内外合治大学生紧张型头痛的临床疗效观察
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[摘要] 目的:观察按摩与阿米替林及谷维素的西药合用对大学生紧张型头痛的疗效。方法:将32例紧张型头痛患者随机分为两组,对照组15例予阿米替林及谷维素口服治疗,治疗组17例在上述治疗基础上,加用按摩治疗,两组1个疗程均为1周,治疗后行疗效评判,进行疗效比较。结果:1周后,治疗组治愈5例,好转11例,无效1例;对照组治愈1例,好转8例,无效6例。治疗组总体疗效优于对照组,其总有效率高达94.1%。结论:采用内外合治治疗大学生紧张型头痛的临床疗效显著。
[关键词] 按摩;阿米替林;谷维素;紧张型头痛;大学生
[中图分类号] R747.205[文献标识码]C [文章编号]1674-4721(2010)05(b)-169-02
Observation on mixed treatment of tension-type headache over college students
ZHAO Yuanyuan
(Medical Office,Liaoning University of Traditional Chinese Medicine,Dalian 116000,China)
[Abstract] Objective: To observe the efficacy on the treatment of tension-type headache over college students with using massage and western medicine which contained amitriptyline and oryzanol. Methods: 32 patients with tension-type headache were randomly divided into treatment group and contrast group. The treatment group was consisted with 15 cases who were treated with oral amitriptyline and oryzanol; The contrast group was consisted with 17 cases who were treated with the above treatments plus massage therapy. Both groups therapy were setted as 1 week, and the treatment efficacy evaluation was given by then. Results: After 1 week, for the treatment group, 5 cases were cured, 11 cases were improved and 1 patient was with no effect. In all, the total effect of the treatment group was higher than that of the contrast group, with efficiency as high as 94.1%. Conclusion: The treatment efficacy with mixed using internal and external way on tension-type headache over college students is effective.
[Key words] Massage; Amitriptyline; Oryzanol; Tension-type headache; College students
紧张型头痛又称为肌紧张型头痛、肌收缩性头痛、功能性头痛或神经性头痛,约占头痛患者的40%,是大学生较常见的一种头痛。在实际工作中,笔者对32名症状较重的在校大学生患者采用了内外合治的治疗方法,取得了满意的疗效,现报道如下:
1资料与方法
1.1 一般资料
32例患者均为近几年来在本院门诊就诊的大学生,将其随机分为治疗组(内外合治治疗组)、对照组(单纯西药)。治疗组17例,男7例,女10例;平均年龄22岁;病程3～8个月,平均(4.56±1.23)个月。对照组15例,男6例,女9例;平均年龄23岁;病程2～9个月,平均(5.11±1.28)个月。两组患者一般资料差异无统计学意义(P>0.05),具有可比性。
1.2 纳入标准
符合2004年国际头痛协会制订的头面部疼痛分类诊断标准中紧张性头痛的标准[1];未合并其他原因引起的头痛。
1.3 治疗方法
对照组口服西药治疗,阿米替林12.5～50.0 mg,每日2次,谷维素10～30 mg,每日2次,口服,必要时给予心理疏导治疗;1个疗程7 d。
治疗组在给予口服西药的内治法的基础上,采用按摩的外治法,具体如下:治疗时患者坐位,医者居患者侧方,先点按合谷、列缺、风池、风府穴,再用双手提拿肩井穴及其周围大筋,至患者自觉酸胀感;用双手拇指分推印堂→前额→眉弓至太阳穴3~5次,再用双手大鱼际按揉太阳穴2～3 min。然后双手张开,沿患者发际贴紧头皮向斜上方推揉,力度随患者的耐受力而定,反复3~5次,使头皮有发热感,再用双侧手掌按、揉使之有酸胀感;用中指、食指拨揉后颈部两侧大筋3~5次,再用双手掌根自两侧的太阳穴至耳后做推法3~5次,可稍加用力;1个疗程7 d。
1.4 疗效标准
参照国家中医管理局1994年颁布的《中医病证诊断疗效标准》中关于头风的疗效评定标准[2]。
1.5 统计学处理
采用统计学软件SPSS 11.0,对结果进行χ2检验,P<0.05为差异有统计学意义。
2 结果
治疗后按照疗效标准进行疗效评判,经χ2检验,P=0.037<0.05。治疗组总体疗效优于对照组,其有效率高达94.1%,结果见表1。
3 讨论
紧张型头痛属于神经功能性头痛,是大学生较常见的一种头痛,该头痛为非波动性,常为双侧或整个头部弥漫性紧压痛,多数患者主诉为紧压感或压迫、沉重感。枕区疼痛可向颈项及肩胛区放射 ......
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