【作者】 谢其煜；

【导师】 赖新生；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2010， 博士

【摘要】 目的通过对比观察电针结合穴位放血治疗气滞血瘀证三叉神经痛的临床研究的可行性及有效性评价,旨在为原发性三叉神经痛寻求一种疗效确切、持久而副反应少的临床治疗模式。方法病例来源：在台湾德安堂中医门诊就诊病人。根据三叉神经痛的西医诊断标准和气滞血瘀型头痛的中医诊断标准选择入组病例,将入组的病例按照1：1的比例分配到试验组和对照组。试验组采用电针配合穴位放血疗法,电针循经取穴(以足阳明经穴为主穴)：五枢、气冲、髀关、伏兔、足三里、解溪、内庭。对照组采用单纯口服中药失笑散为治疗方法；疗程为20天。治疗后观察疼痛程度的改善情况、疼痛次数的减少情况、疼痛持续时间的缩短情况、中医证候积分的改善情况、中医证候疗效、疾病综合疗效和不良反应等。结果本临床试验有原发性三叉神经痛(气滞血瘀证)合格病例64例,其中试验组32例,对照组32例。治疗前各项基线资料经统计学比较,具有可比性。疗效性结果：1.治疗后,试验组与对照组的疼痛程度评分均比治疗前降低,疼痛程度评分及其前后评分差值和评分变化率,组间差异均有统计学意义(P<0.05)。2.治疗后,试验组与对照组的疼痛发作次数均比治疗前减少,疼痛发作次数及其前后发作次数差值和次数变化率,组间差异均无统计学意义(P>0.05)。3.治疗后,试验组与对照组的疼痛持续时间均比治疗前缩短,疼痛持续时间及其前后持续时间差值和持续时间变化率,组间差异均无统计学意义(P>0.05)。4.治疗后,试验组与对照组的中医证候积分均比治疗前降低,治疗前后中医证候积分变化率比较,组间差异均有统计学意义(P<0.05)。5.试验组与对照组的中医证候疗效等级分布,组间差异均有统计学意义(P<0.05)。6.试验组与对照组的疾病综合疗效等级分布,组间差异有统计学意义(P<0.05)。安全性结果：在本试验过程中,两组均未出现不良事件。结论电针结合穴位放血治疗气滞血瘀证三叉神经痛的疗效优于单纯中药治疗,临床上取得令人满意的效果,且无西药常见的毒副作用,值得临床大力推广。更多还原

【Abstract】 ObjectiveThe study observes the feasibility and therapeutic effect of using electro-acupuncture and acupoint bloodletting method in the treatment of trigeminal neuralgia.MethodAll patients were from De An Tang TCM Clinic in Taiwan and were diagnosed with trigeminal neuralgia with TCM headache syndrome caused by stagnation of qi and blood stasis. The patients were divided into treatment and control groups according to a 1:1 ratio. The treatment group used the electro-acupuncture and bloodletting method; the acupoints for electro-acupuncture were mostly along the stomach meridian, which include: wushu, qichong, biguan, futu, zusanli, jiexi, and neiting. The control group was prescribed shixiaosan concoction alone. The course of treatment for both groups was 20 days. After treatment, the intensity, frequency, and duration of pain were assessed, as well as the TCM symptoms. The effectiveness was analyzed and any possible adverse effect was determined.ResultsA total of 64 qualified patients were diagnosed with trigeminal neuralgia of the qi stagnation and blood stasis syndrome. The treatment and control each had 32 patients. All indices in both groups were analyzed statistically and were not significantly different, thus, the groups were comparable.Effectiveness:1. After treatment, the intensity of pain decreased in both groups, but the difference between the two groups was statistically significant (p<0.05). 2. After treatment, the frequency of recurring pain lowered in both groups; the group difference was found to be statistically insignificant (p>0.05).3. After treatment, the duration of pain shortened in both groups; the group difference was not statistically significant (p>0.05).4. After treatment, the TCM syndrome score was lower in both groups. The group difference of the change in score before and after treatment was statistically significant (p<0.05).5. Regarding the effectiveness in terms of TCM syndrome, the group difference was statistically significant (p<0.05).6. Regarding total effectiveness of the disease, the group difference was statistically significant (p<0.05).Safety:No adverse reactions were encountered in both groups in the experiment. ConclusionTreatment of trigeminal neuralgia with stagnation of qi and blood stasis syndrome with electro-acupuncture and herbal concoction was more effective than herbal concoction alone. The therapy poses no adverse effect for the patients, thus, should be widely used in common practice.更多还原