| Objective:Through the research on the literature theory of massage therapy for migraine,to explore the characteristics and deficiencies of clinical applications of massage in migraine treatment,summarize the acupoint of massage,the manipulation of massage,the operation area of massage,the combination therapy of massage and other clinical application rules of massage,better guide the clinical study,improve the therapeutic effect,and provide the literature theory basis for the study on the treatment of migraine.In this clinical study,migraine patients with acute phase as the research object,by observing the changes of the clinical symptoms,the degree of pain,the quality of life,the cerebral hemodynamics and the related blood vessel active substances in the three groups before and after treatment,to analyze the efficacy of migraine by massage combined with acupuncture method of soothing the Liver and regulating the Spirit,and to study the mechanism of massage and acupuncture in analgesia.Methods:Using the methods of literature and data mining in the application of traditional Chinese medicine,to retrieve the clinical research literature on the migraine treatment of CNKI before January 1,2018.Through the manual sifting of the literature that has no relation with this study,collating and summarize the clinical literature included in the study.to classify the acupoint of massage,the manipulation of massage,the operation area of massage,the combination therapy of massage and other datas,then establish database and apply IBM SPSS Statistics 22.0 software to statistical analysis.Clinical studies refer to the research indicators of this literature study,the 96 cases selected in the study who were diagnosed with migraines were divided into observation group(massage combined with acupuncture method of soothing the Liver and regulating the Spirit),acupuncture group((acupuncture method of soothing the Liver and regulating the Spirit)and massage group(massage therapy)by a random number digital table according to the propotion,each group of 32 people.All cases were treated for 4 weeks,observing the clinical symptoms points of the patients,short-form Mc Gill pain questionnaire score(SF-MPQ),the quality of life quality score(MSQ),plasma 5-HT,SP,CGRP content and the systolic blood flow velocity(Vs)of the main arteries(MCA,ACA,PCA,BA,VA)before and after treatment.Results:1.In the literature study,there were 96 acupoints for clinical application of massage therapy for migraine,including 91 meridians and 5 odd acupoints.There are 50 kinds of manipulation methods in total,including 23 compound techniques and 27 single techniques.A total of 17 combined treatments for migraine with massage,involving 15 kinds of diagnostic criteria,5 kinds of criteria for efficacy evaluation,11 kinds of therapeutic observation indicators.2.Comparison of general information:There was no statistically significant difference in the sex,age,course of disease and other general data between three groups.The clinical symptom score,SF-MPQ score,MSQ score,plasma 5-HT,SP,CGRP content,and systolic peak flow rate of ACA,MCA,PCA,BA and VA were not statistically significant,so there was comparability between the groups.3.Comparison of total effective rate: the total sensible efficiency(87.5%)of the observation group was higher than that of massage group(71.9%)and acupuncture group(65.6%),and the total effective rate(93.6%)was also higher than that of massage group(81.3%)and acupuncture group(78.1%),and the difference was statistically significant(all P < 0.05).4.Clinical symptoms integral comparison: compared with before treatment,after four weeks of treatment,the patients of three groups had significant improvement in the number of headache attacks,the degree of headache,duration,and accompanying symptoms,and the difference was significantly significant(P < 0.01).The improvement of observation group was better than that of acupuncture group and massage group(P < 0.01).5.Comparison of SF-MPQ score: the scores of SF-MPQ were significantly decreased after treatment in the three groups compared with that of before treatment,and the difference was statistically significant(all P < 0.01).Comparison between two groups after treatment,the improvement of the PRI sensory score and the PRI emotional score in the observation group and the massage group were better than that of the acupuncture group,and the difference was statistically significant(all P < 0.01).The VAS score,PPI score and SF-MPQ total score in the observation group were better than those in the acupuncture group and the massage group,and the differences were statistically significant(all P < 0.05).6.MSQ score comparison: compared with before treatment,after treatment the MSQ scores of three groups of patients were significantly lower,the difference had statistical significance(P < 0.01),and the improvement of the observation group was better than that of acupuncture group and massage group(all P < 0.05).7.Comparison of the levels of plasma 5-ht,SP and CGRP: compared with pre-treatment,the plasma contents of SP,CGRP and 5-ht of the three groups were significantly reduced after treatment,at the same time the difference was statistically significant(all P < 0.01).In comparison between groups,the improvement of plasma 5-ht,SP and CGRP in the observation group was better than that of acupuncture group and massage group(all P < 0.01),and the difference was statistically significant.8.TCD comparison: compared with those before treatment,Vs in the three groups of patients which was mainly manifested as an increasing speed were significantly decreased after treatment,and the differences in the decrease of MCA,ACA,BA and VA were statistically significant(all P < 0.05).Vs which was mainly manifested as an decreasing speed in the three groups were significantly increased after treatment,and the differences in the rise of MCA and ACA were statistically significant(all P < 0.05).After treatment,comparison between groups which’s TCD appears as the Vs enhanced,the improvement of the BA and VA in observation group is superior to the acupuncture group and massage group(all P < 0.05).Comparison between groups which’s TCD appears as the Vs slackened,the improvement of the MCA and ACA in observation group were better than acupuncture group and massage group(all P <0.05).Discussion:1.The skills of massage therapy for migraine are variety,it also has significant advantages of reliable curative effect and high patient acceptance,worthy of clinical promotion and application.2.Massage combine with acupuncture method of soothing the Liver and regulating the Spirit can reduce the number of headache attacks,shorten the duration of the headache,reduce the intensity of the pain,and improve the quality of life of the patients.By reducing the blood flow velocity of the abnormal elevated MCA,ACA,BA,VA and improving the blood flow velocity of the abnormal MCA and ACA,achieved regulating the cerebral blood flow,thus improving cerebral perfusion.It also can reduce the release of 5-HT,CGRP and SP of the neurotransmitter,regulated the content of blood vessels in peripheral blood,promoting the normal function of vasoconstriction.It has analgesic and therapeutic effect on migraine.3.Massage,acupuncture method of soothing the Liver and regulating the Spirit and massage combine with acupuncture method of soothing the Liver and regulating the Spirit,these different therapies all have therapeutic effects on migraine sufferers.Massage combine with acupuncture method of soothing the Liver and regulating the Spirit as a kind of combination therapy,can play a different role of acupuncture and massage,as well as the synergy of acupuncture and massage,which can strengthen the treatment effect.Therefore,in the treatment of migraine,the analgesic effect and long-term therapeutic effect are better than that of single acupuncture or massage therapy.4.Massage combine with acupuncture method of soothing the Liver and regulating the Spirit regard governance and defendence of spirit as the treatment principle,it has the effect of invigorating the circulation of blood and qi,dredging meridian,adjusting the viscera function,through the combination stimulation of massage and acupuncture to the acupoints and meridian,realizing the therapeutic effect of soothing the liver and qi,dredging the channels and relieving the pain,activating the blood and extinguish the wind,quieting the heart and Calming the spirit.5.The mechanism of massage combine with acupuncture method of soothing the Liver and regulating the Spirit for migraine was by converting the mechanical energy produced by massage and acupuncture stimulation into heat energy,expanding local capillaries,accelerating the blood circulation,improving blood perfusion and oxygen supply of local tissues as well as brain tissues,thus effectively relieve the spasm constriction of the intracranial vessels,prompting the recovery of normal vasoconstriction function,to adjust blood flow velocity,improve cerebral blood flow,relieve headaches symptoms.Joint mechanical stimulation of acupuncture and massage in local tissues,nerves,and blood vessels,can enhance the function of these local tissues as well as nerves and blood vessels,accelerate the metabolism absorption of the inflammatory substances in tissues,eliminate the aseptic inflammation of the dominant nerve,and promote the recovery of neurological function in patients.In addition,it can reduce the release of neuropeptides pain-causing substances like 5-ht,SP and CGRP,reduce the content in peripheral blood,reduce the damage to blood vessels,inhibit the production of hyperalgesia,improve tissue pain threshold,and thus play analgesic effect;Through the regulation of the content of blood vessel active substances,massage combine with acupuncture therapy of soothing the Liver and regulating the Spirit method can promote the recovery of normal vasoconstriction function,indirectly to regulate the cerebral blood vessels,and the cerebral blood flow can be improved to achieve the goal of treating migraine. |
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