Acupuncture at sphenopalatine ganglion combined with conventional acupuncture for episodic cluster headache: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture at sphenopalatine ganglion combined with conventional acupuncture for episodic cluster headache (CH).@*METHODS@#One hundred and eighty patients with episodic CH were randomly divided into a combined group (60 cases, 3 cases dropped off)，an acupuncture group (60 cases, 2 cases dropped off) and a sphenopalatine ganglion group (60 cases, 2 cases dropped off and 1 case was removed). The patients in the acupuncture group were treated with conventional acupuncture at Touwei (ST 8), Yintang (GV 24+), Yangbai (GB 14), Hegu (LI 4), etc., once a day, 6 times a week. The patients in the sphenopalatine ganglion group were treated with acupuncture at sphenopalatine ganglion, once every other day, 3 times a week. On the basis of the conventional acupuncture, the combined group was treated with acupuncture at sphenopalatine ganglion once every other day. Two weeks were taken as a course of treatment, and 3 courses of treatment were required in the 3 groups. The score of visual analogue scale (VAS), the number of headache attacks per week, the duration of each headache attack and the score of migraine-specific quality of life questionnaire version 2.1 (MSQ) were observed before and after treatment and in follow-up of 3 months after treatment. The clinical efficacy of each group was compared.@*RESULTS@#After treatment and in follow-up, the VAS score of headache, the number of headache attacks per week, the duration of each headache attack, and each various scores and the total score of MSQ of each group were lower than those before treatment (P<0.01). Except that the number of headache attacks per week in the combined group was lower than the sphenopalatine ganglion group (P<0.01), other indexes in the combined group were lower than the other two groups (P<0.05, P<0.01). The total effective rate in the combined group was 93.0% (53/57), which was higher than 75.9% (44/58) in the acupuncture group and 73.7% (42/57) in the sphenopalatine ganglion group（P<0.05, P<0.01).@*CONCLUSION@#Acupuncture at sphenopalatine ganglion combined with conventional acupuncture could reduce the degree of pain in patients with episodic CH, reduce the number and duration of headache attacks, and improve the quality of life of patients. It is more effective than simple conventional acupuncture or acupuncture at sphenopalatine ganglion alone.

Bi-level positive airway pressure ventilation for post-extubation respiratory support under deep anesthesia in hypertension patients / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the effect of bi-level positive airway pressure ventilation (BiPAP) for post-extubation respiratory support under deep anesthesia in hypertension patients.@*METHODS@#Forty primary hypertension patients who were scheduled for lower abdominal surgery or total hip joint replacement were randomly divided into 2 groups: one was extubated when being awake (Group A, n = 20, and the other was extubated under deep anesthesia (Group B, n = 20). The combined inhalation and the intravenous general anesthesia were performed on all patients, and inhalation anesthesia was maintained with only continued infusion of propofol when major procedure of surgery had been finished. In Group A, anesthesia was ceased when the surgery was finished, and trachea was removed after the patients awoke. In Group B, anesthesia was ceased immediately before the extubation, and trachea was removed under deep anesthesia, followed by an uninvasive ventilation of BiPAP. Blood pressure (BP, heart rate ( HR, and bispectral index (BIS) before or after the extubation, artery blood-gass analysis in BIPAP, and the incidence rate of complication in the recovery period were recorded.@*RESULTS@#In Group A, BP and HR increased significantly after the patients awoke (P < 0.01) and after the extubation (P < 0.05), compared with the data before the surgery and before the extubation. In Group B, however, BP and HR had no difference before and after the extubation, and the data of blood gas maintained approximately normal. The incidence rate of glos- soptosis in Group B was obviously higher than those in Group A (P < 0.01), while complications such as cough during the recovery stage in Group A were more than those in Group B (P <0.05).@*CONCLUSION@#BiPAP is suitable for post-extubation respiratory support under deep anesthesia in hypertension patients.