《世界针灸杂志》巨刺法治疗肝阳上亢型偏头痛

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巨刺法治疗肝阳上亢型偏头痛的临床疗效及其对患者血浆NO含量的影响*

Clinical efficacy of great needling in the treatment of migraine with the symptom of ascendant hyperactivity of liver yang and its effect on NO level in plasma of patients*

YAN Bing1 (闫兵), WU Yong-gang1 (吴永刚), WEI Yan-fang2 (魏燕芳), DU Jing1 (杜静), LIAO Fen1 (廖芬), LIU Yong-feng1 (刘永锋)

1. Department of acupuncture and moxibustion, Shenzhen TCM Hospital, Shenzhen 518000, Guangdong Province, China; 2. Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China (1 深圳市中医院针灸科，广东深圳，518000；2 广州中医药大学，广东广州，510000)

ARTICLE INFO

First author: YAN Bing (1983-), female, attending physician.

Research field: Acupuncture for the treatment of encephalopathy and mental neurological diseases

E-mail： [e-mail]

 Corresponding author: WU Yong-gang (1963-), male, chief physician.

Research field: Acupuncture for the treatment of miscellaneous diseases.

E-mail：[e-mail]

*Supported by Traditional Chinese Medicine Bureau of Guangdong Province, project number: 20141240

ABSTRACT

Objective To observe the clinical efficacy of great needling for the treatment of migraine with the symptom of ascendant hyperactivity of liver yang and its effect on NO level in plasma of patients. Methods A total of 60 migraine patients with the symptom of ascendant hyperactivity of liver yang who met the inclusive criteria were randomly divided into treatment group and control group by using SPSS15.0 software according to the registration order with 30 patients in each group. Patients in treatment group were treated with great needling. Tàichōng (太冲LR 3), Zhōngzhŭ (中渚TE 3), Zúlínqì (足临泣GB 41) and Qiūxū (丘墟GB 40) in the uninjured side were selected. After obtaining qi, drainage method was used. Then Tàixī (太溪KI 3) in the uninjured side was selected. After obtaining qi, supplementation method was used. Needles were retained for 30 minutes. Patients in control group were treated with routine acupuncture. Local Āshì point, Sìshéncōng (四神聪EX-HN1), Yìfēng (翳风TE 17), Fēngchí (风池GB 20), Sīzhúkōng (丝竹空TE 23), Shuàigŭ (率谷GB 8), Hégŭ (合谷LI 4) and Lièquē (列缺LU 7) were selected. After puncturing, drainage method was used routinely and needles were retained for 30 minutes. 2 weeks after treatment, migraine specific quality of life questionnaire (MSQ), visual analogue scale (VAS) and nitric oxide (NO) level in plasma of patients in two groups were observed. Results After treatment, MSQ, VAS and NO of two groups were significantly improved compared with those before treatment. After treatment, score of MSQ functional limitation was 73.41 ± 10.22 in treatment group and 60.95 ± 10.15 in control group; score of MSQ dysfunction was 86.11 ± 8.22 in treatment group and 75.45 ± 8.34 in control group; score of MSQ emotion was 80.51 ± 10.16 in treatment group and 75.01 ± 10.20 in control group. The improvements of treatment group were superior to those of control group, and the differences were all statistically significant (P <0.05). After treatment, VAS score was 0.93 ± 1.25 in treatment group and 2.17 ± 1.70 in control group. The improvement of treatment group was superior to that of control group, and the difference was statistically significant (P <0.05). After treatment, NO level was 42. 15 ± 16.15 in treatment group and 62. 76 ± 15.17 in control group. The improvement of treatment group was superior to that of control group, and the difference was statistically significant (P <0.05). Overall response rate was 86.7% in treatment group and 53.3% in control group, and the difference between two groups was statistically significant (P <0.05).Conclusion Great needling is an effective method for the treatment of migraine with the symptom of ascendant hyperactivity of liver yang. Its mechanism is to regulate the generation of NO in migraine patients, and improve the relaxation and contraction of cerebral vascular smooth muscle, so as to adjust the cerebral circulation.

KEY WORDS: acupuncture therapy; migraine; great needling; nitric oxide

【摘要】目的 观察巨刺法对肝阳上亢型偏头痛的临床疗效及其对患者血浆NO含量的影响。方法 将60例符合纳入标准的肝阳上亢型偏头痛患者按就诊顺序编号，采用SPSS15.0软件进行随机化分配，分为治疗组30例和对照组30例。治疗组采用巨刺法治疗, 取穴：健侧太冲、中渚、足临泣、丘墟，得气后采用泻法，再取健侧太溪，得气后采用补法，留针30min；对照组采用常规针刺治疗，取穴：局部阿是穴、四神聪、翳风、风池、丝竹空、率谷、合谷、列缺，进针后施以常规泻法，留针30min。治疗两周后观察两组偏头痛生活质量特异性量表（Migraine specific quality of life questionnaire,MSQ）、视觉模拟评分（Visual Analogue Scale，VAS）、血浆一氧化氮（NO）含量。结果 治疗后两组MSQ 、VAS、NO均较治疗前有显著改善。治疗组治疗后MSQ中功能受限73.41±10.22，对照组治疗后MSQ中功能受限60.95±10.15，治疗组治疗后MSQ中功能障碍86.11±8.22，对照组治疗后MSQ中功能障碍75.45±8.34，治疗组MSQ中情感80.51±10.16，对照组MSQ中情感75.01±10.20，差异均有统计学意义（P＜0.05），且治疗组均优于对照组（P＜0.05）。治疗后两组VAS，治疗组0.93±1.25，对照组2.17±1.70，差异均有统计学意义（P＜0.05），且治疗组均优于对照组（P＜0.05）。治疗后两组NO，治疗组42. 15 ±16.15，对照组62. 76± 15.17，差异均有统计学意义（P＜0.05），且治疗组均优于对照组（P＜0.05）。治疗组总有效率为86.7%,对照组为53.3%,两组比较差异有统计学意义(P＜0.05)。结论 巨刺法是一种治疗肝阳上亢型偏头痛的有效方法，其机制与调节偏头痛患者NO生成，从而改善脑血管平滑肌舒张和收缩功能，调整脑的循环有关。

【关键词】针刺疗法 偏头痛 巨刺法 一氧化氮