【摘要】：目的:通過(guò)觀察雙側(cè)針刺健側(cè)通電治療原發(fā)性三叉神經(jīng)痛與口服卡馬西平治療療效差異,為治療原發(fā)性三叉神經(jīng)痛提供一種療效確切,操作簡(jiǎn)單,經(jīng)濟(jì)安全的治療方法。方法:將62例來(lái)自黑龍江中醫(yī)藥大學(xué)附屬第二醫(yī)院針灸五門診的符合納入標(biāo)準(zhǔn)的原發(fā)性三叉神經(jīng)痛患者按照隨機(jī)分組法分成兩組,即治療組(針刺組)和對(duì)照組(西藥組),每組各31例。對(duì)照組(西藥組)口服卡馬西平(由北京曙光藥業(yè)有限責(zé)任公司生產(chǎn),規(guī)格為0.1g/片)。首劑0.1g,每日2次。以后每天增加0.1g,直到疼痛停止,但是最大量不能超過(guò)1000mg/d。治療組(針刺組):患者仰臥位,或坐立位。百會(huì)、予針刺后施以強(qiáng)捻轉(zhuǎn)快速法,持續(xù)約2分鐘。面部腧穴采取常規(guī)透刺手法,手法柔和,得氣即止。遠(yuǎn)端腧穴采取常規(guī)針刺手法,平補(bǔ)平瀉。用英迪牌KWD808Ⅱ電針治療儀,密波70HZ、波形固定,根據(jù)患者的耐受程度可做適當(dāng)?shù)募訙p,導(dǎo)線連接:連接健側(cè)太陽(yáng)(+),四白(-);連接健側(cè):下關(guān)(+),夾承漿(-)。每次治療持續(xù)30分鐘,每日針刺1次,6天為一療程,共四個(gè)療程,每個(gè)療程間隔一天。于治療前,治療后分別詳細(xì)采集記錄患者視覺(jué)模擬評(píng)分(VAS)、生活質(zhì)量評(píng)分、疼痛癥狀積分進(jìn)行評(píng)價(jià)。結(jié)果:1.本試驗(yàn)共納入62例患者,過(guò)程中治療組和對(duì)照組各有一例脫落,最終治療組對(duì)照組各有30例患者完成試驗(yàn)。2.療效評(píng)價(jià):經(jīng)課題設(shè)計(jì)的方法治療完成過(guò)后,治療組(針刺組)治愈5例,顯效17例,有效5例,無(wú)效3例;對(duì)照組(西藥組)治愈2例,顯效11例,有效12例,無(wú)效5例。治療組總有效率90.00%,對(duì)照組總有效率83.33%。經(jīng)統(tǒng)計(jì)學(xué)分析,試驗(yàn)結(jié)果具有統(tǒng)計(jì)學(xué)意義(P0.05),可得出治療組療效優(yōu)于對(duì)照組療效的結(jié)論。3.VAS評(píng)分、生活質(zhì)量評(píng)分以及疼痛癥狀積分,治療組和對(duì)照組的這三者在自身治療前后的對(duì)照,均有顯著差異(P0.01),且治療組優(yōu)于對(duì)照組(p0.05),差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:1.治療組、對(duì)照組對(duì)治療原發(fā)性三叉神經(jīng)痛均有效,治療組療效優(yōu)于對(duì)照組。2.治療組、對(duì)照組對(duì)于降低VAS評(píng)分、疼痛癥狀積分、生活質(zhì)量評(píng)分均有效,治療組效果優(yōu)于對(duì)照組。即是治療組在減輕PTN患者的臨床癥狀和痛苦以及提高生活質(zhì)量上優(yōu)于對(duì)照組。3.雙側(cè)針刺健側(cè)通電是一種有效且操作簡(jiǎn)便的治療方式,值得進(jìn)一步的研究和推廣。
[Abstract]:Objective: to observe the difference of therapeutic effect of bilateral acupuncture on primary trigeminal neuralgia and oral carbamazepine in the treatment of primary trigeminal neuralgia, and to provide an effective, simple, economical and safe method for the treatment of primary trigeminal neuralgia. Methods: Sixty-two patients with primary trigeminal neuralgia from the Fifth Clinic of Acupuncture and moxibustion of the second affiliated Hospital of Heilongjiang University of traditional Chinese Medicine were randomly divided into two groups: treatment group (acupuncture group) and control group (western medicine group). There were 31 cases in each group. The control group (western medicine group) took carbamazepine orally (produced by Beijing Shuguang Pharmaceutical Co., Ltd., 0.1g/ tablet). The first dose is 0.1 g, twice a day. After that, increase 0.1 g a day until the pain stops, but the maximum is not more than 1000 mg / d. Treatment group (acupuncture group): patient supine position, or sitting position. Apply strong twisting method after acupuncture for about 2 minutes. Facial acupoints take a routine penetration technique, the manipulation of soft, Qi namely stop. The distal acupoint adopts the routine acupuncture manipulation, leveling tonifying and leveling the diarrhea. KWD808 鈪，

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