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火针联合毫针治疗紧张型头痛的疗效及其对颅周肌紧张度的影响。

The curative effect of fire needling combined with filiform needling on tension-type headache and its effect on the tenderness of pericranial muscles.

机构信息

Beijing University of Chinese Medicine, Beijing 100029, China.

Acupuncture and Moxibustion Center of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University/Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010.

出版信息

Zhen Ci Yan Jiu. 2023 Nov 25;48(11):1151-1158. doi: 10.13702/j.1000-0607.20230189.

Abstract

OBJECTIVES

To observe the curative effect of fire needling pricking pericranial tender points combined with filiform needling on tension-type headache (TTH) and its effect on pericranial muscle tenderness, and explore the correlation between changes of headache symptoms and pericranial muscle tenderness in TTH, to analyze the influence of pericranial muscle tenderness on TTH.

METHODS

A total of 41 TTH patients in the treatment group and 38 TTH patients in the control group completed the study. The patients in the treatment group were treated with fire needling at pericranial tender points combined with filiform needling at Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), Touwei (ST8) and Fengchi (GB20). The patients in the control group were only treated with the same filiform needling as the treatment group. Patients in the two groups were treated twice a week for 8 weeks. Before and after treatment, the days of headache onset, the number and distribution of pericranial muscle tender points were recorded, the degree of headache was evaluated by visual analogue scale and the threshold of pericranial muscle tender points were measured. The correlations between the changes of the days and degree of headache onset and the changes of the number and threshold of pericranial muscle tender points were analyzed. The effective rates in the two groups were calculated.

RESULTS

Compared with those before treatment, the days of headache onset and the degree of headache were decreased (<0.05) in the two groups;the number of pericranial muscle tender points was decreased (<0.05) and the tenderness threshold was increased (<0.05) in the treatment group. After treatment, compared with the control group, the days of headache onset, the degree of headache, and the number of pericranial muscle tender points were decreased (<0.05), and the tenderness threshold was increased (<0.05) in the treatment group. The decrease of the days and degree of headache was positively correlated with the decrease of number and the increase of tenderness threshold of pericranial muscle tender points (<0.05). The effective rate in the treatment group was 87.80% (36/41), which was higher than 57.89% (22/38) in the control group (<0.05). The most common anatomic location of tender points in baseline was superior trapezius muscle, followed by sternocleidomastoid muscle, superior nuchal line, temporal muscle, masseter muscle, etc.

CONCLUSIONS

The fire needling at the pericranial muscle tender points combined with filiform needling on TTH patients can significantly improve the clinical symptoms and reduce the pericranial muscle tenderness. The pericranial muscle tenderness is an important factor in the pathogenesis of TTH.

摘要

目的

观察头穴丛刺结合毫针治疗紧张型头痛(TTH)的疗效及其对颅周肌紧张度的影响,探讨 TTH 头痛症状变化与颅周肌紧张度的相关性,分析颅周肌紧张度对 TTH 的影响。

方法

将 41 例 TTH 患者纳入治疗组,38 例 TTH 患者纳入对照组。治疗组采用头穴丛刺结合百会(GV20)、四神聪(EX-HN1)、神庭(GV24)、头维(ST8)、风池(GB20)毫针治疗,对照组仅采用与治疗组相同的毫针治疗。两组患者均每周治疗 2 次,共治疗 8 周。治疗前后记录头痛发作天数、颅周肌紧张点数量及分布,采用视觉模拟评分法(VAS)评估头痛程度,测量颅周肌紧张点阈值。分析头痛发作天数和程度的变化与颅周肌紧张点数量和阈值变化的相关性,计算两组的有效率。

结果

与治疗前比较,两组患者头痛发作天数和头痛程度均降低(P<0.05),颅周肌紧张点数量减少(P<0.05),颅周肌紧张点阈值升高(P<0.05);与对照组比较,治疗组头痛发作天数、头痛程度和颅周肌紧张点数量减少(P<0.05),颅周肌紧张点阈值升高(P<0.05)。头痛发作天数和程度的降低与颅周肌紧张点数量的减少和阈值的升高呈正相关(P<0.05)。治疗组有效率为 87.80%(36/41),高于对照组的 57.89%(22/38)(P<0.05)。基线时紧张点最常见的解剖位置为斜方肌上部,其次为胸锁乳突肌、枕上嵴、颞肌、咬肌等。

结论

头穴丛刺结合毫针治疗 TTH 患者能显著改善临床症状,减轻颅周肌紧张度。颅周肌紧张度是 TTH 发病的重要因素。

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