针药结合防治肝阳上亢型偏头痛的临床观察  

Clinical observation on acupuncture and medication combined prevention and treatment of migraine of liver-yang hyperactivity syndrome

作　　者：索李慧 李文涛[1] SUO Lihui;LI Wentao(Department of Encephalopathy,Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200041,China)

机构地区：[1]上海中医药大学附属市中医医院脑病科,上海200041

出　　处：《上海中医药杂志》2021年第9期55-59,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市科委“科技创新行动计划”临床医学领域项目(18401971200);上海市卫健委上海市“十三五”临床重点专科建设项目(shslczdzk04901)。

摘　　要：目的观察以清肝泻火立法的针药结合疗法防治肝阳上亢型偏头痛的临床疗效。方法将159例肝阳上亢型偏头痛患者随机分为中药组、针药结合1组、针药结合2组,每组53例。中药组予清肝化瘀方治疗,针药结合1组予清肝化瘀方结合常规针刺治疗,针药结合2组予清肝化瘀方结合清肝泻火针刺治疗,各组疗程均为8周,治疗结束后随访4周。观察临床疗效,比较偏头痛症状(头痛发作次数、头痛持续时间、头痛程度、伴随症状)积分及中医证候积分的变化情况。结果(1)试验过程中,中药组脱落4例,针药结合1组脱落7例,针药结合2组脱落6例,最终完成试验者142例,其中中药组49例、针药结合1组46例、针药结合2组47例。(2)中药组、针药结合1组、针药结合2组的总有效率分别为57.41%、76.09%、95.74%,组间临床疗效比较,针药结合1组、针药结合2组优于中药组(P<0.05),针药结合2组优于针药结合1组(P<0.05)。(3)治疗4周后、治疗8周后、随访4周时与治疗前组内比较,各组中医证候积分、偏头痛症状总积分及各分项(头痛发作次数、头痛持续时间、头痛程度、伴随症状)积分均降低(P<0.05)。(4)治疗4周后组间比较,针药结合1组、针药结合2组偏头痛症状总积分、头痛程度积分差值大于中药组(P<0.05),且针药结合2组头痛程度积分差值大于针药结合1组(P<0.05);治疗8周后、随访4周时组间比较,针药结合1组、针药结合2组头痛发作次数、头痛持续时间、头痛程度积分及偏头痛症状总积分、中医证候积分差值大于中药组(P<0.05),且针药结合2组头痛发作次数、头痛持续时间、头痛程度积分及偏头痛症状总积分、中医证候积分差值大于针药结合1组(P<0.05)。结论以清肝泻火立法的针药结合疗法防治肝阳上亢型偏头痛疗效满意,能有效减少偏头痛发作次数,缩短头痛持续时间,减轻头痛程度,并改善中医证候。Objective To observe the clinical effect of acupuncture and medication combined prevention and treatment of migraine of liver-yang hyperactivity syndrome based on the method of clearing liver and purging fire.Methods A total of 159 patients with migraine of liver-yang hyperactivity syndrome were randomly divided into traditional Chinese herbal medicine(TCHM)group,acupuncture and medication combined(AMC)group 1 and AMC group 2,with 53 cases in each group.The TCHM group was administered with Qinggan Huayu Prescription,the AMC group 1 was administered with Qinggan Huayu Prescription together with conventional acupuncture,and the AMC group 2 was administered with Qinggan Huayu Prescription together with liver-clearing and fire-purging acupuncture therapy.The course of treatment in each group was 8 weeks,with 4 weeks of follow-ups after treatment.The clinical effect was observed,and the changes of migraine symptoms(headache attack frequency,headache duration,headache degree,accompanying symptoms)scores and traditional Chinese medicine(TCM)syndrome scores before and after treatment were compared.Results(1)During the trial,there were 4 drop-out cases in the TCHM group,7 drop-out cases in the AMC group 1,and 6 drop-out cases in the AMC group 2.Finally,142 cases completed the trail,including 49 cases in the TCHM group,46 cases in the AMC group 1,and 47 cases in the AMC group 2.(2)The effective rate of TCHM group,AMC group 1 and AMC group 2 was 57.41%,76.09%,and 95.74%,respectively.According to the inter-group comparisons,the AMC group 1 and AMC group 2 showed better clinical effects than the TCHM group(P<0.05),and AMC group 2 had even better clinical effects than AMC group 1(P<0.05).(3)According to the intra-group comparisons before treatment and after 4 weeks of treatment,8 weeks of treatment,and 4 weeks of follow-ups,the scores of TCM syndromes,the total scores of migraine symptoms,and the scores of various items(headache attack frequency,headache duration,headache degree,and accompanying symptoms)all decreased in each

关 键 词：偏头痛 清肝泻火 针刺 清肝化瘀方 

分 类 号：R277.7[医药卫生—中医学]