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颈旁神经阻滞联合针刺干预对颈源性头痛的影响

[Effect of cervical paravertebral block combined with acupuncture intervention on cervicogenic headache].

作者信息

Wu Jia-Xuan, Fan Ru-Jun, Song Wen-Xue, Chen Ping

机构信息

Department of Anesthesia, People's Hospital of Jiuquan City, Gansu Province, Jiuquan 735000, China.

出版信息

Zhen Ci Yan Jiu. 2013 Oct;38(5):411-4.

Abstract

OBJECTIVE

To observe the therapeutic effect of cervical paravertebral block plus acupuncture treatment for cervicogenic headache.

METHODS

Sixty cases of cervicogenic headache were randomly and equally divided into cervical paravertebral block (control) group and acupuncture plus cervical paravertebral block (acupuncture) group. Paravertebral block was performed by injection of 5 mL of 0.3% lidocaine solution containing triamcinolone (10 mg) into the 2nd cervical paravertebral tissue from the cross point between the posterior border of the sternomastoid muscle and the angle of jaw, once every week for three weeks. Manual acupuncture stimulation was applied to Baihui (GV 20), unilateral Fengchi (GB 20) and Jiaosun (SJ 20), once daily for 3 weeks. The patients' headache severity was assessed by visual analogue scale (VAS) and their cervical vertebral activity assessed by range of motion (ROM) before and after the treatment.

RESULTS

Compared with pre-treatment in the same one group, the scores of both VAS and ROM at time points of one, two and three weeks after the treatment were significantly decreased in the control and acupuncture groups (P < 0.05), suggesting a marked improvement of both headache and cervical motion after the treatment. Comparison between the two groups showed that the VAS and ROM scores of the acupuncture group were evidently lower than those of the control group at each time point after the treatment (P < 0.05), displaying a better therapeutic effect of acupuncture plus paravertebral block for cervicogenic headache.

CONCLUSION

Acupuncture combined with cervical paravertebral block is effective in relieving cervicogenic headache and improving cervical vertebral activity in cervicogenic headache patients, and can strengthen the therapeutic effect of simple paravertebral block.

摘要

目的

观察颈椎旁阻滞联合针刺治疗颈源性头痛的疗效。

方法

将60例颈源性头痛患者随机等分为颈椎旁阻滞(对照组)和针刺联合颈椎旁阻滞(针刺组)。从胸锁乳突肌后缘与下颌角交点处进针,向第2颈椎椎旁组织注射含曲安奈德(10mg)的0.3%利多卡因溶液5mL进行椎旁阻滞,每周1次,共3周。针刺百会(GV20)、单侧风池(GB20)和角孙(SJ20),每日1次,共3周。治疗前后采用视觉模拟评分法(VAS)评估患者头痛严重程度,采用活动度(ROM)评估颈椎活动情况。

结果

与同组治疗前比较,对照组和针刺组治疗后1、2、3周时VAS评分和ROM均显著降低(P<0.05),提示治疗后头痛和颈椎活动均有明显改善。两组比较显示,治疗后各时间点针刺组的VAS评分和ROM均明显低于对照组(P<0.05),表明针刺联合椎旁阻滞治疗颈源性头痛的疗效更佳。

结论

针刺联合颈椎旁阻滞可有效缓解颈源性头痛患者的头痛症状,改善颈椎活动度,增强单纯椎旁阻滞的治疗效果。

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