| 引用本文:魏韬，张树森，鲁凌云，郑倩华，周思远，李瑛.针刺治疗慢性紧张型头痛临床疗效与期待值的相关性研究[J].世界中医药,2018,(07):. |
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| 针刺治疗慢性紧张型头痛临床疗效与期待值的相关性研究 |
| Acupuncture Treatment for Chronic Tension-type Headache：The Correlation Between the Expectant Value of the Therapeutic Effect and Clinical Efficacy |
| 投稿时间：2018-06-15 |
| DOI：10.3969/j.issn.1673-7202.2018.07.007 |
| 中文关键词: 针灸 慢性紧张型头痛 针灸期待值 临床疗效 相关性 |
| English Keywords:Acupuncture Chronic tension-type headache Acupuncture expectant value Clinical efficacy Correlation |
| 基金项目:四川省科技厅国际科技合作及交流计划项目（2016HH0007） |
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| 中文摘要: |
| 目的：以慢性紧张型头痛（Chronic Tention-type Headache，CTTH）患者为研究对象，以针刺治疗为干预手段，观察患者疗效期待值与临床疗效的相关性。方法：选取2016年8月至2018年1月成都中医药大学附属医院神经内科就诊的患者或社会招募CTTH患者90例，采用中央随机将患者分为深刺组与浅刺组，每组45例。选取百会、双侧风池、太阳、合谷、太冲为针刺穴位。深刺组采取深刺，进针后行提插捻转平补平泻手法，留针时间30 min，留针期间共行针2次；浅刺组采取浅刺，留针时间30 min，留针期间不行针不要求得气。针灸治疗8周，其中前4周，每周治疗3次，后4周每周治疗2次，共计治疗20次。于针刺治疗前，根据患者对针灸疗效的期待值高低将患者分为疗效高期待组76例与疗效低期待组14例。比较治疗8周时疗效高期待组和疗效低期待组间头痛临床疗效指标，即头痛发作天数、头痛程度评分（Visual Analogue Score，VAS）以及头痛持续时间（h）的差异，以观察疗效高低期待值对针刺治疗CTTH患者疗效的影响。结果：疗效高低期待组基线期患者年龄、性别、病程、焦虑与抑郁评分、头痛发作天数、头痛程度、头痛持续时间（h）等均无统计学意义（P>0.05）。针灸治疗结束时，2组患者头痛发作天数、头痛程度及头痛持续时间（h）比较均无统计学意义（P>0.05）。且治疗8周时，疗效高、低期待组头痛减少天数、头痛减少程度及头痛减少时间（h）差异亦无统计学意义（P>0.05）。结论：患者对针灸治疗CTTH的疗效期待高低与针灸治疗CTTH的临床疗效无明显相关性。 |
| English Summary: |
| To observe the correlation between the expectant value of the therapeutic effect and the clinical efficacy, by using acupuncture treatment as an intervention method in patients with chronic tension-type headache (CTTH). Methods:A total of 90 patients with CTTH in our hospital from August 2016 to January 2018 were enrolled. The patients were randomly divided into the deep puncture group and the shallow puncture group by the Brightech Clinical Information Management System (CIMS) system, with 45 cases in each group. The treatment selected Baihui (DU 20), bilateral Fengchi (GB 20), Taiyang (EX-HN5), Hegu (LI 4) and Taichong (LV 3) as acupuncture points. The deep penetration group took deep penetration, and the range of needle penetration was between 3 and 5 mm. The needle retention time was 30 min, and the total manipulating needle time during needle retention was two. The shallow puncture group performed shallow puncture. The needle retention time was 30 min and manipulating needle was not performed. The treatment period was 8 weeks, during which the patients were treated 3 times a week in the first 4 weeks and twice a week in the following weeks. Each patient had a total of 20 treatments. Prior to acupuncture treatment, item 2 of the Acupuncture Expectation Evaluation Table was used to evaluate the expectation of efficacy in both groups of patients. At 8 weeks of treatment, the clinical efficacy indicators of headache between the high-expectant group and the low-expectant group were compared, namely, the number of days of headache attack, Visual Analogue Score (VAS), and duration of headache (h) to observe the effect of the expected value of acupuncture treatment on CTTH patients. Results:Baseline data analysis results：there was no statistical difference between the two groups of patients' age, sex, course of disease, anxiety and depression score, headache days and headache time (P<0.05). At the end of acupuncture treatment, there was no significant difference in headache attack days, headache degree and headache duration (h) between the two groups (P>0.05). At the 8th week of treatment, there was no significant difference in the number of days of headache reduction, the degree of headache reduction and the time of headache reduction (h) in the high-prevalence and low-exposure groups (P>0.05). Conclusion:The expected value of curative effect is not related to the clinical efficacy of acupuncture for the treatment of CTTH. |
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