目的 观察“龙虎交战”针法针刺八脉交会穴对无先兆偏头痛（Migraine without aura，MO）患者头痛天数及外周血降钙素基因相关肽（Calcitonin gene related peptide，CGRP）表达水平的影响。方法 按照头痛程度将90例MO受试者区层随机分为治疗Ⅰ组、治疗Ⅱ组和对照组各30例。治疗Ⅰ组施以“龙虎交战”针法针刺八脉交会穴（外关和足临泣），治疗Ⅱ组施以平补平泻针法针刺八脉交会穴（外关和足临泣），对照组施以平补平泻针法针刺非经非穴点，每次留针30分钟，5次/周，共治疗20次。于治疗前、治疗结束4周后的随访分别记录三组患者头痛天数的变化情况以判定疗效，并采集患者治疗前、治疗结束4周后随访的肘部静脉血用ELISA法检测血清中的CGRP含量的变化。结果 ①各组治疗前患者的头痛天数无显著差异（Ｐ > 0.05），治疗Ⅰ组、治疗Ⅱ组和对照组治疗结束4周后随访的头痛天数较治疗前均显著降低（Ｐ < 0.05）；治疗Ⅰ组头痛天数的降低显著优于治疗Ⅱ组和对照组（Ｐ < 0.001），治疗Ⅱ组头痛天数的降低显著优于对照组（Ｐ < 0.05）；②3组治疗前CGRP的表达无显著差异，治疗Ⅰ组、治疗Ⅱ组治疗结束4周后随访CGRP的表达较治疗前均显著下降（Ｐ < 0.001），对照组治疗结束4周后随访CGRP的表达较治疗前差异无显著性（Ｐ > 0.05）；治疗Ⅰ组CGRP治疗结束4周随访的表达较治疗Ⅱ组和对照组均显著下降（Ｐ < 0.01），治疗Ⅱ组CGRP的表达较对照组显著下降（P < 0.01）。结论 ①八脉交会穴施以“龙虎交战”针法针刺能明显改善MO患者的头痛天数，同时降低MO患者血清CGRP的表达水平，这可能是针刺八脉交会穴治疗MO的机制之一；②非经非穴点的针刺效应无持续性，而八脉交会穴的针刺效应具有持续性；③八脉交会穴可以充分发挥复式针刺手法的治疗效应，提示我们在临床上治疗疾病时不仅要注意腧穴配伍，恰当的针刺手法更是提高临床疗效、事半功倍的关键。

Objective To observe the long-term clinical efficacy of Dragon-Tiger Fighting Needling Method at the eight confluence points in the treatment of migraine without aura (MO) and the effect of plasma levels of calcitonin gene related peptide (CGRP).Methods 90 patients with MO were randomly divided into treatment Ⅰ group, treatment Ⅱ group and control group with 30 cases each according to the degree of headache. Treatment Ⅰ group was treated with Dragon-Tiger Fighting Needling Method at the eight confluence points (Waiguan and Zulinqi); treatment Ⅱ group was treated with mild reinforcing and attenuating at the eight confluence points (Waiguan and Zulinqi); control group was treated with mild reinforcing and attenuating at non-acupoints for 30 min each time, 5 times/week, for 4 weeks in total. Changes in the number of days with headache in the three groups were recorded before treatment and 4-week follow-up after treatment. The elbow venous blood of migraine patients before and 4-week follow-up after treatment was collected to detect the changes of plasma levels of CGRP of migraine patients in each group by ELISA.Results ①There was no significant difference in the number of days with headache before treatment among the three groups (P > 0.05); the number of days with headache of 4-week follow-up after treatment in the three groups were all significantly decreased compared with that of pre-therapy (P < 0.05); the number of days with headache of the treatment Ⅰ group were significantly lower than those of the control group and the treatment Ⅱ group (P < 0.001); the number of days with headache of the treatment Ⅱ group was significantly higher than the control group (P < 0.05). ② There was no significant difference in CGRP expression in the three groups before treatment. 4-week follow-up after treatment, CGRP expression in the treat I group and treat Ⅱ group was significantly decreased compared with that of pre-therapy (P < 0.001); in the treatment Ⅰgroup, CGRP expression was significantly decreased compared with that in the treatment Ⅱ group and the control group (P < 0.01); in the treatment Ⅱ group, CGRP expression was significantly decreased compared with that in the control group (P < 0.01).Conclusion ①Dragon-Tiger Fighting Needling Method at the eight confluence points can significantly reduce the number of days with headache of MO patients, and reduce the plasma levels of CGRP, which may be one of the possible mechanisms of Dragon-tiger contending method at the eight confluent acupoints connecting the eight extraordinary channels. ② The acupuncture effect of non-points is not persistent, while the acupuncture effect of the eight confluent acupoints connecting the eight extraordinary channels is persistent; ③ the eight confluent acupoints connecting the eight extraordinary channels can give full play to the therapeutic effect of compound acupuncture manipulation, suggesting that we can get twice the result with half the effort and improve the clinical curative effect by selecting the corresponding specific points for compatibility and combining the correct manipulation in the clinical treatment of diseases.

R245.3