神经阻滞联合小针刀治疗颈源性头痛疗效观察

摘要

目的:观察神经阻滞联合小针刀治疗颈源性头痛的效果.方法:将诊断明确的颈源性头痛患者60例随机分为A、B两组,每组30例.A组为治疗组,先行患侧枕大神经、枕小神经、后入路法颈2椎旁神经阻滞,再于患侧枕部和上颈部最多见最敏感的3个压痛点行小针刀治疗,每周1次,共治疗3次.B组为对照组,只行患侧枕大神经、枕小神经、后入路法颈2椎旁神经阻滞治疗.观察每次治疗后、1个月疼痛指标和3个月、6个月后总体疗效.结果:两组治疗颈源性头痛均有明显疗效,但是比较两组治疗效果及远期疗效,A组明显优于B组.结论:神经阻滞联合小针刀治疗颈源性头痛疗效满意,远期疗效优于单纯神经阻滞治疗.%Objective:To observe the efficacy of combination of nerve block with acupotomy in the treatment of cervicogenic headache (CH).Methods:A total of 60 consecutive patients with conformed CH were randomly divided into groups A (treatment) and B (control),with 30 patients in each group.The patients of group A firstly received nerve block in the greater occipital nerve,lesser occipital nerve,and the second cervical paravertebral nerve through posterior approach,and then underwent acupotomy therapy on 3 most common and most susceptible pressure pain points in the affected side of occiput and upper hind neck (once a week,for 3 weeks).The patients in group B as control only received nerve block as performed in group A.The pain indexes were observed and compared between the two groups just after every therapy and at 1 month after therapy,and the total curative effect was also studied at 3 and 6 months after treatment.Results:Obvious effectiveness was observed in both groups,but group A was superior to group B in treatment outcome and long-term efficacy.Conclusion:Combining nerve block with acupotomy has the advantages of satisfying outcome and better long-term efficacy compared with simple nerve block therapy.