针刺治疗急性期无先兆偏头痛的临床疗效

目的观察针刺对急性期无先兆偏头痛病人视觉模拟评分(VAS)、血清降钙素基因相关肽(CGRP)、P物质(SP)的影响。方法将60例急性期无先兆偏头痛病人随机分为治疗组与对照组,各30例,通过双模拟研究技术,治疗组给予针刺百会、神庭、双侧风池、太阳、率谷、头维和口服布洛芬安慰剂治疗;对照组给予口服布洛芬片和针刺非经非穴治疗。比较两组治疗前、治疗后20 min、治疗后40 min、治疗后1 h、治疗后2 h VAS评分及血清CGRP、SP水平变化。结果与治疗前比较,两组治疗后各时间VAS评分较治疗前均下降;治疗后20 min、治疗后40 min,治疗组VAS评分低于对照组(P<0.01);治疗后1 h、治疗后2 h,两组VAS评分比较,差异无统计学意义(P>0.05);组别与时间因素存在交互作用(P<0.01)。治疗后,两组血清CGRP、SP水平较治疗前均下降(P<0.05),且治疗组低于对照组(P<0.01)。治疗后20 min、治疗后40 min,治疗组有效率均高于对照组(P<0.01)。结论干预因素、时间和两者的交互作用下,针刺治疗急性期无先兆偏头痛可快速起效,疗效好,病人血清CGRP和SP水平降低提示针刺可减少三叉神经节中神经肽释放,调控神经源性炎症,抑制痛觉传导通路激活,从而起到抗偏头痛作用。

Effects of Acupuncture for Acute Migraine without Aura

Objective To observe the effects of acupuncture on the visual analogue scale(VAS),serum calcitonin gene related peptide(CGRP)and substance P(SP)of acute migraine patients without aura.Methods Sixty patients of acute migraine without aura were randomly divided into treatment group and control group,with 30 cases in the each group.With double simulation study technique,the treatment group was treated with acupuncture Baihui,Shenting,bilateral fengchi,Sun,Shuigu,Touwei and oral ibuprofen placebo,while the control group was treated with oral ibuprofen tablets and acupuncture without meridian or acupoint treatment.Before and after treatment at 20 min,at 40 min,1 h,2 h,the levels of CGRP and SP were compared between two groups.Results Compared with data before treatment,VAS scores of both groups at all time after treatment decreased(P<0.05).VAS scores in the treatment group were lower than those in control group after treatment at 20 min,at 40 min(P<0.01).There was no significant difference in VAS scores between two groups after treatment at 20 min,at 40 min(P>0.05).There was an interaction between group and time(P<0.01).After treatment,the levels of CGRP and SP in both groups decreased compared with data before treatment(P<0.05),and those in treatment group were lower than those in control group(P<0.01).The clinical efficacy of the treatment group was better than that of the control group after treatment at 20 min,at 40 min(P<0.01).Conclusion Under the interaction of intervention factors,time factors and the interaction of both,acupuncture in the treatment of acute migraine without aura could reduce the levels of CGRP and SP,and suggested trigeminal ganglion released neuropeptides regulated,neurogenic inflammation,and inhibited pain pathway activation.