目的比较激痛点（myofascial trigger points, MTrPs）针刺疗法和外周神经阻滞治疗颈源性头痛（cervicogenic headache, CEH）的临床疗效及安全性。方法选择2019年11月至2020年4月在徐州医科大学附属医院疼痛科就诊的64例 CEH患者，按照随机数字表法分为激痛点针刺治疗组（A组）和外周神经阻滞治疗组（B组），每组32例。A组行MTrPs针刺疗法 治疗，B组行外周神经阻滞治疗。记录两组患者治疗前、治疗周期结束后（以下简称治疗后）1周、1个月、3个月的疼痛数字评 分（Numerical Rating Scale, NRS）、颈部关节活动度（cervical range of motion, CROM）、颈椎功能障碍指数（neck disability index, NDI），同时记录住院期间补救药物使用率和不良反应发生情况。结果两组患者治疗后各时间点NRS、NDI评分较治疗前 降低（P<0.05），CROM较治疗前增加（P<0.05）。A组在治疗后1个月、3个月的NRS、NDI评分较B组降低（P<0.05），CROM较B 组增高（P<0.05）。两组患者住院期间补救药物使用率、不良反应发生率差异无统计学意义（P>0.05）。结论MTrPs针刺疗 法和外周神经阻滞均能显著缓解CEH患者疼痛，改善患者颈部活动度和生活质量。MTrPs针刺疗法1个月后临床疗效优于外 周神经阻滞治疗。
Objective To compare the clinical effectiveness and safety of myofascial trigger points (MTrPs) acupuncture and peripheral nerve block in the treatment of cervicogenic headache (CEH). Methods A total of 64 patients with CEH who were admit⁃ ted to Department of Pain, the Affiliated Hospital of Xuzhou Medical University from November 2019 to April 2020 were enrolled. Ac⁃ cording to the random number table method, they were divided into two groups (n=32): a myofascial trigger points acupuncture group (group A) and a peripheral nerve block group (group B). Their scores of Numerical Rating Scale (NRS), cervical range of motion (CROM) and neck disability index (NDI) before and one week, one month, three months after treatments cycles (hereafter referred to as "after treatment"). Meanwhile, the use of rescue drugs and adverse reactions during hospitalization were recorded. Results After treatment, both groups presented remarkable improvement in NRS, NDI and CROM scores at each time points compared with those be⁃ fore treatment (P<0.05). Compared with group B, substantial improvement was found as to NRS, NDI and CROM scores in group A one and three months after treatment (P<0.05). During hospitalization, there was no statistical difference as to the use of rescue drugs and the incidence of adverse reactions between the two groups (P>0.05). Conclusions Both MTrPs acupuncture and peripheral nerve block can obviously relieve pain, improve neck mobility and enhance the quality of life, where the clinical effectiveness of the former is better than that of the latter one month after treatment.
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