颈源性头痛286例治疗分析

目的探讨引起颈源性头痛（CEH）的病理分类及采用个体化中医治疗的疗效。方法对确诊的CEH患者286例进行病理变化分类，并据此分别和联合采用中医整复、针刀、牵引、及注射等方法进行个体化组合治疗，按疼痛6点行为评分法评价疗效。结果本组患者中，颈椎关节功能紊乱145例，占50．7％；颈椎生理曲度消失53例，占18．5％；重度肥大性颈椎炎24例，占8．4％；颈椎椎间盘突出16例，占5．6％；单纯肌筋膜粘连者12例，占4．2％；合并两种及以上病理变化36例，占12．6％。分别和联合采用中医整复、针刀、牵引、及注射等治疗方法，总有效率为97．9％（280／286例）。结论颈椎关节功能紊乱是引起CEH的主要原因。应根据不同的病理变化进行个体化治疗。分别或联合采用中医整复、针刀、牵引及注射等方法治疗的疗效高。

Retrospective analysis of 286 cases with cervicogenic headache

Objective To explore the pathological causes of cervicogenic headache （CEH） and the efficacy of individualized medicine treatment. Methods CEH patients were treated with different individualized treatment of Chinese medicine, 6 pain score were used to evaluate the efficacy. Results Of 286 patients with CEIl, 145 cases were cervical joint dysfunction （50.7 %）, 53 cases were cervical curve disappear（18.53%） , 24 cases were severe hypertrophic spondylosis（8.4%）, 16 cases were cervical disc herniation（5.6%）, 12 cases were simple myofascial adhesions （4.2%）, 36 cases were patients with pathological changes in two or more type （12.6%）. After using Chinese medicine restoration, needle-knife, and blockade treatment methods respectively or jointly, the total effective rate was 97.9% （280/286 cases）. Conclusion Cervical joint dysfunction is the main cause of the CEH. According to the different pathological changes the treatments are individidualized. Chinese medicine restoration, needle-knife, and blockade treatment methods are used respectively or jointly, so the efficacy is good.