目的:观察星状神经节阻滞联合亚甲蓝帽状腱膜下注射治疗慢性紧张型头痛的疗效.方法:60例患者随机分为A、B两组,每组30例.A组(治疗组)先行星状神经节阻滞,再于患者枕外隆凸处、双侧耳颞区、前额区亚甲蓝帽状腱膜下注射.每周一次,4次为一疗程.B组(对照组),盐酸氟西汀和盐酸乙哌立松及布洛芬缓释胶囊口服用药,连续服药4周.动态观察治疗前后患者头痛发作程度、频率、持续时间的变化,并对各组治疗效果及并发症进行比较,头痛程度采用视觉模拟评分(visual analogue scale,VAS)表示.结果:两组患者治疗后,头痛频率、持续时间和头痛程度都有缓解,A组优于B组.A组治疗后优良率(86.7％)高于B组(53.3％).结论:星状神经节阻滞联合亚甲蓝帽状腱膜下注射是治疗慢性紧张型头痛的一种有效方法.%Objective: To observe the clinical effects of stellate ganglion block (SGB) combined with methylene blue injection under epicranial aponeurosis on chronic tension type headache. Methods: 60 patients with chronic tension type headache were randomly and evenly divided into treatment group (group A) and control group (group B). The patients in group A received SGB combined with methylene blue injection under epicranial aponeurosis once a week for 4 weeks. The patients in group B received oral fluoxetine hydrochloride, eperisone hydrochloride and ibuprofen sustained-release capsules for 4 weeks. The degree of severity, the frequency of attacks and the duration of headache, the treatment effects were observed and recorded. The degree of headache severity was evaluated by visual analogue scale (VAS). Results: Compared with pre-treatment, the degree of severity, the frequency of attacks and the duration of headache were alleviated after treatment in two groups, and the treatment effects in group A was better than that in group B. The excellent rate of pain relief in group A (86.7%) was higher than that in group B (53.3%). Conclusion: SGB combined with methylene blue injection under epicranial aponeurosis is an effective treatment for chronic tension type headache.
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