颈痛颗粒联合颈脊神经后支射频消融术对颈源性头痛疗效观察

Clinical observation on the treatment of cervical headache by Jingtong granules combined with posterior ramus of cervical spinal nerve radiofrequency ablation

关键词:  颈痛颗粒  颈脊神经后支射频消融术  颈源性头痛  颈椎活动度  抑郁

Key words:  Jingtong granules  cervical spinal nerve radiofrequency ablation  cervicogenic headache  cervical mobility  depression

摘要:

[目的]观察颈痛颗粒联合颈脊神经后支射频消融术对颈源性头痛（CEH）相关临床症状的效果评价。[方法]采用前瞻性研究的方法，对2014年6月-2015年12月收治的99例反复发作的气滞血瘀型CEH患者进行随机分组，试验分为颈痛颗粒组、射频组、联合组，最终脱落、剔除以及中止病例数9例，有效病例90例。颈痛颗粒组30例，予颈痛颗粒，每次4 g，每日3次，疗程为4周；射频组30例，行颈脊神经后支射频消融术；联合组30例，予上述颈痛颗粒方案同时，联合颈脊神经后支射频消融术。患者分别于治疗前、治疗后1、7、28 d填写视觉模拟评分量表（VAS）、抑郁自评量表（SDS），记录颈椎活动度（ROM）评分。[结果]治疗前3组VAS、SDS、ROM差异无统计学意义（P>0.05），治疗后组内各时间点VAS、SDS、ROM评分均趋向好转，各组内比较差异有统计学意义（P<0.05）；各组间统计学分析，3组VAS值比较，联合组优于颈痛颗粒组和射频组，差异有统计学意义（P<0.05）；3组ROM评分、SDS评分比较，各组间差异无统计学意义（P>0.05）。[结论]颈痛颗粒联合射频组对头痛的缓解优于射频组和颈痛颗粒组；3种方法均能减轻CEH引起的颈椎受限及抑郁状态，且效果基本相同，治疗后均接近正常水平。

Abstract:

[Objective] To observe the effect of Jingtong granules combined with posterior ramus of cervical spinal nerve radiofrequency ablation on cervical headache.[Methods] A prospective study, from June 2014 to December 2015, we analyzed 99 cases of recurrent CEH (the Type of qi Stagnancy and Blood Stasis) patients, the test is divided into 3 groups, one group of 30 cases received jingtong granules treatment(jingtong granules group). 4 g/times, 3 times/day, for 4 weeks; one group of 30 cases received posterior ramus of cervical spinal nerve radiofrequency ablation treatment(RF group); one group of 30 cases received jingtong granules combined with posterior ramus of cervical spinal nerve radiofrequency ablation treatment(combined group). Patients fill in the VAS scale, SDS scale, and recorded the ROM score before treatment, 1 days, 7 days and 28 days after treatment.[Results] VAS, SDS and ROM of three groups had no significant difference before treatment (P>0.05). After treatment, VAS, SDS, ROM were tend to improve in each groups, and there was a significant difference within groups (P<0.05). Between the three groups, the VAS value of combined group is better than the Jingtong granules group and RF group, the difference was statistically significant (P<0.05); comparison of ROM score, SDS score of three groups, there was no significant difference between the groups (P>0.05).[Conclusion] Jingtong granules combined with posterior ramus of cervical spinal nerve radiofrequency ablation alleviate headache superior to posterior ramus of cervical spinal nerve radiofrequency ablation and Jingtong granules. Both of the three methods can alleviate the poor cervical mobility and depression, and the effect is basically the same. They were close to normal level after treatment.