸钠肠溶片,每次50 mg,每日2次,口服。均连续治疗10 d。观察治疗前后视觉模拟评分法(VAS)评分、中医症状积分、焦虑自评量表评分(SAS)和抑郁自评量表评分(SDS),分析临床疗效。结果锥体区组总有效率为93.33%,明显优于常规针灸组(86.67%)、西药组(70.00%)和非经非穴组(63.33%),差异有统计学意义(χ2=24.440,P=0.004)。与本组治疗前比较,4组治疗后VAS评分、中医症状积分均明显下降(P0.05)。锥体区组治疗后VAS评分明显低于其他3组(P0.05),中医症状积分明显低于西药组及非经非穴组(P0.05)。与本组治疗前比较,非经非穴组SDS评分及其他3组的SAS、SDS评分均明显降低,差异有统计学意义(P0.05),锥体区组治疗后SAS、SDS评分明显低于其他3组(P0.05)。结论电针针刺锥体区治疗偏头痛疗效显著,可减少不良情绪的发生。     

针刺少阳经穴联合颈肩部走罐治疗偏头痛的临床疗效观察（英文）

目的:观察针刺少阳经穴联合颈肩部走罐治疗偏头痛的临床疗效。方法:将64例患者按随机数字表法分为观察组和对照组,每组32例。观察组予针刺少阳经穴联合颈肩部走罐治疗,每星期针刺5次,走罐1次;对照组予口服盐酸氟桂利嗪胶囊,10 mg/次,1次/d。两组均以治疗2个星期为1个疗程,共治疗2个疗程。观察治疗前后视觉模拟量表(VAS)评分及偏头痛残疾程度评估问卷(MIDAS)评分,并比较临床疗效。结果:观察组的总有效率及愈显率分别为93.8%和71.9%,高于对照组的78.1%和43.8%,组间差异均有统计学意义(均P0.05)。治疗后两组的VAS及MIDAS评分均下降,与本组治疗前差异有统计学意义(均P0.05),两组间差异亦有统计学意义(均P0.05)。结论:针刺少阳经穴联合颈肩部走罐治疗偏头痛疗效确切,能减轻患者疼痛,降低偏头痛对生活的影响,其疗效优于口服盐酸氟桂利嗪胶囊。     

基于推拿治疗偏头痛随机对照试验的枢经特异性研究

目的:评价推拿少阳经、阳明经、太阳经、非经非穴治疗偏头痛疗效的差异。方法:将160例偏头痛患者随机分为4组,每组40例,少阳经推拿组、阳明经推拿组和太阳经推拿组分别在相应经脉上进行推拿,非经非穴推拿组在少阳经旁开1寸处进行推拿,观察患者治疗前后症候积分,颅内动脉平均血流速度,评价各组临床疗效。结果:治疗30 d后,少阳经组各条动脉平均血流速度较治疗均前减缓(P0.05),阳明经组R-MCA、R-ACA、L-ACA平均血流速度较治疗前减缓(P0.05),太阳经组R-ACA、L-ACA、LPCA、BA平均血流速度较治疗前减缓(P0.05),非经非穴组RMCA和R-PCA平均血流速度较治疗前减缓(P0.05);少阳经组治疗后各动脉平均血流速度较其他3组低(P0.05);4组患者临床症状积分较治疗前均有改善(P0.05),少阳经组与其他3组比较临床症状积分降低幅大(P0.05)。结论:推拿少阳经穴位较推拿阳明经、太阳经和非经非穴能更有效改善偏头痛患者颅内血流速度和临床症状,初步论证少阳经治疗偏头痛具有特异性。     

辨经刺井结合"三风一针"对无先兆偏头痛急性期即时镇痛及脑血流速的影响

目的观察辨经刺井结合“三风一针”对无先兆偏头痛患者急性期即时镇痛及脑血流速的影响。方法将60例无先兆偏头痛急性期患者随机分为治疗组和对照组。观察组采用辨经刺井穴结合“三风一针”透刺治疗,对照组予以常规针刺治疗。对比分析两组患者治疗前和治疗后各时间节点视觉模拟评分(VAS)评分值。对比分析两组无先兆偏头痛急性期经络辨证分型头痛治疗前及治疗后30 min时间节点VAS评分值。对比分析两组患者治疗前后基底动脉(BA)、双侧椎动脉颅内段(VA)、双侧大脑中动脉(MCA)、双侧大脑前动脉(ACA)、双侧大脑后动脉(PCA)的平均流速值(MFV)。结果观察组患者各时间节点VAS评分均低于对照组(P<0.05)。观察组各经头痛VAS分值均低于对照组(P<0.05)。观察组患者MCA、PCA、BA、VA的MFV改善显著优于对照组(P<0.05),对ACA的MFV改善方面两者差异无统计学意义(P>0.05)。结论辨经刺井结合“三风一针”透刺法对急性期无先兆偏头痛患者有较好即时镇痛作用,并可改善患者脑血流速度。     

毫火针宣通法治疗偏头痛疗效观察

目的:观察毫火针宣通法治疗偏头痛的临床疗效。方法:将90例偏头痛患者随机分为对照组和治疗组。对照组患者口服盐酸氟桂利嗪胶囊,治疗组在对照组基础上给予毫火针宣通法治疗,治疗4周。比较两组治疗前后视觉模拟评分法(VAS)评分、头痛持续时间、中度以上头痛发作天数、偏头痛特异生活质量问卷(MSQ)、焦虑自评量表(SAS)、抑郁自评量表(SDS)。结果:治疗4周后,治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前两组患者头痛持续时间、中度以上头痛发作天数及VAS、MSQ、SAS、SDS评分比较,差异无统计学意义(均P>0.05)。两组患者治疗4周后、治疗后1个月、治疗后3个月头痛持续时间,中度以上头痛发作天数及VAS、SAS、SDS评分均降低,MSQ评分则升高,差异有统计学意义(均P<0.05)。治疗组各时间点头痛持续时间、中度以上头痛发作天数及VAS、SAS、SDS评分均低于对照组,MSQ评分高于对照组,差异有统计学意义(均P<0.05)。结论:毫火针宣通法治疗偏头痛疗效较好,可减轻患者疼痛,缩短疼痛持续时间,减少疼痛发作天数,提高患者生活质量。     

Study of electroacupuncture with different frequencies for the treatment of headache and anxiety-depression symptoms in patients with migraine: A randomized clinical trial: 不同频率电针改善偏头痛患者头痛及焦虑抑郁症状的差异性研究-随机临床试验

ObjectiveTo observe the effects of electroacupuncture (EA) with varied frequencies on headache and anxiety-depression symptoms in patients with migraine and to screen optimal frequency of EA for patients with such conditions.DesignSingle-center, randomized, controlled clinical trial was designed, and the outcome assessors and statisticians were blinded. The patients with migraine were randomized into 2 Hz EA group, 100 Hz EA group and sham-stimulation group. In each group, the changes in migraine attacks, days with headache, the scores of visual analogy scale (VAS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and migraine-specific quality-of-life questionnaire (MSQ), as well as the dosage of analgesics were observed at the baseline, during treatment, in 1, 2 and 3 months of follow-up separately.SettingPatients were enrolled in the Third Affiliated Hospital of Zhejiang Chinese Medical University, between 1^st August 2018 and 31^st July 2021.ParticipantsSixty-five migraine patients with or without aura.InterventionsIn the EA groups, the acupoints were bilateral Fengchi (GB20), Gongxue (Extra), Sizhukong (TE23), Taiyang (EX-HN5), Shuaigu (GB8), Waiguan (TE5) and Yanglingquan (GB34). Electric stimulation was exerted at GB20 and Gongxue (Extra), with 2 Hz and 100 Hz separately. In the sham-stimulation group, the shallow acupuncture was operated at the sites 1 cm lateral to GB20 and Gongxue (Extra), and on the radial side of TE5 and GB34. The output wires were cut off after attached to the acupoints. The patients in each group received the treatment 3 times weekly, once every two days, for consecutive 4 weeks. The complete intervention was composed of 12 treatments.Main outcome measuresChanges in numbers of migraine attacks at treatment phase (week 1 to week 4) from the baseline(week -4 to week 0) in patients of each groupResults(1) Changes in migraine attacks and days with headache: In the 2 Hz EA and 100 Hz EA groups, the changes for migraine attacks and days of headache were higher significantly when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (2) Changes of VAS score: In the 2 Hz EA and 100 Hz EA groups, the changes of VAS score were significantly higher when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (3) Assessment of anxiety and depression: The differences in the changes of SAS and SDS scores had no statistical significance in patients of each group at each assessment stage (P > 0.05). (4) Assessment on the quality of life: Compared with the sham-stimulation group at the same time stage, the improvement in MSQ score was increased significantly during treatment in patients of the 2 Hz EA and 100 Hz groups (P < 0.05). There was no statistical difference between two EA groups. (5) Assessment on safety and compliance: The patients of each group had sound compliance. There was no adverse events during trial, suggesting promising safety of treatment.ConclusionEA may effectively reduce the migraine attacks, and the days and intensity of headache, presenting promising safety. However, there was no significant improvement on anxiety-depression symptoms, and no significant difference between high and low frequencies of EA treatment in relieving headache and anxiety/depression symptoms in the patients with migraine.Trial registrationChiCTR1800017259     

Clinical observation on acupuncture at points of Shaoyang meridians plus moving cupping on the neck and shoulder for migraine

Objective

To observe the efficacy of acupuncture at points of Shaoyang meridians plus moving cupping on neck and shoulder for migraine.

Methods

A total of 64 migraine cases were randomly allocated into an observation group and a control group, 32 cases in each group. Random number table method was used in allocation. Acupuncture at points of Shaoyang meridians and cupping on neck and shoulder were used for cases in the observation group, which contain acupuncture 5 times a week and cupping once a week. Oral flunarizine hydrochloride capsules were used for cases in the control group, 10 mg for each dose, 1 dose a day. 2 weeks constitutes a course of treatment. The patients were treated for two courses of treatment in both groups. After that, the changes of visual analogue scale (VAS) and the migraine disability assessment questionnaire (MIDAS) were observed, as well as the clinical efficacy.

Results

The total effective rate and recovery and marked effective rate in the observation group were 93.8% and 71.0% respectively, versus 78.1% and 43.8% in the control group, showing statistical significant differences (both P<0.05). There were significant decreases in VAS and MIDAS scores after treatments in both groups (both P<0.05). VAS and MIDAS scores in the observation group were significantly different from those in the control group (both P<0.05).

Conclusion

Combining acupuncture at points of Shaoyang meridians and cupping on neck and shoulder can relieve headache and reduce influence of migraine on life. It can produce a better efficacy than oral flunarizine hydrochloride capsules in treating migraine patients.

     

针刺治疗偏头痛急性发作疗效观察

目的观察针刺治疗偏头痛急性发作的临床镇痛疗效。方法将142例偏头痛患者随机分为治疗组和对照组,每组71例。治疗组采用针刺治疗,对照组采用口服镇痛药治疗,比较两组治疗前后头痛VAS计分及VAS加权值。结果治疗前后两组组内VAS计分比较,差异均有统计学意义（P〈0.05）,治疗组治疗后VAS计分及治疗前后VAS计分差值与对照组比较,差异均有统计学意义（P〈0.05）;治疗组总有效率为95.6%,对照组总有效率为89.9%,两组比较差异有统计学意义（P〈0.05）。结论针刺治疗偏头痛急性发作止痛效果佳,镇痛疗效优于口服镇痛药。     

足三阳经循经井穴刺血治疗偏头痛临床研究

目的:观察足三阳经循经井穴刺血法治疗偏头痛的临床疗效。方法:选取符合纳入标准的70例偏头痛患者作为研究对象,按数字奇偶法分为2组各35例。对照组给予常规针刺治疗,研究组在对照组治疗方案的基础上给予足三阳经循经井穴刺血治疗。观察2组治疗前后疼痛视觉模拟评分法(VAS)评分、偏头痛综合评分及临床疗效。结果:2组疼痛VAS评分、偏头痛综合评分治疗前后比较,差异均有统计学意义(P<0.01);治疗后研究组疼痛VAS评分、偏头痛综合评分均明显低于对照组,差异均有统计学意义(P<0.01)。临床疗效总有效率研究组91.43%,对照组80.00%,2组比较,差异无统计意义(P>0.05)。结论:相较于单纯常规针刺治疗,加用足三阳经循经井穴刺血治疗镇痛效果更佳。     

EFFECTS OF LONG-TERM ACUPUNCTURE TREATMENT ON RESTING-STATE BRAIN ACTIVITY IN MIGRAINE PATIENTS:A COMPARATIVE STUDY ON ACTIVE ACUPOINTS AND INACTIVE ACUPOINTS

Objective: Acupuncture has been commonly used for preventing attacks and relieving pain, although there is limited knowledgeon the physiological mechanism behind this method.The objectives of this study were to compare the differences in brain activities evoked by active acupoints and inactive acupoints and to investigate the possible correlation between clinical efficacy and brain responses.Methods: Eighty migraineurs without aura were enrolled to receive either active acupoint acupuncture or inactive acupoint acupuncture treatment for 8 weeks.Twenty patients in each group were randomly selected for a resting-state fMRI examination.The treatment schedule lasted for 8 weeks.VAS score, frequency of the migraine attack, number of days with migraine, and HIT-6 score were employed to evaluate the efficacy of acupuncture treatment, and ReHo value was used to detect brain activity.Results: The decrease in the VAS score in the active acupoint group was significantly greater than that in the control group after treatment(P0.05).However, there were no significant differences between the two groups in others(P0.05).The neuroimaging data indicated that long-term active acupoint therapy elicited a more extensive and remarkable cerebral response compared with acupuncture at inactive acupoints.The decrease in the VAS score was significantly related to the increased average ReHo values in the ACC in the two groups(P=0.0020, P=0.0015).Moreover, the decrease in the VAS score was associated with the increased average ReHo values in the insula(P=0.0003), and SMA(P=0.0130), which could be detected in the active acupoint group.Conclusion: Active acupoints were significantly superior to inactive acupoints in alleviating pain intensity for migraineurs.The efficacy of acupuncture at active acupoints might result partly from regulating some disease-affected key regions and the pain circuitry for migraine, promoting reintegration of several dimensions of the inner body, and establishing psychophysical pain homeostasis.     

川芎清脑颗粒联合氟桂利嗪对比单用氟桂利嗪治疗偏头痛疗效和安全性的Meta分析

目的:系统评价川芎清脑颗粒联合氟桂利嗪对比单用氟桂利嗪治疗偏头痛的疗效和安全性。方法:计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、EMbase、The Cochrane Library,搜集川芎清脑颗粒联合氟桂利嗪对比单用氟桂利嗪治疗偏头痛的随机对照试验(RCT)。筛选文献、提取资料后采用Jadad量表对纳入文献进行治疗评价,采用RevMan5.3软件对治疗总有效率、头痛程度视觉模拟评分(Visual Ana logue Score,VAS)及不良反应反生率等指标进行Meta分析。结果:共纳入9项RCT,共计883例患者。Meta分析结果显示:试验组治疗有效率[RR=1.20,95%CI(1.13,1.28),P<0.001]优于对照组,差异有统计学意义;治疗后患者头痛程度(VAS)评分[MD=-1.41,95%CI(-2.02,-0.81),P<0.001]低于单用氟桂利嗪,差异有统计学意义;两组比较不良反应发生率[OR=0.84,95%CI(0.28,2.56),P=0.76],差异无统计学意义(P>0.05)。结论:川芎清脑颗粒联合氟桂利嗪治疗偏头痛的疗效显著优于单用氟桂利嗪,在安全性方面二者没有差异。     

壮医药线点灸治疗偏头痛疗效观察

目的:观察壮医药线点灸治疗偏头痛的疗效和不良反应。方法:将120例偏头痛患者随机分为药线组和药物组。药线组60例用壮医药线点灸疗法治疗,药物组60例口服麦角胺咖啡因片治疗,两组均连续治疗30天。观察患者头痛积分变化和不良反应,并进行疗效评价。结果:两组患者治疗后头痛积分较治疗前降低,差异均有统计学意义(均P<0.05);治疗后两组间头痛积分比较,差异无统计学意义(P>0.05);药线组总有效率为93.3%(56/60),药物组总有效率为90.0%(54/60),两组疗效比较,差异无统计学意义(P>0.05);药线组无任何不良反应,药物组有20例出现面红、上腹部不适等症状。结论:壮医药线点灸治疗偏头痛与药物疗效相当,但无不良反应。     

针刺远端和近端腧穴治疗牙痛疗效的对比观察

目的对比观察腧穴的远治与近治疗效。方法将78例符合入选标准的牙痛患者随机分成治疗组及对照组。治疗组给予针刺近端腧穴,对照组给予针刺远端合谷穴,疗程为4d,对两组疼痛情况进行观察。结果两组治疗前后VAS评分均有统计学差异（P〈0．05）：两组治疗后VAS评分比较差异有统计学意义（P〈0．05）。治疗组总有效率为94．7％,对照组总有效率为88．6％,两组比较差异有统计学意义（P〈0．05）。结论针刺治疗牙痛近端腧穴作用优于远端腧穴。