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[采用“颈部七线”选穴法针刺治疗肝阳上亢型无先兆偏头痛的预防性研究:一项随机对照试验]

[Prophylaxis of migraine without aura of liver hyperactivity treated with acupuncture at the points selected using the "seven lines of the neck" method: a randomized controlled trial].

作者信息

Xing Yu, Zhang Chongyang, Meng Yan, Shi Anni, Bai Xue, Sun Wenting, Zhou Yuqi, Bai Peng

机构信息

Department of Acupuncture and Moxibustion, Third Affiliated Hospital of Beijing University of CM, Beijing 100029, China.

Department of Acupuncture and Moxibustion, Beijing Longfu Hospital.

出版信息

Zhongguo Zhen Jiu. 2024 Jun 12;44(6):611-7. doi: 10.13703/j.0255-2930.20231105-k0006.

DOI:10.13703/j.0255-2930.20231105-k0006
PMID:38867620
Abstract

OBJECTIVE

To observe the clinical effect of prophylaxis on migraine without aura differentiated as liver hyperactivity undergoing acupuncture at the points selected using the "seven lines of the neck" method.

METHODS

Fifty-eight patients with migraine without aura of liver hyperactivity at remission stage were randomly divided into an observation group (29 cases, 3 cases dropped out) and a control group (29 cases, 4 cases dropped out). In the observation group, acupuncture was delivered at Dazhui (GV 14), Fengfu (GV 16), bilateral Fengchi (GB 20), Gongxue (Extra), etc., selected using the "seven lines of the neck" method. In the control group, conventional acupuncture was applied to point, Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5) and others on the affected side. The treatment was given once every other day or every two days, 3 interventions weekly, for consecutive 8 weeks. Before treatment, after 4 and 8 weeks of treatment, and after 4 weeks of treatment completion (follow-up visit), the days of migraine episodes, the frequency of migraine episodes, the score of visual analogue scale (VAS) for pain intensity, and the score of migraine specific quality of life questionnaire (MSQ) were observed in the patients of the two groups. Before treatment and after 8 weeks of treatment, the score of TCM syndrome was observed. After 4 and 8 weeks of treatment and after 4 weeks of treatment completion (follow-up visit), the response rates of 50% reduction in the days and the frequency of migraine episodes were calculated in the two groups.

RESULTS

After 4 and 8 weeks of treatment and during follow-up visit, the days and the frequency of migraine episodes were decreased (<0.01) and VAS scores were declined (<0.01) when compared with those before treatment in the two groups. The days and the frequency of migraine episodes in the observation group were lower during the follow-up visit (<0.05) and VAS scores were lower after 8 weeks of treatment and during the follow-up visit (<0.05) when compared with those in the control group. After 4 and 8 weeks of treatment, and during follow-up visit, the scores of "role function-preventive" and "emotional function" of MSQ were increased in comparison with those before treatment in the observation group (<0.05). After 8 weeks of treatment and during the follow-up visit, the scores of "role function-restrictive" of MSQ were increased in comparison with those before treatment in the observation group (<0.05), and the scores of "role function-restrictive" "role function-preventive" and "emotional function" were higher when compared with those before treatment in the control group (<0.05). After 8 weeks of treatment, the scores of TCM syndrome were decreased in comparison with those before treatment in the two groups (<0.01). In the observation group, the response rate of 50% reduction in the days of migraine episodes after 8 weeks of treatment and that of the frequency of migraine episodes during the follow-up visit were higher than those of the control group (<0.05).

CONCLUSION

Acupuncture at the points selected using the "seven lines of the neck" method can reduce the days and frequency of migraine episodes and pain intensity, ameliorate the syndrome of TCM and improve the quality of life of the patients with migraine without aura of liver hyperactivity.

摘要

目的

观察采用“颈部七条线”选穴法针刺对肝阳上亢型无先兆偏头痛的预防作用。

方法

将58例处于缓解期的肝阳上亢型无先兆偏头痛患者随机分为观察组(29例,脱落3例)和对照组(29例,脱落4例)。观察组采用“颈部七条线”选穴法针刺大椎(GV 14)、风府(GV 16)、双侧风池(GB 20)、供血(奇穴)等穴位;对照组采用常规针刺患侧的丝竹空(TE 23)、率谷(GB 8)、太阳(EX-HN 5)等穴位。治疗隔日或每两日1次,每周3次,连续治疗8周。分别于治疗前、治疗4周、8周及治疗结束后4周(随访)观察两组患者偏头痛发作天数、发作频率、疼痛视觉模拟评分(VAS)及偏头痛特异性生活质量问卷(MSQ)评分;于治疗前及治疗8周后观察中医证候评分;于治疗4周、8周及治疗结束后4周(随访)计算两组患者偏头痛发作天数及发作频率减少50%的有效率。

结果

两组治疗4周、8周及随访时偏头痛发作天数及发作频率均较治疗前减少(P<0.01),VAS评分均降低(P<0.01);随访时观察组偏头痛发作天数少于对照组(P<0.05),治疗8周及随访时观察组VAS评分低于对照组(P<0.05)。观察组治疗4周、8周及随访时MSQ“角色功能-预防”及“情感功能”评分较治疗前升高(P<0.05);治疗8周及随访时观察组MSQ“角色功能-限制”评分较治疗前升高(P<0.05),且治疗8周及随访时观察组“角色功能-限制”“角色功能-预防”及“情感功能”评分高于对照组(P<0.05)。两组治疗8周后中医证候评分较治疗前降低(P<0.01)。观察组治疗8周后偏头痛发作天数减少50%的有效率及随访时发作频率减少50%的有效率高于对照组(P<0.05)。

结论

采用“颈部七条线”选穴法针刺可减少肝阳上亢型无先兆偏头痛患者的发作天数、发作频率及疼痛程度,改善中医证候,提高患者生活质量。

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