基于临床病案资料研究偏头痛中医证候及疼痛特点  

The Characteristics of Pain and TCM Syndromes of Migraine Based on Clinical Data

作　　者：刘美斯 王青 左阳 王玉瑶 石博文 王力苇 赵永烈 LIU Meisi;WANG Qing;ZUO Yang;WANG Yuyao;SHI Bowen;WANG Liwei;ZHAO Yonglie(The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Fangshan Hospital,Beijing University of Chinese Medicine,Beijing 102400,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]北京中医药大学房山医院,北京102400

出　　处：《西部中医药》2025年第1期38-42,共5页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81873256);国家重点研发计划“中医药现代化研究”(2019YFC1709702);北京中医药大学新教师启动基金项目(2024-BUCMXJKY007)。

摘　　要：目的:基于临床病案资料,探究偏头痛患者的中医证候特点及疼痛特点。方法:对诊断为偏头痛的128位患者进行回顾性分析,完整记录基本信息、一般情况及头痛相关情况等,将数据录入Excel,应用SPSS 22.0分析频次,并对高频证候进行聚类分析。结果:偏头痛患者常见的前15种症状、体征为眠差、口干、恶心、跳痛、恶风、口苦、舌暗红、汗多、舌暗、头晕、脉弦滑、情志失调、劳累、苔白腻、脉弦细。通过聚类分析可归纳为风邪袭络、胆郁痰扰证及肝郁脾虚证两种证型。常见诱发因素为情志失调、劳累、受风、睡眠不佳等。常见疼痛性质为跳痛、胀痛等,疼痛部位以颞部、顶部、枕部等为主。结论:偏头痛的主要病理因素为风、痰、火,病变脏腑主要在肝、胆、脾,临床常见证型为风邪袭络、胆郁痰扰证及肝郁脾虚证。Objective:To investigate the characteristics of pain and TCM syndromes of migraine based on clinical data.Methods:The basic information,general conditions and headache-related conditions of 128 patients diagnosed with migraine were completely recorded via a retrospective analysis.After the information was inputted into Excel,SPSS 22.0 was applied to carry out cluster analysis of high-frequency syndromes.Results:The top 15 symptoms and body signs commonly seen in patients with migraine were sleep-deprived,dry mouth,nausea,iumping pain aversion to wind,bitter taste in mouth,dark and red tongue,excessive sweating,dark tongue,dizziness,stringy and slippery pulse,emotional disorder,fatigue,whitish greasy fur and stringy and thready pulse.Migraine could be categorized into two patterns of wind-evil attacking the collateral,bile-depression and phlegm disturbance,and liver-qi stagnation and spleen deficiency through cluster analysis.The common inducing factors are emotional disorder,fatigue,wind attacking and poor sleep.The common pains contain jumping pain and distending pain,and the pain is located in tempus,vertex and occiputs mainly.Conclusion:The main pathological factors of migraine involve wind,phlegm and fire,the viscera mainly are liver,gallbladder and spleen,and the common syndromes are wind-evil attacking the collateral,bile-depression and phlegm disturbance,and liver-qi stagnation and spleen deficiency in clinic.

关 键 词：偏头痛 中医证候 疼痛特点 聚类分析 

分 类 号：R277.7[医药卫生—中医学]