作者：吴晓新，丁颖颖，缪小祥

单位：

226500江苏省如皋市中医院神经内科

Units：

Department of Neurology, Rugao Hospital of Traditional Chinese Medicine, Rugao 226500, China

关键词：

头痛；枕大神经痛；隔药灸；普瑞巴林；治疗结果

Keywords：

Headache; Great occipital neuralgia; Herbal-partitioned moxibustion; Pregabalin; Treatment outcome

CLC：

R 741.041

DOI：

10.12114/j.issn.1008-5971.2023.00.233

Funds：

2021年度南通市基础研究和民生科技计划指导性项目（MSZ21108）

摘要：

　目的　探讨隔药灸联合普瑞巴林治疗枕大神经痛的临床疗效。方法　选取2021年1月至2022年1月在如皋市中医院脑病科门诊确诊的枕大神经痛患者160例，按照随机数字表法将其分为对照组和治疗组，每组80例。对照组患者接受普瑞巴林胶囊口服治疗；治疗组患者在对照组的基础上接受隔药灸治疗。比较两组治疗前及治疗3、7、14、30 d视觉模拟量表（VAS）评分，初次头痛消失时间，治疗后3个月内头痛发作次数，治疗前和治疗30 d后汉密尔顿焦虑量表（HAMA）评分，临床疗效，治疗后3个月内复发率。结果　时间与治疗方法在VAS评分上存在交互作用（P＜0.05）；时间、治疗方法在VAS评分上主效应均显著（P＜0.05）。两组治疗3、 7、14、30 d VAS评分分别低于本组治疗前，且治疗组治疗14、30 d VAS评分低于对照组（P＜0.05）。治疗组初次头痛消失时间短于对照组，治疗后3个月内头痛发作次数少于对照组（P＜0.05）。两组治疗30 d后HAMA评分分别低于本组治疗前，且治疗组治疗30 d后HAMA评分低于对照组（P＜0.05）。治疗组临床疗效优于对照组（Z=2.170，P=0.030）。两组治疗后3个月内复发率比较，差异无统计学意义（χ2=2.209，P=0.137）。结论　隔药灸联合普瑞巴林治疗枕大神经痛的临床疗效明显，其可有效缓解患者疼痛，缩短头痛消失时间，减轻由头痛引发的焦虑情绪，值得临床推广与应用。

Abstract：

Objective To investigate the clinical efficacy of herbal-partitioned moxibustion combined withpregabalin in the treatment of great occipital neuralgia. Methods A total of 160 patients with great occipital neuralgia diagnosedin the Department of Encephalopathy of Rugao Hospital of Traditional Chinese Medicine from January 2021 to January 2022were selected and divided into control group and treatment group according to random number table method, with 80 cases ineach group. Control group was given oral treatment with pregabalin capsule. The treatment group was given herbal-partitionedmoxibustion treatment on the basis of the control group. Visual Analogue Scale (VAS) scores before treatment and at 3 days, 7days, 14 days and 30 days of treatment, the time when the first headache disappeared, the number of headache attacks within 3months after treatment, Hamilton Anxiety Scale (HAMA) score before treatment and 30 days after treatment, the clinical efficacyand recurrence rate within 3 months after treatment were compared between the two groups. Results There was interactionbetween time and treatment method on VAS score (P < 0.05) . The main effect of time and treatment method on VAS score wassignificant (P < 0.05) . VAS scores at 3, 7, 14 and 30 days of treatment in two groups were lower than those before treatmentrespectively, and VAS scores at 14 and 30 days of treatment in the treatment group were lower than those in the control group (P< 0.05) . The time when the first headache disappeared in the treatment group was shorter than that in the control group, and thenumber of headache attacks within 3 months after treatment was less than that in the control group (P < 0.05) . The HAMA scoreafter 30 days of treatment of the two groups was lower than that before treatment respectively, and the HAMA score after 30 daysof treatment of the treatment group was lower than that of the control group (P < 0.05) . The clinical effect of treatment group wasbetter than that of control group (Z=2.170, P=0.030) . There was no significant difference in recurrence rate within 3 months aftertreatment between the two groups (χ2=2.209, P=0.137) . Conclusion Herbal-partitioned moxibustion combined with pregabalinhave obvious curative effect in the treatment of great occipital neuralgia, which can effectively relieve the pain of patients, shortenthe disappearance time of headache, reduce the anxiety caused by headache, and is worthy of clinical promotion and application.

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