2024 年第 10 期 第 19 卷

枕下肌群筋膜阻滞治疗颈源性头痛的价值分析

Analysis of the value of fascial block of suboccipital muscle group in the treatment of cervicogenic headache

作者：庞金磊符舟洋刘亚静孙海燕冉广原何明伟

英文作者：Pang Jinlei Fu Zhouyang Liu Yajing Sun Haiyan Ran Guangyuan He Mingwei

单位：首都医科大学附属北京安贞医院疼痛科，北京100029

英文单位：Department of Pain Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：颈源性头痛；枕下肌群筋膜阻滞；临床疗效；安全性

英文关键词：Cervicogenicheadache;Fascialblockofsuboccipitalmusclegroup;Clinicalefficacy;Safety

• 摘要：

• 目的 探究枕下肌群筋膜阻滞治疗颈源性头痛（CEH）的价值。方法 选取2023年1—12月在首都医科大学附属北京安贞医院就诊的100例CEH患者作为研究对象。按照随机数字表法分为观察组和对照组，各50例。对照组给予布洛芬缓释胶囊口服治疗，观察组给予枕下肌群筋膜阻滞治疗。比较2组疼痛视觉模拟量表(VAS)评分、疼痛分级指数(PRI)评分、颈椎功能障碍指数(NDI)评分、疗效及安全性指标。结果 治疗后2组患者VAS、PRI、NDI评分均低于治疗前且观察组均低于对照组（均P<0.05）。对照组治愈0例、显效2例、好转38例、无效10例，总有效率80.0%（40/50）；观察组治愈0例、显效13例、好转35例、无效2例，总有效率96.0%（48/50）；观察组疗效优于对照组，差异有统计学意义（Z=-3.649，P<0.001）。观察组患者未出现出血、治疗区域感染等不良事件情况。对照组中有3例患者诉口服药物后出现恶心呕吐的不适感，症状较轻微，能自行缓解。结论 枕下肌群筋膜阻滞在治疗CEH中具有一定的价值。其能够显著减少头痛的频率和强度，改善患者的生活质量，并且安全性良好。

• Objective To explore the value of suboccipital muscle group fascial block in the treatment of cervicogenic headache (CEH). Methods A total of 100 CEH patients who were treated in Beijing Anzhen Hospital, Capital Medical University from January to December 2023 were selected as the research objects. According to the random number table method, they were divided into the observation group and the control group, 50 cases in each group. The control group was treated with ibuprofen sustained-release capsules, and the observation group was treated with suboccipital muscle group fascial block. The visual analogue scale (VAS) score, pain rating index (PRI) score, neck disability index (NDI) score, efficacy and safety indexes were compared between the two groups. Results After treatment, the VAS, PRI and NDI scores of the two groups were lower than those before treatment, and those of the observation group were lower than those of the control group (all P<0.05). In the control group, 0 case was cured, 2 cases were markedly effective, 38 cases were improved, and 10 cases were ineffective, with a total effective rate of 80.0%(40/50); in the observation group, 0 case was cured, 13 cases were markedly effective, 35 cases were improved, and 2 cases were ineffective, with a total effective rate of 96.0%(48/50); the efficacy of the observation group was better than that of the control group (Z=-3.649, P<0.001). There were no adverse events such as bleeding and infection in the treatment area in the observation group. Three patients in the control group complained of nausea and vomiting after oral medication, and the symptoms were mild and relieved by themselves. Conclusion Fascial block of suboccipital muscle group has certain value in the treatment of CEH. It can significantly reduce the frequency and intensity of headache, improve the quality of life of patients, and has good safety.