| Obj ective:By systematically evaluating the analgesic effect of acupuncture at different nerve innervation points in acute migraine without aura to preliminarily clarifies the characteristics and rules of the analgesic effect of acupuncture at different nerve distribution points in acute migraine,so as to optimize the selection of acupoints and improve the therapeutic effect.Methods:264 patients who met the criteria of case selection were divided into group A occipital pain group and group B frontotemporal orbital pain group according to the location of headache.The group was randomly divided into three groups:the occipital nerve innervation group(A1,B1),the trigeminal nerve innervation group(A2,B2),the distal acupoints group(A3,B3),the occipital nerve + trigeminal nerve innervation group(A4,B4).The occipital nerve acupoint group was treated with pai-zhen-ping-ci at occipital part for 2 hours;the trigeminal nerve distribution group was treated with pai-zhen-ping-ci at frontotemporal part for 2 hours;and the distal acupoints group was treated with distal acupoint according to the National Textbook of acupuncture and moxibustion,except for the head and face acupoints.for 0.5 hours;the combined acupoint group was treated with A+B acupuncture method.Visual analogue scale(VAS)was used to evaluate the degree of headache before acupuncture and after acupuncture at 5min,30min and 2 hours.Comparing VAS at different time points before and after treatment,VAS at the same time in different nerve distribution areas of the same headache site.VAS difference at the same time points in different headache location of the same nerve distribution area and 2-hour effective rate.Results:1.Comparison of VAS scores before and after treatment in each group:The VAS scores at different time points in each group were analyzed,and the difference of VAS scores at different time points was statistically significant(P<0.05);The paired comparison indicated that each nerve innervation area acupoint group had a certain effect on occipital pain and frontotemporal pain,but the time needed to reach the peak effect was different.It takes less time for the acupoint group of corresponding nerve innervation area to reach the peak curative effect of headache.2.Comparison of VAS in different nerve distribution areas at the same headache site;The curative effect of occipital pain,occipital nerve innervation point group and occipital nerve plus trigeminal nerve innervation point group was better than that of trigeminal nerve innervation point group and distal point group at 5 minutes and 2 hours after treatment(P<0.05),but the curative effect was similar between the two groups(P>0.05);for frontotemporal orbital pain,at 5 minutes and 2 hours after treatment,the curative effect of occipital nerve,trigeminal nerve and occipital nerve plus trigeminal nerve innervation area acupoint group was better than that of distal acupoint group(P<0.05).there was no statistical difference among the three groups(P>0.05).but the therapeutic effect was in order of occipital nerve plus trigeminal nerve innervation point group,trigeminal nerve innervation point group and occipital nerve innervation point group.and with the prolongation of needle retention time,the difference of curative effect among the three groups became smaller.3.Comparison of VAS in sanme nerve distribution areas at different headache site:the curative effect of occipital nerve innervation area acupoint on occipital pain was significantly better than that of frontotemporal orbital pain at 5 minutes after treatment(P<0.05),and the curative effect of two parts of headache was similar at 2 hours after treatment(P>0.05);the curative effect of trigeminal nerve innervation area acupoint group on frontotemporal orbital pain was significantly better than that of occipital pain at 5 minutes and 2 hours after treatment(P<0.05):the curative effect on headache in two parts was similar at 5 minutes and 2 hours after treatment for the distal acupoint group(P>0.05);at 5 minutes after treatment,the effect of occipital nerve plus trigeminal nerve innervation area acupoint group on frontotemporal orbital pain was significantly better than that of occipital pain(P<0.05),and at 2 hours after treatment,the curative effect on two parts of headache was similar(P>0.05).4.2-hour effective rate:For occipital pain,the two-hour effective rate of the occipital nerve innervation group was similar to that of the occipital nerve+trigeminal nerve innervation group(P>0.05),which was significantly higher than that of the trigeminal nerve and distal acupoint group(P<0.05);for frontotemporal orbital pain,the two-hour effective rate of the occipital nerve,trigeminal nerve and occipital nerve+trigeminal nerve innervation group was significantly higher than that of the distal acupoint group(P<0.05),and the acupoint group of occipital nerve+trigeminal nerve innervation area was the best.The 2-h effective rate of acupoints in the occipital nerve innervation area was similar to that in the two parts of headache(P>0.05),but they had a slight advantage over the occipital pain.The 2-h effective rate of acupoints in the trigeminal nerve innervation area of frontotemporal orbital pain was significantly higher than that of occipital pain(P<0.05).Conclusion:(1)The acupoint groups of occipital nerve distribution region,trigeminal nerve distribution region and the distal acupoints group have certain analgesic effects on occipital pain and frontotemporal orbital pain.(2)The acupoint group of occipital nerve distribution region has good analgesic effect on occipital pain and frontotemporal orbital pain,but it may have specific analgesic ef fect on occipital pain,and this specificity is not only reflected in the degree of analgesia,but also in the speed of analgesia;the acupoint group of trigeminal nerve distribution region may have specific analgesic effect on frontotemporal orbital pain;the distal acupoints group may have no specific analgesic effect on headache in different parts.(3)For the three acupoint methods involved in this experiment,for occipital pain,the occipital nerve distribution region acupoint group should be the first choice;for frontotemporal orbital pain,the occipital nerve combined with trigeminal nerve distribution region acupoint group should be the first choice. |
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