电针结合神经松动术治疗枕神经痛的临床观察

摘要

目的:观察电针结合神经松动术对枕神经痛的影响,探讨枕神经痛的治疗方案.方法:枕神经痛患者随机分为电针治疗组19例、神经松动术组22例及电针结合神经松动术组21例.电针治疗组采用电针针刺玉枕、风池、天柱、完骨等穴;神经松动术组采用C2神经松动术治疗;电针结合神经松动术组将两种方法结合治疗.均每日治疗1次,治疗2周.治疗前后评价视觉模拟量尺(VAS)评分、头痛6点行为评分(BRS-6)并评价疗效.结果:与本组治疗前相比,各组患者VAS评分、BRS-6评分均降低(P<0.05),电针结合神经松动术组较其他两组降低更明显(P<0.01,P<0.05).电针治疗组、神经松动术组和电针结合神经松动术组的总有效率分别为78.95％(15/19)、68.18％(15/22)和90.48％(19/21),电针结合神经松动术组总有效率高于电针治疗组和神经松动术组(P<0.05).结论:电针、神经松动术以及电针结合神经松动术均能改善枕神经痛患者的症状,疗效确切.电针结合神经松动术疗法对于枕神经痛的疗效优于单纯电针疗法或神经松动术疗法.%Objective To observe the effect of electroacupuncture (EA) combined with neural mobilization (NM) in the treatment of occipital neuralgia .Methods A total of 62 occipital neuralgia patients were randomized into EA group (19 cases) , NM group (22 cases) and EA+NM group (21 cases) .EA was applied at acupoint-pairs as Yuzhen (BL 9)-Tianzhu (BL 10) , Fengchi (GB 20)-Wangu (GB 12) ,etc .NM intervention consisted of occipital muscle group mobilization ,C2 spinous process mobilization ,cervical joint passive movement management mobilization ,etc .,was performed at the impaired cervical spine seg-ment .The two methods were used in combination for patients in the EA+NM group .All the treatment was given once a day for 2 weeks .Before and after treatment ,the visual analogue scale (VAS) and the 6-point (1-6 points) behavioral rating scale (BRS-6) of headache were used to assess the severity of pain .The therapeutic effect was evaluated according to the"Criteria for Diagno-sis and Cure-Improvement of Clinical Conditions" formulated by State Administration of Traditional Chinese Medicine of the Peo-ple's Republic of China in 1994 .Results After treatment ,both VAS and BRS-6 scores were significantly lower than those before treatment in each of the three groups ( P<0 .05) ,and were significantly lower in the EA +NM group than in the simple EA and simple NM groups ( P<0 .01 ,P<0 .05) .The total effective rates were 78 .95％ (15/19) in the EA group ,68 .18％ (15/22) in the NM group ,and 90 .48％ (19/21) in the EA+NM group ,with an obviously better therapeutic effect being in the EA+NM group relevant to each of the other two treatment groups ( P<0 .05) .Conclusion EA ,NM and EA combined with NM can improve symptoms of patients with occipital neuralgia ,and EA+NM has a synergic analgesic effect for occipital neuralgia .