加味丹栀逍遥散联合疏肝调神针法对偏头痛伴抑郁焦虑障碍认知功能及预后的影响  

Effect of Modified Danzhi Xiaoyao Powder(加味丹梔逍遥散)Combined with“Soothing Liver and Regulating Spirit”Acupuncture on Cognitive Function and Prognosis of Patients with Migraine Accompanied by Depression and Anxiety Disorder

作　　者：王榕 宋汉琳 徐福 WANG Rong;SONG Hanlin;XU Fu(The First Clinical Medical College of Zhejiang Chinese Medical University,Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310003,Zhejiang,China)

机构地区：[1]浙江中医药大学第一临床医学院,浙江省中医院,浙江杭州310003

出　　处：《中华中医药学刊》2024年第6期183-186,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局项目(GZY-KJS-2022-036)。

摘　　要：目的 探讨加味丹栀逍遥散联合疏肝调神针法对偏头痛伴抑郁焦虑障碍患者认知功能及预后的影响。方法 选择医院2020年1月—2023年1月收治的120例偏头痛伴抑郁焦虑障碍患者作为研究对象,采用随机数字表通过简单随机的方法,将其分为研究组与对照组,每组60例,给予对照组患者疏肝调神针灸治疗,研究组在对照组的基础上,接受加味丹栀逍遥散治疗,两组均连续治疗4周时间,比较两组治疗前后头痛症状评分,采用汉密尔顿抑郁量表(Hamilton Depression Scale, HAMD)与汉密尔顿焦虑量表(Hamilton Anxiety Scale, HAMA)评价两组治疗前后抑郁焦虑情况,参考威斯康星卡片分类测验(WCST)对患者认知功能进行评定,在治疗前、后采用经颅多普勒超声(Transcranial Doppler, TCD)检测双侧大脑前动脉(Anterior cerebral artery, ACA)、大脑后动脉(Posterior cerebral artery, PCA)、大脑中动脉(Middle cerebral artery, MCA)、椎动脉(Vertebral artery, VA)、基底动脉(Basilar artery, BA)的平均血流速度。结果 治疗后两组头痛严重程度、发作次数、持续时间、伴随症状评分以及总分均明显低于本组治疗前,其中研究组明显低于对照组(P<0.05),治疗后两组HAMA、HAMD评分均明显低于本组治疗前,其中研究组明显低于对照组(P<0.05),研究组治疗后持续应答、持续错误、总错误患者比例均显著低于对照组(P<0.05),治疗后两组MCA、ACA、PCA血流平均速度均较本组治疗前降低,且研究组明显低于对照组,差异具有统计学意义(P<0.05),两组治疗期间均未见严重不良反应发生。结论 加味丹栀逍遥散联合“疏肝调神”针灸治疗偏头痛伴抑郁焦虑障碍具有显著效果,可明显改善患者抑郁焦虑、认知功能,并有效降低了脑动脉血流平均速度,且安全性较高,适合推广应用。Objective To investigate the effects of Modified Danzhi Xiaoyao Powder(加味丹栀逍遥散)combined with“soothing liver and regulating spirit”acupuncture on cognitive function and prognosis of patients with migraine accompanied by depression and anxiety disorder.Methods A total of 120 patients with migraine with depression and anxiety disorder admitted to the hospital from January 2020 to January 2023 were selected as research objects.By simple random number table,they were di-vided into study group and control group with 60 cases in each group.The patients in the control group were given“soothing liver and regulating spirit”acupuncture treatment.The headache symptom scores of the two groups were compared before and after treatment.The depressive and anxiety conditions of the two groups were evaluated by Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA).The cognitive function of the patients was evaluated by Wisconsin card classification Test(WCST).The average blood flow velocities of bilateral anterior cerebral artery(ACA),posterior cerebral artery(PCA),middle cerebral artery(MCA),vertebral artery(VA)and basilar artery(BA)were measured by transcranial Doppler ultrasound(TCD)before and after treatment.Results After treatment,headache severity,attack frequency,duration,concomitant symptom score and total score of the two groups were significantly lower than those before treatment,and those of the study group were significantly lower than those of the control group(P<0.05).After treatment,HAMA and HAMD scores of the two groups were significantly lower than those before treatment,and scores of the study group were significantly lower than those of the control group(P<0.05).The proportion of patients with sustained response,persistent error and total error in the study group after treatment was significantly lower than that in the control group(P<0.05).The average blood flow velocities of MCA,ACA and PCA in the two groups after treatment were lower than those before treatment,and the velocitie

关 键 词：加味丹栀逍遥散 疏肝调神针法 偏头痛 抑郁焦虑障碍 认知功能 

分 类 号：R246[医药卫生—针灸推拿学] R277.749.4[医药卫生—中医临床基础]