肖蕾 王炎 王胜 王立新 崔祺 张晨 姚路红 邵靓宇 邢军

摘要：目的 觀察电针针刺锥体区治疗偏头痛的临床疗效。方法 采用随机数字表法将120例偏头痛患者分为锥体区组、常规针灸组、西药组、非经非穴组各30例。锥体区组针刺锥体区（玉枕至天柱连线），常规针灸组双侧常规取穴，非经非穴组针刺锥体区旁开2寸，均予电针，8～20 mA，2/100 Hz疏密波，每次30 min，每日1次；西药组予双氯芬酸钠肠溶片，每次50 mg，每日2次，口服。均连续治疗10 d。观察治疗前后视觉模拟评分法（VAS）评分、中医症状积分、焦虑自评量表评分（SAS）和抑郁自评量表评分（SDS），分析临床疗效。结果 锥体区组总有效率为93.33%，明显优于常规针灸组（86.67%）、西药组（70.00%）和非经非穴组（63.33%），差异有统计学意义（χ2=24.440，P=0.004）。与本组治疗前比较，4组治疗后VAS评分、中医症状积分均明显下降（P<0.05）。锥体区组治疗后VAS评分明显低于其他3组（P<0.05），中医症状积分明显低于西药组及非经非穴组（P<0.05）。与本组治疗前比较，非经非穴组SDS评分及其他3组的SAS、SDS评分均明显降低，差异有统计学意义（P<0.05），锥体区组治疗后SAS、SDS评分明显低于其他3组（P<0.05）。结论 电针针刺锥体区治疗偏头痛疗效显著，可减少不良情绪的发生。

关键词：偏头痛；电针；锥体区

DOI：10.3969/j.issn.1005-5304.2018.01.005

中图分类号：R277.772；R245 文献标识码：A 文章编号：1005-5304（2018）01-0019-04

Clinical Study on Electro-acupuncture Treatment of Migraine

in Surface Projection Zone of the Pyramid Decussation

XIAO Lei， WANG Yan， WANG Sheng， WANG Li-xin， CUI Qi，

ZHANG Chen， YAO Lu-hong， SHAO Jing-yu， XING Jun

Department of Rehabilitation Medicine， 254 Hospital of PLA， Tianjin 300142， China

Abstract： Objective To observe the clinical effects of electro-acupuncture in surface projection zone of the pyramid decussation in treatment of migraine. Methods Totally 120 patients with migraine who met the inclusion criteria were randomly divided into four groups as projection zone group， ordinary acupuncture group， western medicine group and non-acupoint group， with 30 cases in each group. Projection zone group was treated with electro-acupuncture in pyramidal cross area （from Yuzhen to Tianzhu）； Ordinary acupuncture group was treated with routine point locating according to acupuncture therapeutics； Non-acupoint group was treated with 2 inch acupoints opened beside projection zone， and 3 groups were treated with electro-acupuncture （8–20 mA， 2/100 Hz） for 30 min. Western medicine group was treated with diclofenac sodium enteric-coated table. The treatment course was 10 day. Visual Analogue Scale （VAS） score， TCM syndrome score， self-rating anxiety scale score （SAS） and self-rating depression scale score （SDS） were evaluated before and after treatment. The therapeutic effects of the four groups were compared and analyzed. Results The total effective rate of projection zone group was 93.33%， which was obviously better than the ordinary acupuncture group （86.67%）， western medicine group （70.00%） and non-acupoint group （63.33%）， with statistical significance （χ2=24.440， P=0.004）. Compared with before treatment， the VAS score and TCM syndrome scores in the four groups after treatment decreased significantly （P<0.05）. The VAS score in the projection zone group after treatment was significantly lower than the other three groups， and the TCM syndrome scores were significantly lower than the western medicine group and non-acupoint group （P<0.05）. Compared with before treatment， the SDS score in the non-acupoint group and SAS and SDS scores in the other three groups decreased significantly， with statistical significance （P<0.05）. SAS and SDS scores in projection zone group after treatment was significantly lower than the other three groups （P<0.05）. Conclusion The method of electro-acupuncture in surface projection zone of the pyramid decussation has obviously clinical effects， and can reduce the occurrence of bad mood.

Keywords： migraine； electro-acupuncture； surface projection zone of the pyramid decussation

偏头痛是常见的致失能性疾病之一，多为单侧发作性搏动样头痛，一般持续4～72 h，伴有恶心、呕吐、对光及声音过敏等。因头痛持续时间过长或头痛严重，易产生焦虑、抑郁情绪。针灸治疗偏头痛疗效显著，目前临床应用广泛。笔者前期研究表明，电针针刺锥体区可迅速缓解偏头痛[1]。本研究观察电针针刺锥体区治疗偏头痛的临床疗效及对焦虑、抑郁的改善情况，现报道如下。

1 资料与方法

1.1 一般资料

选择2014年2月-2016年10月本院门诊及住院患者120例，采用随机、单盲、平行对照法将患者分为锥体区组、常规针灸组、西药组、非经非穴组各30例。根据随机数字表随机指定从第一行第一列开始，依次读取2位数作为1个随机数录于编号下，取满1行后自动转到下一行，共取120个随机数。……