摘要： 目的 观察臭氧局部注射治疗中、重度偏头痛的临床效果。方法 采用前瞻设计、自身对照方法，选择2017年4月至2019年1月我科连续诊治的偏头痛患者55例，中度疼痛（VAS 4~6）32例，重度疼痛（VAS 7~9）23例。取头痛侧或疼痛较重侧，于颅周常见扳击点（额部眶上、颞部、枕部和疼痛固定点）多位点（3~4点）注射臭氧（30 μg/mL，≤ 10 mL），注射深度自骨膜至头皮下层，连续治疗2次。疼痛程度缓解50%以上为治疗有效，随访（256±184）d。结果 55例中，44例治疗有效，有效率80%，VAS评分下降显著；症状缓解50%~<80%（VAS 2~5）12例，占22%（12/55）。在不同随访时间疗效无统计学差异。结论 颅外周多位点臭氧局部注射治疗中、重度偏头痛有效，且效果持久，无不良反应，具有与外科神经减压的类似效果，且无创伤。

臭氧局部注射治疗偏头痛的临床观察

侯海培, 刘会, 张佩斯, 马冬冬

中国医科大学人民医院, 辽宁省人民医院神经外一科, 沈阳 110016

收稿日期:2020-12-08出版日期:2021-09-30发布日期:2021-09-18
通讯作者:刘会E-mail:drliuhui8269@163.com
作者简介:侯海培(1987-),男,主治医师,硕士.



关键词: 偏头痛, 颅外周扳击点, 固定痛点, 臭氧局部注射, 臭氧神经减压, 外科神经减压
Abstract: Objective To observe the clinical efficacy of local injections of ozone in treating moderate and severe migraines. Methods Using a prospective design and a self-control method,we included 55 consecutive patients with migraine headaches who were diagnosed and treated at the Department of Neurosurgery,Liaoning Provincial People's Hospital,from April 2017 to January 2019. The intensity of the pain was determined by the visual analog scale (VAS). Among the 55 patients,32 had moderate pain (VAS 4 to 6) and 23 had severe pain (VAS 7 to 9). On either the headache-side or the heavier-feeling-side,the common pericranial trigger points were located:supraorbital,temporal,occipital and regions in which the pain was localized. An ozone concentration of 30 μg/mL,quantity ≤ 10 mL was injected at these sites. The injection was administered at depths ranging from the periosteum to the subscalp,at 3 to 4 points,for 2 consecutive treatments. The treatment was considered effective if the pain level reduced by more than 50%. The mean follow-up period was 256±184 days,and the follow-up visit time points were 8,180,and 360 days. Results The treatment was effective in 44 cases,with an efficacy rate of 80% (44/55),among whom the VAS score decreased significantly (P<0.01). The symptom relief rate ranged from 50% to <80% (VAS 2 to 5) in 12 cases,accounting for 22% (12/55). No significant difference in treatment effects was observed between the different follow-up periods. Conclusion Localized ozone injection at multiple pericranial sites is an effective treatment with long-lasting outcomes for moderate and severe migraine headaches. This ozone nerve decompression treatment has similar effects to surgical nerve decompression and is noninvasive.
Key words: migraine headache, extracranial trigger site, fixed pain point, ozone local injection, ozonenerve decompression, surgical nerve decompression
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