針刺應用於治療頭痛療效評估

Assessment of the Efficacy in Acupuncture Treatment of Headache

10.6516/TJTCM.2015.18(2)01

羅明宇(Mine-Yu Lo)；孫維仁(Wei-Zne Sun)；林昭庚(Taung-Geng Lin)

針刺 ； 頭痛 ； 近紅外線光譜 ； acupuncture ； headache ； near-infrared spectroscopy

中醫藥研究論叢

18卷2期（2015 / 09 / 30）

1 - 17

繁體中文

針刺已被證實能作為偏頭痛的預防性治療，然而在腦血流循環改變機轉仍不明確。本研究的目的是研究針刺偏頭痛臨床療效及腦血循環改變的關連性。假設頭針針刺組治療偏頭痛比體針安慰組針刺更為有效，而安慰組又比沒有針刺治療純止痛藥組更有效。療效評估的指標包括腦血氧飽和度、頭痛疼痛指數、平均每月頭痛發作天數和每次頭痛發作持續時間的變化。以近紅外線光譜儀（NIRS）監測腦血氧飽和度以驗證針刺頭痛止痛療效評估。本研究設計了一項隨機分配、安慰對照組之準雙盲研究。以近紅外線光譜於療程中即時記錄其數值。在研究過程中，所有患者皆可依據頭痛嚴重狀況繼續用藥。目前已確認收案數為11位，取得初步之成果如下：在頭針組和體針組於針刺前後，腦血氧飽和度的改變、頭痛疼痛指數和每月止痛藥服用次數變化有統計學上的變化，但在平均每月頭痛發作天數和每次頭痛發作持續時間，或因個案數不足，尚無明顯差異。另頭針組和體針組之間，無論在腦血氧飽和度改變、頭痛疼痛指數差異、每月頭痛發作天數、每月止痛藥服用次數變化和每次頭痛發作持續時間，目前尚無統計學上顯著的不同。是否還是因個案數不足，以及有安慰劑效應，尚待大量收案方足以分析比較差異性。

Acupuncture has recently found affirmation as a prophylactic treatment for migraine, but its effect on cerebral hemodynamics remain unclear. The aim of the study is to investigate the effectiveness of acupuncture for migraine and the changes in cerebral blood circulation. In this study, we hypothesize that verum acupuncture is more effective than placebo acupuncture and that placebo acupuncture is more effective than not receiving any kind of acupuncture. The indicators to assess the efficacy of the acupuncture treatments includes the changes of cerebral oxygen saturation, the VAS recordings, the number of days which headache attacks per month and the duration of each headache attack, and using near-infrared spectroscopy (NIRS) to monitor the changes ofcerebral oxygen saturationduring all the acupuncture treatments to assess the efficacy of acupuncture treatments. This study plans a randomized, placebo-controlled, quasi double-blind study. Also, NIRS readings are taken at all acupuncture sessions. All patients have access to individually prescribed medications depending on their migraine condition throughout the study. We have achieved preliminary outcomes are as follows: Statistically differences have been found in changes of cerebral oxygen saturation, the VAS recordings and the number of time which the medicine have been taken by verum and placebo group, but it can't find significant differences between the number of the onset of headache days and the duration of headache attacks because of the number of eligible subjects. Whether the changes in cerebral blood flow, the VAS differences, the average onset of headache days per month and monthly differences in the number of doses of painkillers, headache duration of each episode, there is no statistically significant in the present is different. Probably because the lacking of the number of eligible subjects or there may be a placebo effect? We'll analysis it if we have enough number of eligible subjects.

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