归脾汤加减治疗慢性紧张性头痛临床疗效及影响因素的Logistic回归分析  

Logistic Regression Analysis Of Clinical Effect And Influencing Factors Of Guipi Decoction On Chronic Tension Headache

作　　者：李晓刚[1] 刘刚[1] 曹峰[1] 陈耀辉[1] LI Xiao-gang;LIU Gang;CAO Feng;CHEN Yao-hui(Department of Pharmacy,Guiyang University of Chinese Medicine,Guiyang 550002,China)

机构地区：[1]贵阳中医学院方药教研室,贵阳550025

出　　处：《中国中医基础医学杂志》2018年第12期1720-1722,1789,共4页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：贵州省教育厅高等学校人文社会科学研究项目(2017zc153);-加味归脾汤联合催眠疗法对紧张性头痛治疗的临床疗效观察;贵州省2016年度(第九批)科技创新人才团队(黔科合平台人才[2016]5620)-贵州省中医养生文化研究与产业科技创新人才团队

摘　　要：目的:观察归脾汤加减治疗慢性紧张性头痛临床疗效并分析影响疗效的主要因素。方法:收集归脾汤加减治疗265例慢性紧张性头痛患者的临床资料,包括年龄、性别、病程、家族史、文化程度、吸烟、饮酒、体质量指数、头痛程度、HAMD评分、睡眠障碍等,在治疗结束后2个月根据头痛综合评分量表进行疗效判定,并对临床疗效和影响临床疗效的因素行统计分析。结果:治疗结束后2个月时,265例慢性紧张性头痛患者中痊愈87例(32.8%),显效132例(49.8%),有效32例(12.0%),无效14例(5.4%),临床总有效率82.6%,经多因素Logistic回归分析得出,病程(OR=3.743,95%CI:2.138～4.205)、体质量指数(OR=1.454,95%CI:0.818～3.626)、头痛程度(OR=1.827,95%CI:0.646～2.848)、HAMD评分(OR=2.421,95%CI:1.032～4.212)、睡眠障碍(OR=1.994,95%CI:1.582～3.410)是影响临床疗效的主要因素。结论:归脾汤加减能够有效缓解患者临床症状,对临床疗效较差或病程缠绵的患者,可从"久痛入络""痰湿论治""情志失调"等方面进行药物加减,进一步提高临床疗效。Objective: To observe the clinical curative effect of Guipi Decoction on the treatment of chronic tension headache, and analyze the main factors affecting curative effect.Method: Collected by Guipi Decoction on the treatment of 265 cases of patients with chronic tension headache the clinical data, including age, gender, disease duration, family history, education level, smoking and drinking, BMI, headache degree, HAMD score, sleep disorder, in 2 months after the end of treatment according to the comprehensive score for efficacy of headache determination on clinical efficacy and analysis of influence factors of clinical efficacy for statistics by using SPSS22.0 software. Results: Two months after the end of treatment, 87 cases(32.8%) were cured in 265 patients with chronic tension headache, 132 cases(49.8%) were markedly effective, 32 cases(12.0%) were effective, and 14 cases(5.4%) were invalid. The effective rate was 82.6%, and the multivariate logistic regression analysis showed that the course of disease(OR=3.743, 95%CI:2.138~4.205), body mass index(OR=1.454, 95%CI:0.818~3.626), degree of headache(OR=1.827,95%CI:0.646~2.848),HAMD score(OR=2.421,95%CI:1.032~4.212) and sleep disturbance(OR=1.994,95%CI:1.582~3.410) are the main factors affecting clinical efficacy.Conclusion: Guipi Decoction can effectively relieve the clinical symptoms of patients with chronic tension headache in clinical diagnosis and treatment of late for poor clinical outcome or long duration of patients, according to the specific circumstances of patients from the chronic pain of collaterals, the treatment of phlegm,emotion and other aspects of drug addition and subtraction, in order to improve the clinical curative effect.

关 键 词：归脾汤 慢性紧张性头痛 临床疗效 LOGISTIC回归分析 

分 类 号：R441.1[医药卫生—诊断学]