目的：基于“气街四海”理论观察项七针治疗瘀血阻络型偏头痛的有效性。方法：纳入瘀血阻络型偏头痛患者64例，按随机数字表法分为治疗组与对照组各32例（治疗组脱落1例，对照组脱落2例）。治疗组取项七针及阿是穴进行针刺，对照组取率谷、风池、外关等进行针刺。两组患者均每日治疗1次，每周5次，连续治疗4周，8周后进行随访。于治疗前、治疗30 min后观察两组视觉模拟评分法（VAS）评分；于治疗前、治疗4周后及8周后随访分别观察两组临床症状评分、特异性生活质量问卷（MSQ）评分、焦虑自评量表（SAS）评分变化；于治疗前、治疗4周后测定两组患者大脑前动脉（ACA）、大脑后动脉（PCA）、大脑中动脉（MCA）及椎动脉（VA）、基底动脉（BA）血流速度的变化情况，并评价两组的临床疗效。结果：治疗30 min后两组VAS评分高于治疗前（P<0.05），且治疗组比对照组下降更明显（P<0.05）。治疗4周后及8周后随访，两组临床症状评分、MSQ评分、SAS评分均优于治疗前（P<0.05），且治疗组优于对照组（P<0.05）。治疗后，ACA、PCA、MCA及VA、BA血流速度与治疗前比较明显加快（P<0.05），且治疗组与对照组比较，各指标差异具有统计学意义（P<0.05）。临床疗效评价，治疗组显愈率87.09%，与对照组疗效比较，各指标差异有统计学意义（P<0.05）。结论：“气街四海”理论指导下的项七针治疗瘀血阻络型偏头痛疗效显著且稳定持续，具有即时镇痛明显、远期疗效稳定的临床效应，可缓解焦虑心理状态，提高患者生活质量，其机制可能与调节脑血流速度、改善脑血流动力学状态相关。

Objective :To observe the effectiveness of Neck Seven Needles in the treatment of migraine with blood stasis and obstruction of collaterals type based on the “Qi Street and Four Seas” theory.Methods:Sixty-four patients with migraine of blood stasis and obstruction of collaterals type were included and divided into treatment group and control group,with 32 cases in each group according to the random number table method(1 case dropped out in the treatment group and 2 cases dropped out in the control group). The treatment group received acupuncture at the seven acupoints on the neck and the Ashi points,while the control group received acupuncture at Shuaigu(GB8),Fengchi(GB20),Waiguan(ST5),and other acupoints. Both groups of patients were treated once a day,five times a week,for four consecutive weeks.The follow-up was conducted after eight weeks. The Visual Analogue Scale(VAS) scores of the two groups of patients were observed before treatment and 30 minutes after treatment. The changes in clinical symptom scores,Migraine Specific Quality of Life Questionnaire(MSQ) scores,and Self-Rating Anxiety Scale(SAS) scores of the two groups were observed before treatment,4 weeks after treatment,and 8 weeks after treatment(during the follow-up) respectively. The changes in blood flow velocity of the anterior cerebral artery(ACA),posterior cerebral artery(PCA),middle cerebral artery(MCA),vertebral artery(VA),and basilar artery(BA) of the two groups were measured before treatment and 4 weeks after treatment,and the clinical efficacy of the two groups was evaluated. Results:After 30 minutes of treatment,the VAS scores of the two groups were higher than those before treatment(P<0.05),and the decrease in the treatment group was more significant than that in the control group(P<0.05). After 4 weeks and 8 weeks after treatment(the follow-up),the clinical symptom scores,MSQ scores,and SAS scores of both groups were better than those before treatment(P<0.05),and the treatment group was better than the control group(P<0.05). After treatment,the blood flow velocities of ACA,PCA,MCA,VA and BA were significantly accelerated compared with those before treatment(P<0.05),and the difference was statistically significant between the treatment group and the control group(P<0.05). In terms of clinical efficacy evaluation,the cure rate of the treatment group was 87.09%,and compared with the control group,the difference was statistically significant(P<0.05). Conclusions:Under the guidance of the “Qi Street and Four Seas” theory,Neck Seven Needles has a remarkable and stable therapeutic effect in the treatment of migraine with blood stasis and obstruction of collaterals type. It has obvious immediate analgesia and stable long-term efficacy. It can alleviate the anxiety psychological state and improve the quality of life of patients. Its mechanism may be related to regulating cerebral blood flow velocity and improving cerebral hemodynamic state.