针刺对偏头痛患者疼痛及脑血流动力学的影响:随机对照研究

目的:观察针刺结合药物与单纯药物治疗偏头痛的临床疗效差异及其对脑血流动力学的影响。方法:将120例偏头痛患者随机分为针药组(60例,脱落3例)和药物组(60例,脱落6例)。药物组口服盐酸氟桂利嗪胶囊,每日10 mg,每晚睡前服;针药组在药物组基础上结合针刺治疗,穴取丝竹空、率谷、太阳、风池等,每次30 min,每天1次,两组均连续治疗4周。观察两组治疗前后疼痛视觉模拟量表(VAS)评分、脑血流动力学指标大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)、椎动脉(VA)、基底动脉(BA)血流速度]、中医证候总积分变化,并比较两组临床疗效及不良反应发生率。结果:与治疗前比较,治疗后两组VAS评分,ACA、MCA、PCA、VA、BA血流速度,中医证候总积分均下降(P<0.05);治疗后针药组VAS评分,ACA、MCA、PCA、VA、BA血流速度及中医证候总积分均较药物组低(P<0.05)。针药组总有效率为96.5%(55/57),高于药物组的90.7%(49/54,P<0.05)。两组的不良事件发生率比较差异无统计学意义(P>0.05)。结论:针刺结合盐酸氟桂利嗪可显著改善偏头痛患者疼痛程度,降低颅内血流速度,效果优于单纯口服盐酸氟桂利嗪。

Effect of acupuncture on pain and cerebral hemodynamics in patients with migraine: a randomized controlled trial

Objective To observe the therapeutic effect between acupuncture combined with medication and simple medication on migraine and cerebral hemodynamics. Methods A total of 120 patients with migraine were randomized into an acupuncture plus medication group(60 cases, 3 cases dropped off) and a medication group(60 cases, 6 cases dropped off). In the medication group, flunarizine hydrochloride capsule was given orally before sleep, 10 mg a day. On the basis of the treatment in the medication group, acupuncture was applied at Sizhukong(TE 23), Shuaigu(GB 8), Taiyang(EX-HN 5), Fengchi(GB 20) and etc. in the acupuncture plus medication group, 30 min each time, once a day. Treatment for 4 weeks was required in both groups. Before and after treatment, the visual analogue scale(VAS) score, indexes of cerebral hemodynamic blood flow velocity of anterior cerebral artery(ACA), middle cerebral artery(MCA), posterior cerebral artery(PCA), vertebral artery(VA) and basilar artery(BA)] and total TCM syndrome score were observed, and the clinical therapeutic effect and the incidence of the adverse events were evaluated in both groups. Results Compared before treatment, the VAS scores, the blood flow velocity of ACA, MCA, PCA, VA, BA and the total TCM syndrome scores were decreased in both groups(P<0.05). After treatment, the VAS score, the blood flow velocity of ACA, MCA, PCA, VA, BA and the total TCM syndrome score in the acupuncture plus medication group were lower than those in the medication group(P<0.05). The total effective rate was 96.5%(55/57) in the acupuncture plus medication group, which was superior to 90.7%(49/54) in the medication group(P<0.05). There was no statistical difference in the incidence of adverse events between the two groups(P>0.05). Conclusion Acupuncture combined with flunarizine hydrochloride capsule can effectively relieve the pain in patients with migraine, reduce the cerebral blood flow velocity, the efficacy is superior to simple flunarizine hydrochloride capsule.