Li Shao-Kang, Liao Wei-Dong, Zhao Jie, Cao Xiao-Wen
Department of Acupuncture, Gongli Hospital of Pudong New Area, Shanghai 200135, China.
Department of Acupuncture-moxibustion and Tuina, People's Hospital Group of Yantian District, Shenzhen 518083, Guangdong Province.
Zhen Ci Yan Jiu. 2020 Dec 25;45(12):995-9. doi: 10.13702/j.1000-0607.200150.
To observe the clinical effect of acupuncture on patients with stroke-related headache during convalescent and analyze its related factors.
A total of 116 stroke-related headache patients admitted to the Acupuncture Department of Gongli Hospital of Pudong New Area, Shanghai, from October 2018 to December 2019 were divided into a treatment group and a control group according to a random number table, with 58 cases in each group. Patients in both groups were given conventional treatments for control of blood pressure, blood sugar, blood lipids and anticoagulation. At the same time, patients in the treatment group were treated with "nape seven needles" (acupuncture at Fengfu［GV16］, bilateral Fengchi［GB20］, bilateral Tianzhu［BL10］ and bilateral Wangu［GB12］)combined with penetration needling for 30 min; patients in the control group were treated with Flunarizine hydrochloride capsules (5 mg). Both interventions were conducted once daily for 4 weeks. The visual analogue scale(VAS) score and integrative sores of headache, and plasma serotonin (5-HT), dopamine (DA), substance P (SP), α-endorphin (α-EP), and β-endorphin (β-EP) levels before and after treatment were compared between the two groups. The total therapeutic effective rate of the two groups was calculated.
There was no significant difference in VAS score, headache score, plasma 5-HT, DA, SP, α-EP, β-EP levels between the two groups before treatment (>0.05). After treatment, both groups have significant decrease in the VAS score, integrative sores of headache, the plasma 5-HT, DA, SP levels (<0.05), and significant increase in the plasma α-EP and β-EP levels (<0.05). At the same time, the VAS score, integrative sores of headache, the plasma 5-HT, DA, SP levels of the treatment group were lower (<0.05), and the plasma α-EP and β-EP levels were higher (<0.05) than those in the control group. The total effective rate of the treatment group(51/58, 87.9%) was higher than that of the control group (42/58, 72.4%, <0.05).
Acupuncture therapy can increase the release of endogenous opioid peptide, reduce the secretion of 5-HT, DA, SP, and have a significant effect in treating stroke related headache.
观察针刺对中风相关性头痛恢复期患者的临床疗效并分析其相关因素。
选取2018年10月至2019年12月在上海浦东新区公利医院针灸科收治的116例中风相关性头痛患者，按随机数字表法分为治疗组和对照组，每组58例。两组患者均给予控制血压、血糖、血脂及抗凝的常规治疗。同时，治疗组患者采用“项七针”（针刺风府［GV16］、双侧风池［GB20］、双侧天柱［BL10］及双侧完骨［GB12］）结合透刺治疗30分钟；对照组患者给予盐酸氟桂利嗪胶囊（5毫克）治疗。两种干预均每日进行1次，共4周。比较两组治疗前后的视觉模拟评分（VAS）、头痛综合评分以及血浆5-羟色胺（5-HT）、多巴胺（DA）、P物质（SP）、α-内啡肽（α-EP）和β-内啡肽（β-EP）水平。计算两组的总治疗有效率。
治疗前两组患者的VAS评分、头痛评分、血浆5-HT、DA、SP、α-EP、β-EP水平比较，差异无统计学意义（>0.05）。治疗后，两组患者的VAS评分、头痛综合评分、血浆5-HT、DA、SP水平均显著降低（<0.05），血浆α-EP和β-EP水平显著升高（<0.05）。同时，治疗组患者的VAS评分、头痛综合评分、血浆5-HT、DA、SP水平低于对照组（<0.05），血浆α-EP和β-EP水平高于对照组（<0.05）。治疗组的总有效率（51/58，87.9%）高于对照组（42/58，72.4%，<0.05）。
针刺疗法可增加内源性阿片肽的释放，减少5-HT、DA、SP的分泌，对治疗中风相关性头痛有显著效果。
