林坤成1 廖炎智2 李政育3
1.德昌中醫診所
2.國防醫學院 三軍總醫院核醫部
3.育生中醫診所
通訊作者：林坤成
連絡地址：新北市新店市中正路370號
Tel：886-2-2219-5401
E-Mail：drfrank9199@yahoo.com.tw
2014年08月17日受理; 2014年12月14日刊載
摘要 :
研究背景
無先兆性偏頭痛（migraine without aura）是指無眼部先兆，如閃
輝、黑朦、霧視、偏盲等明顯先兆症狀的一類偏頭痛，它是偏頭痛中最為
常見的類型，約占偏頭痛病人的80%，常表現為在頭痛發作前數小時或數
日，可有一些非特異性的前驅症狀。偏頭痛是多發病，常見病之一，特別
是，隨著生活節奏的日益緊張，生存壓力的日益加大，偏頭痛的發病率又
有所增高，並且累及人群廣泛，影響因素複雜，反復發作，各種療法難以
徹底治癒，給患者及其家庭帶來極大的痛苦和沉重的醫藥負擔，同時引發
不同程度的心理、社會問題。
研究目的
雖然針對無先兆性偏頭痛已有多種治療方法，但目前各類治療方法皆
有一定的局限性，故需尋找一種效果明顯、副作用低、簡單易行的治療方
法。結合無先兆性偏頭痛的發病原因，以及以往在臨床上對本病治療的經
驗，採用電針為主這一治療方法，以改進和豐富無先兆性偏頭痛的治療。
研究方法
選取2008年1月至2009年12月在德昌中醫診所就診病人共147例。依臨
床表現，將本病分為三類:頭痛發作時伴隨畏光、畏聲；頭痛發作時伴有
噁心、嘔吐；頭痛發作時伴有畏光、畏聲且噁心、嘔吐。每類無先兆性偏
頭痛均隨機分成電針治療組及單純針刺對照組兩組，對療效進行綜合評
價，同時根據臨床表現和中醫學理論，將每類無先兆性偏頭痛又分成常見
的水不涵木、痰熱內阻和肝風上擾三種證型，對電針治療本病不同中醫證
型的療效進行分析。
研究結果
電針組總有效率為72.15%，優於單純針刺組52.94%。採用電針及單純
針刺兩組治療後，各症狀比較臨床療效無差異(P>0.05)。各組治療後的頭
痛指數均明顯低於治療前；治療後兩組間頭痛指數比較，差異無顯著性意
義（P>0.05）；兩組差值比較，其差異有統計學意義（P<0.05），說明治
療組在緩解頭痛指數上優於對照組。
選擇絲竹空透率谷、頷厭透懸顱為主穴，水不涵木型配太溪、太沖；
痰熱內阻型配豐隆、陰陵泉；肝風上擾型配陽陵泉、太沖；以電針為主進
行治療。此法具有平肝潛陽、滋水涵木、祛風化痰通絡的作用，從而使之
熄風通絡，補腎填髓，促進腦部血液迴圈，達到止頭痛的目的。
結論
本研究運用主穴為主，並辨證配穴的電針和針刺的方法治療無先兆性
偏頭痛患者，觀察其臨床療效，並探討其療效機制。運用絲竹空透率谷、
頷厭透懸顱為主穴，並根據不同證型辨證配穴的以電針為主的療法具有療
效確切、實用、無副作用等優勢，值得推廣應用和進一步的療效機理研
究。
關鍵詞：
無先兆性偏頭痛；電針；水不涵木；痰熱內阻；肝風上擾
The clinical curative effect appraisal of
MiuCifa
to periarthritis humeroscapularis
Lin Kun-Chen 1 Liao Yan-Chih 2 Lee Chen-Yu 3
1. Der-Cha Traditional Chinese Medical Clinic
2. Chairman of the Acupuncture and Moxibustion Society of ROC
3. Yu-Sheng Chinese Medical Clinic
Authors：Lin Kun-Cheng
Address：No.370, Zhongzheng Rd., Xindian Dist., New Taipei City, Taiwan
(R.O.C.)
Tel：886-2-2219-5401
E-Mail：drfrank9199@yahoo.com.tw
Received：2014.08.17; Accepted：2014.12.14
Abstract
Background：
Migraine is a frequently-occurring disease, one of the common diseases,
especially
in recent years, with the increasingly intense pace of life, survival
growing
pressure, migraine headache, there are the higher the incidence of,
and involving
a broad population, affecting factors are very complex, and the a recurring
problem, difficult to completely cure a variety of therapies to give
patients and
their families great pain and heavy medical burden, while trigger different
levels
of psychological, social and economic issues. Migraine without aura
in migraine
headache is the most common type, accounting for 80% of migraine patients.
There are many ways the current treatment of migraine, such as the western
medicine, Chinese medicine and acupuncture, but because of its pathogenesis
is
still at the exploratory stage, so that treatment is largely dependent
on the pilot.
Explore the treatment of the disease pathogenesis and therapeutic mechanism
of
effective treatment studies are very necessary.
Objective:
The use of clinical epidemiology methods, choice met the inclusion criteria
for
migraine without aura patients was studied, using coin on the basis
of acupuncture
with electro-acupuncture, systematic observation before and after treatment
of
symptoms, onset of cycle and time, and to explore the approach in the
treatment
of migraine without aura in operating specifications, scope of application,
contraindications, comprehensive analysis and evaluation of the near
future,
long-term clinical effect.
Methods:
Select from January 2008 to December 2009 TCM clinics in Taiwan, Dersha
Chinese medicine clinics and meet the inclusion criteria of cases of
migraine
without aura patients with 147 cases. Migraine without aura the clinical
manifestations of the disease will be divided into three categories:
attacks of
headache accompanied by sensitivity to light, fear sound; headache attack
accompanied by nausea, vomiting; headache attack accompanied by sensitivity
to light, sound fear and nausea, and vomiting . For each type of migraine
without
aura were randomly divided into electro-acupuncture group and control
group,
two sets of simple acupuncture. As well as a comprehensive evaluation
of
efficacy, while based on clinical manifestations and Chinese medicine
theory,
each type of migraine without aura is divided into a common water is
not Han
wood, phlegm-heat resistance and liver wind disturbance on the three
kinds of
syndromes, and electrical Acupuncture treatment of the disease the efficacy
of
different TCM syndromes were analyzed.
Results:
The results show that electro-acupuncture group, the total effective
rate was
72.15%, better than simple acupuncture group, the total effective rate
was 52.94%.
Use of electro-acupuncture and simple acupuncture treatment groups after
migraine
without aura, the symptoms of clinical efficacy compared no significant
difference
(P> 0.05). Electro-acupuncture group and simple acupuncture group
were the late
obvious side effects.
This study was based on the clinical data of four clinics ，three categories
of
non premonitory migraine patients are divided into three syndromes:
shuibuhanmu,
tanreneizu，ganfengneirao. To use electroacupuncture observation on TCM
different types of effects, the main point is the wind and string music
penetration
rate of valley temple, Han thoroughly disgust mainly hanging skull hole;
water
not culvert last point: too Rive and too rushed; type of resistance
on the penalty
points for: Hong Leong, Yin mausoleum Springs; stirring of invading-point:
too
rushed, yanglingquan. Treatment results through statistical analysis,
found
on each type of migraine without aura of two syndromes of differences
are not
significant significance (P > 0.05).
Conclusion:
This study shows that the use of the wind and string music penetration
rate of
valley temple, Han thoroughly disgust mainly hanging skull hole, and
according
to different syndromes Syndrome with acupuncture point in order to electroacupuncture-
based therapies have the effect of accurate, practical, no side effects,
etc. advantage, it is worth pushing factory application and further
study of the
efficacy of the mechanism.
Key Words:
Migraine without aura; Electro-acupuncture;
Water is not Han wood,
Phlegm-heat resistance, Liver-wind on the disturbance.