Cheng Tingxiu
Rehabilitation department of Dongning First People's Hospital, Heilongjiang province.157200
[Abstract] Objective: To observe the result of treating chronic daily headache by acupunture based on myofascial-theory. Methods: to compare the effects of treating chornic daily headache with theory-based myofascial acupuncture or traditional acupuncture, with headache diary, VAS score, number of headache days per months as outcome measures. Results: After 8 weeks of treatment and 3 months of follow-up, treating daily headache by acupuncture based on myofascial Theory were better than routine acupuncture group and was statistically significant (P <0.05). Conclusion: Chronic daily headache may be associated with head and neck myofascial dysfunction, the effect of myofascial Theory based acupuncture is remarkable.
Keywords: myofacial, acupuncture, chronic daily headache, clinical research
Chronic Daily Headache Chronic (CDH) is a continuous 3 months or more, a headache of more than 15 days a month[1]; There is not only the physical and mental disorder caused by the life quality is reduced, there are obvious daily life, social and professional functions of serious damage to[2]. The majority of patients with long-term administration of analgesics, serious damage to the health of the body[3]; The author is based on the theory of muscle fascia in the treatment of chronic daily headache, and achieved significant effect, The report is as follows:
1 Data and methods
1.1 Diagnostic criteria:Diagnostic criteria of chronic daily migraine and chronic daily tension headache in the diagnosis of ICHD- II[4、5] .
1.2 Inclusion criteria:Consistent with the above diagnostic criteria, male and female age, age 65 - 18 years, signed informed consent, no serious hypertension, heart, liver, kidney and other diseases.
1.3 Exclusion criteria:Exclude cluster headache, mental factors such as caused by a headache; secondary headache; blood pressure control is not ideal; afraid of needles, fainting refused to join researchers
1.4 General information:In February 2010 to October 2013. In our hospital outpatient department of rehabilitation medicine in collected 60 cases of chronic daily headache, including 21 males, 39 cases of female, the age is 45.5 + 10.5 years. Using the method of random number table, according to 1:1 ratio: 1. The patients were divided into treatment group and control group; two groups of age, sex, course of disease, etc. there is no statistical significance (P > 0.05).
1.5 Treatment method
Treatment group:On the basis of the muscle fascia theory combined with botulinum toxin in the treatment of chronic headache in the anatomical position, in the frontal muscle, occipital muscle and temporal muscle, splenius capitis, semispinalis muscle, pillow under the muscle, sternoclavicular mastoid muscle 10 - 16 acupuncture points(acupuncture points as shown below), with 0.25 mm * 30 mm acupuncture needle acupuncture, acupuncture select 2 - 3 acupuncture point, Hua Tuo brand connection SDZ- II electroacupuncture instrument wire, select the density wave, intensity adjustment to the patient can tolerate, acupuncture once a day, 5 days a course of treatment, interval of 2 days a course of treatment.
Control group: According to Shi Xuemin[6] practical acupuncture and moxibustion choice Neiguan, ditch, Hegu, Taichong, Baihui, Sishencong, Fengchi, bone, Tianzhu points, acupuncture select 2 - 3 acupuncture point, Hua Tuo brand connection SDZ- II electroacupuncture instrument wire, select the density wave, intensity adjustment to the patient can tolerate, acupuncture once a day, 5 days a course of treatment, interval of 2 days a course of treatment.
2 Result
2.1 Curative effect index: Before treatment were 1 month before the headache days, VAS, etc., after treatment, patients completed a headache diary, VAS score 2 weeks for an assessment, headache days per month to assess the time of 4 weeks, eight weeks of treatment, the treatment end to record a headache diary and followed up for 3 months for final evaluation.
2.2 Statistical methods: The data were analyzed by SPSS13.0 software package, and the differences of the groups were analyzed by repeated measures ANOVA, and the count data were X2 test.. Determine the inspection level = 0.05.
2.3 Treatment outcome
Headache diary case
VAS score of patients with CDH(x±s)
Group |
Cases(n) |
Before treatment |
2 weeks |
4 weeks |
6 weeks |
8 weeks |
Follow up |
Treatment group |
30 |
5.98±1.86 |
4.56±1.96# |
△4.02±1.65# |
△3.75±1.73# |
△3.30±1.84# |
△4.10±1.86# |
Control group |
30 |
5.89±1.92 |
5.54±1.89 |
4.89±1.73 |
4.56±1.68# |
4.36±1.75# |
5.36±1.79 |
Note: compared with before treatment #P is less than 0.05, compared with the control group P < 0.05, there was statistical significance.
CDH patients episodes(x±s)
Group |
Cases(n) |
Before treatment |
4 weeks |
8 weeks |
Follow up |
Treatment group |
30 |
19.00±4.16 |
15.25±6.51# |
△11.68±7.45# |
△13.58±5.62# |
Control group |
30 |
18.93±4.05 |
17.50±6.60 |
15.03±6.82# |
15.46±7.22# |
Note: Compared with before treatment #P is less than 0.05, compared with the control group P < 0.05, there was statistical significance.
3 Discussion
Daily Headache Chronic (CDH) in the world, about 3% - 5% of people with chronic daily headache[7], China prevalence of 732.1 / (100000) people[8]. The muscle fascia disorder of head and neck myofascial dysfunction can cause headache[9], clinical findings of myofascial dysfunction alone will not involving a muscle, and a group of muscles; especially in chronic daily headache patients physical examination can be found in a number of trigger points and tenderness point; the author from the botulinum toxin in treating chronic headache inspired, botulinum toxin treatment of chronic headache, general injection frontalis temporalis muscle, occipital muscles, trapezius muscle, sternocleidomastoid muscle, levator semispinalis muscle, scapular[10、11]; literature of acupuncture treatment of chronic daily headache have certain curative effect[12]; combined with the above method the author puts forward the theory of myofascial acupuncture treatment programs daily headache based on chronic, and implementation.
The test results show that the acceptance in myofascial theory of acupuncture intervention 2 weeks of above, compared with before treatment, the pain degree of patients continued to decline, before and after statistical significance (P < 0.05); received acupuncture treatment of pain for more than 6 weeks compared with before treatment, continued to decline, before and after the more statistically significant (P < 0.05); and 4 weeks after treatment group and the control group compared with significant difference (P < 0.05). After followed up for 3 months, the degree of headache treatment group and treatment before have significant difference (P < 0.05) in the control group had no significant difference (P > 0.05). The same number of episodes before group after 4 weeks of treatment, the treatment is continued to decline, the comparison with statistical significance (P < 0.05), while the control group 8 weeks after than before treatment continued to decline, before and after statistical significance (P < 0.05); and 4 weeks after seizure frequency in treatment group and the control group compared with significant difference (P < 0.05). After followed up for 3 months, headache severity seizure frequency in treatment group and control group before and after treatment had significant difference (P < 0.05).
The research indicated that the method based on myofascial theory of acupuncture treatment of chronic daily headache has obvious curative effect, and is obviously better than that of routine acupuncture group, suggesting that chronic daily headache may be related to head and neck myofascial dysfunction. The reported chronic daily headache acupoint acupuncture is better than that of the non acupuncture treatment, the author will further study the reason, please colleagues.
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