Yang Jun-Xiong, Zhang Jian-Ping, Yu Jian-Chun, Han Jing-Xian
Zhongguo Zhen Jiu. 2014 Aug;34(8):763-8.
To compare the difference in the clinical efficacy on primary trigeminal neuralgia (PTN) between the comprehensive therapy of electroacupuncture (EA) at qi streets acupoints combined with spinal regulation method and medication with carbamazepine (CBZ).
Sixty patients were randomized into a comprehensive therapy group (30 cases) and a medication group (30 cases). In the comprehensive therapy group, the acupoints at qi streets on the head such as Taiyang (EX-HN 5) and Sishencong (EX-HN 1) and those at qi streets on the chest and abdomen such as Shenshu (BL 23), Zhongwan (CV 12) and Guanyuan (CV 4), etc. were selected. After arrival of qi, EA was attached on 2 to 4 groups of acupoints. After acupuncture, the spinal regulation method was applied. This comprehensive therapy was given once a day. In the medication group, CBZ was used for oral administration, 100 mg at the first time, twice a day, and 400 to 600 mg each day as the maintenance dose. Separately, before and after treatment, in 2 and 6 months in follow-up, pain rating index (PRI), life satisfaction index B (LSI-B) and hamilton depression scale (HAMD) were adopted to evaluate comprehensively the clinical efficacy in the two groups and compare the adverse reaction during the treatment between the two groups.
After treatment, the curative and markedly effective rate in the comprehensive therapy group was 76.7% (23/30), which was better than 63.3% (19/30) in the medication group (P < 0.01). The difference in PRI was not significant after treatment between the two groups (all P > 0.05). In 2 and 6 months follow-up, PRI grade in the comprehensive therapy group was superior to that of the medication group (both P<0. 05). After treatment and in follow-up, HAMD score was all reduced in the two groups (P < 0.01, P < 0.05) and the result in follow-up in the comprehensive therapy group was significant as compared with that in the medication group (all P<0. 05). After treatment, LSI-B score was increased obviously in the two groups (all P < 0.05) and the result in the comprehensive therapy group was better than that in the medication group (P < 0.05). The incidence of adverse reaction in the comprehensive therapy group was 16.7% (5/30), which was lower than 30.0% (9/30, P < 0.01) in the medication group.
The comprehensive therapy of EA at qi streets acpoints combined with spinal regulation method achieves the long-term efficacy on PTN as compared with oral administration of CBZ in terms of the improvement of psychological condition, analgesia and life quality. It is the safe, effective and stable therapy.
比较头气街穴位电针（EA）结合脊柱调理法综合治疗与卡马西平（CBZ）药物治疗原发性三叉神经痛（PTN）的临床疗效差异。
将60例患者随机分为综合治疗组（30例）和药物治疗组（30例）。综合治疗组选取头部气街穴位如太阳穴（EX-HN 5）、四神聪（EX-HN 1）以及胸腹部气街穴位如肾俞穴（BL 23）、中脘穴（CV 12）、关元穴（CV 4）等。得气后，在2至4组穴位上连接电针。针刺后，应用脊柱调理法。该综合治疗每天进行1次。药物治疗组口服CBZ，首次100mg，每日2次，维持剂量为每日400至600mg。分别在治疗前、治疗后、随访的2个月和6个月时，采用疼痛评定指数（PRI）、生活满意度指数B（LSI-B）和汉密尔顿抑郁量表（HAMD）综合评估两组的临床疗效，并比较两组治疗期间的不良反应。
治疗后，综合治疗组的治愈和显效率为76.7%（23/30），优于药物治疗组的63.3%（19/30）（P<0.01）。两组治疗后PRI差异无统计学意义（均P>0.05）。在随访的2个月和6个月时，综合治疗组的PRI分级优于药物治疗组（均P<0.05）。治疗后及随访时，两组HAMD评分均降低（P<0.01，P<0.05），且综合治疗组随访结果与药物治疗组相比差异有统计学意义（均P<0.05）。治疗后，两组LSI-B评分均明显升高（均P<0.05），且综合治疗组结果优于药物治疗组（P<0.05）。综合治疗组不良反应发生率为16.7%（5/30），低于药物治疗组（9/30，P<0.01）。
与口服CBZ相比，头气街穴位电针结合脊柱调理法综合治疗在改善心理状态、镇痛及生活质量方面对PTN具有长期疗效。是安全、有效且稳定的治疗方法。
