穴位热痛刺激治疗无先兆偏头痛的近期镇痛疗效观察

目的观察穴位热痛刺激治疗无先兆偏头痛患者的近期镇痛疗效。方法采用随机数字表法将120例无先兆偏头痛患者分为观察组及对照组,每组60例。对照组患者给予西比灵口服,每晚1次,每次5mg,治疗4周为1个疗程。观察组患者在对照组干预基础上辅以穴位热痛刺激,取穴风池、率谷、阳陵泉、外关、太阳、印堂,选用Pathway疼痛及感觉评估系统配置的圆形刺激器,当刺激器加热至54.5℃时发放可调节脉冲热刺激,单个脉冲热刺激其脉宽为0.3s,刺激间隔10s,每个穴位连续刺激5次后换下一穴位,各穴位循环交替刺激,共治疗20min,每日治疗1次,治疗4周为1个疗程。记录治疗前、后2组患者头痛发作频率、持续时间、疼痛视觉模拟评分(VAS)、头痛伴随症状评分、偏头痛特异生活质量问卷量表(MSQ)评分,并对比2组患者近期疗效差异。结果治疗后观察组患者头痛发作频率(1.27±0.13)次/月]、头痛持续时间(2.51±0.22)分钟/次]、疼痛VAS评分(0.43±0.08)分]、头痛伴随症状评分(0.21±0.20)分]、MSQ功能受限评分(79.0±10.2)分]、功能障碍评分(82.6±10.3)分]及情感评分(85.2±10.5)分]均较治疗前及对照组明显改善(均P<0.05);另外治疗后观察组患者总有效率(95.0%)亦显著优于对照组水平(80.0%),组间差异具有统计学意义(P<0.05)。所有患者在治疗期间其心率、血压均未出现不良反应,热痛刺激部位无感染、红肿等异常表现。结论穴位热痛刺激治疗无先兆偏头痛患者近期疗效显著,并且治疗过程安全可靠、副反应少,为偏头痛患者提供了一种新的治疗方法,值得临床推广、应用。

The short-term analgesic effect of heat applied at acupoints to treat migraine headaches

Objective To observe any short-term analgesic effect of using heat stimulation at acupoints for treating migraine headaches without aura. Methods Totally 120 migraine patients were randomly divided into an observation group and a control group, each of 60. Both groups was given 5mg of Sibelium orally each night for 4 weeks. The observation group additionally received heat and pain stimulation at the Feng Chi, Shuai Gu, Yang Ling Quan, Wai Guan, Tai Yang and Yin Tang acupoints. The heat was in 0.3 s pulses at 54.5° with an inter-pulse interval of 10 s. Each acupuncture point was stimulated 5 times in rotation for a total of 20 min daily for 4 weeks. The frequency of headache attacks, their duration, their intensity rated using a visual analogue scale (VAS), accompanying symptoms and responses to a migraine-specific quality of life questionnaire (MSQ) were recorded before and after the treatment. Results After the treatment there was significantly greater improvement in the observation group compared to the control group in terms of headache frequency, headache duration, VAS ratings, and accompanying symptoms. The observation group also improved significantly more in terms of the average limitation dysfunction score, dysfunction score and emotion score on the MSQ. Moreover, the total effectiveness rate of the observation group (95.0%) was significantly higher than that of the control group (80.0%). During the treatment, no adverse reactions were found in terms of heart rate or blood pressure, and no abnormal manifestations such as infection, redness or swelling were observed at the stimulation sites. Conclusion Heat and pain stimulation at acupoints has a significant short-term analgesic effect on migraine without aura. Such treatment is safe and reliable, with few side effects. It provides a new treatment method for migraine patients and is worthy of clinical promotion and application.