中医辨证治疗前庭性偏头痛的多中心前瞻性队列研究  

Syndrome Differentiation and Treatment of Vestibular Migraine:Multi-center Prospective Cohort Study

作　　者：刘寅[1] 艾春玲 李秀玲[1] 王彦红[2] 刘艳华[3] 项颗[1] 孙莉[1] LIU Yin;AI Chunling;LI Xiuling;WANG Yanhong;LIU Yanhua;XIANG Ke;SUN Li(Jilin Academy of Traditional Chinese Medicine,Changchun 130021,China;Changchun Hospital of TCM,Changchun 130052,China;Changchun Central Hospital,Changchun 130051,China)

机构地区：[1]吉林省中医药科学院,吉林长春130021 [2]长春市中医院,吉林长春130052 [3]长春市中心医院,吉林长春130051

出　　处：《西部中医药》2024年第2期149-152,共4页Western Journal of Traditional Chinese Medicine

基　　金：吉林省中医药科技项目(2020027)。

摘　　要：目的:评价中医辨证治疗前庭性偏头痛的临床疗效,探讨中医辨证用药规律。方法:采用前瞻性队列研究方法,选取前庭性偏头痛患者197例,根据是否采用中医辨证治疗为暴露因素,分为中药组与西药组,分别为123例与74例。观察两组治疗第4、8、12周的眩晕复发率及相关结局指标。结果:治疗第4、8、12周,眩晕复发率中药组依次为14.9%、18.4%、29.7%,西药组依次为12.3%、32.8%、55.6%,其中第8、12周两组比较差异有统计学意义(P<0.05);治疗后第4周,眩晕残障量表评分(dizziness handicap inventory,DHI)、VAS评分改善情况西药组优于中药组,但差异无统计学意义(P>0.05),第8、12周DHI、VAS评分改善情况中药组均优于西药组(P<0.05);共收集门诊处方273首,涉及中药76味,使用频率前十位的中药依次为天麻、法半夏、柴胡、茯神、远志、茯苓、酸枣仁、煅龙骨、珍珠母、黄芩。结论:中医辨证治疗前庭性偏头痛在改善眩晕症状,控制眩晕复发方面优势明显,但起效速度方面不及西药治疗。临床用药以疏肝解郁、重镇安神为主,安神之法应贯穿治疗始终。Objective:To evaluate clinical effects of syndrome differentiation and treatment for vestibular migraine,and to explore the medication rules of TCM syndrome differentiation.Methods:A prospective cohort study of 197 patients with vestibular migraine was conducted,according to whether they accepted TCM syndrome differentiation and treatment as exposure factors,they were allocated to TCM group(123 cases)and Western medicine group(74 cases)respectively.To observe vertigo recurrence rate and the relevant outcome indicators after four,eight and 12 weeks of the treatment between both groups.Results:After four,eight and 12 weeks of the treatment,the relapse rates of vertigo in TCM groups were 14.9%,18.4%and 29.7%,while these in Western medicine group were 12.3%,32.8%and 55.6%,and the difference had statistical meaning after eight and 12 weeks of the treatment between both groups(P<0.05);four weeks after the treatment,the improvements of DHI and VAS of the Western medicine group were better than these of TCM group,while the difference had no statistical meaning(P>0.05),the improvements of DHI and VAS of TCM group were superior to these of Western medicine group on the eighth and 12th weeks(P<0.05);all 273 outpatient prescriptions were collected,involving 76 herbs,the top ten traditional Chinese medicine used were Tianma(Gastrodiae rhizoma),Fabanxia(Pinelliae rhizoma praeparatum),Chaihu(Bupleuri radix),Fushen(Poria cum Ligno Hospite),Yuanzhi(Polygalae radix),Fuling(Poria),Suanzaoren(Ziziphi spinosae semen),Duanlonggu(forged fossil fragments),Zhenzhumu(Margaritifera concha)and Huangqin(Scutellariae radix).Conclusion:The advantages of syndrome differentiation and treatment for vestibular migraine are obvious in improving the symptoms of vertigo and controlling the recurrence of vertigo,however,it is slower than the onset of action of Western medicine treatment.Soothing liver and relieving depression,tranquilization with heavy materials could be adopted as the main therapy,and the tranquilizing method should be used throughou

关 键 词：前庭性偏头痛 中医辨证治疗 用药规律 队列研究 

分 类 号：R747.2[医药卫生—神经病学与精神病学]