不同地域偏头痛的针刺疗效及影响因素的临床研究-针灸推拿学专业论文.docxVIP

成都中医药大学硕士学位论文 成都中医药大学硕士学位论文 中文摘要 目的：通过观察同种针刺治疗方法对不同地区同类型的偏头痛的疗效，探讨地 域对偏头痛的发作及其治疗的影响。为偏头痛地域性辨证治疗提供理论依据。 方法：选取成都中医药大学附属医院门诊、广西中医药大学附属瑞康医院门诊 病人中符合肝阳上亢型无先兆型偏头痛病人各 30 例，共 60 例，两组给予同一针 刺治疗方案，痛剧时予口服萘普生片，治疗 4 周后观察患者治疗前后效应指标（疼 痛评分，VAS，头痛发作次数、口服萘普生片数）、安全性指标的变化，对其疗 效和安全性进行评价。 结果：通过对完成试验的 54 例的病疗效比较，结果显示，成都组痊愈 6 例（20%）， 显效 21 例（70.0%），有效 2 例（6.7%），无效 1 例（3.3%），总有效率 96.7%， 广西组的痊愈 1 例（4.2%），显效 16 例（66.7%），有效 5 例（20.8%），无效 2 例（8.3%），总有效率 91.7%。两组疗效构成比比较，差异有统计学意义（P0.05）。 成都组疗效优于广西组。两组治疗前后组内比较：疼痛评分、VAS、头痛发作次 数、口服萘普生的片数，差异有统计学意义（P＜0.05）；治疗后组间比较：疼痛 评分、VAS、头痛发作次数、口服萘普生片数，各项指标均示成都组优于广西组 （P＜0.05）。 结论：针刺治疗对两地偏头痛病人均有效，但地域之间的差异确影响针刺疗效。 且以成都组的疗效优于广西组。 关键词:偏头痛；疗效；地域；影响因素 ABSTRACT Objective：To observe the effect of acupuncture for the same type of migraine patients among regions, find out the possible impact of geographic factors on the attack of migraine and its treatment and provide theoretical evidence for the treating migraine based on regional syndrome differentiation. Methods: 60 cases in accordance with migraine without aura with liver-yang hyperactivity syndrome were selected through random sampling, half of which were from acupuncture clinic of Affiliated Hospital, Chengdu University of Traditional Chinese Medicine and the other half those outpatients in Ruikang Affiliated Hospital of Guangxi Traditional Chinese Medical University. They were given the same acupuncture treatment and also Naproxen tablets were given when they complained of severe pain. After 4 weeks, efficacy of acupuncture was assessed in terms of the following symptom marks as simplify the McGill Pain Questionnaire, visual analogue scale (VAS), headache attacks and times of naproxen taken besides safety index. Moreover, efficacy and safety of acupuncture were estimated. Results: By comparison of effect of the 54 cases completed，results indicated that 6 cases from Chengdu group (CDG) were cured (with cure rate of 20%), 21 markedly effective (accounting for 70% of the total), leaving 2 effective (6.7%) and 1 inv