头痛舒宁方加味治疗瘀血阻络型偏头痛的临床研究  

Clinical Study on the Treatment of Blood Stasis Obstructing Collaterals-Type Migraine with Modified Toutong Shuning Decoction

作　　者：任宏伟 李林[1] 樛秀俊[2] 张楠 尤晓苗[1] 孙丹雨 董冠中 史宗康 REN Hongwei;LI Lin;JIU Xiujun;ZHANG Nan;YOU Xiaomiao;SUN Danyu;DONG Guanzhong;SHI Zongkang(Inner Mongolia Medical University,Hohhot 010100,China;Hulunbuir Zhongmeng Hospital,Hulunbuir 021000,China)

机构地区：[1]内蒙古医科大学,内蒙古呼和浩特010100 [2]呼伦贝尔市中蒙医院,内蒙古呼伦贝尔021000

出　　处：《中医药学报》2025年第3期82-86,共5页Acta Chinese Medicine and Pharmacology

基　　金：内蒙古自治区自然科学基金项目(2024ZD33);内蒙古自治区卫生健康委中医药(蒙医药)科技计划项目(ZMY-2024118);内蒙古自治区第四批老中医药(蒙医药)专家学术经验继承工作项目[内卫中(蒙)传承字〔2022〕161号];内蒙古自治区卫生计生科研计划项目(201701107)。

摘　　要：目的:分析头痛舒宁方加味治疗偏头痛瘀血阻络证的效果。方法:回顾性分析2022年12月—2023年12月呼伦贝尔市中蒙医院诊疗的80例偏头痛患者资料,根据治疗方式分组,其中接受偏头痛常规治疗的40例患者纳入对照组,接受头痛舒宁方加味治疗的40例患者纳入观察组。通过医院电子病历系统,记录并比较主要结局指标,结局指标包括整体疗效、治疗前后的疼痛程度[采用数字疼痛分级法(NRS)评估]、脑血流速度[患侧大脑前动脉(ACA)、中动脉(_(MCA))、后动脉(_(PCA))收缩期最大血流速峰值(V_(ACA)、V_(MCA)、V_(PCA))]、炎症因子[白细胞介素-6(IL-6)、超敏C反应蛋白(HS-CRP)水平]、治疗期间的不良反应发生情况。结果:观察组有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者NRS评分均降低,V_(ACA)、V_(MCA)、V_(PCA)均升高,且观察组NRS评分较对照组低、V_(ACA)、V_(MCA)、V_(PCA)均较对照组高,差异均有统计学意义(P<0.01)。治疗后,两组患者IL-6、HS-CRP水平均下降(P<0.01),且观察组较对照组低,差异有统计学意义(P<0.05,P<0.01)。组间不良反应发生率比较无差异(P>0.05)。结论:瘀血阻络证偏头痛患者应用头痛舒宁方加味治疗,能提高整体疗效,改善患者的脑血流速度、降低炎症水平,患者急性发作时疼痛程度缓解效果好,且联合药物治疗并不会增加不良反应,安全性理想。Objective:To analyze the therapeutic effect of modified Toutong Shuning Decoction for treating migraine with blood stasis obstructing collaterals syndrome.Methods:A retrospective analysis was conducted on 80 migraine patients treated at Hulunbuir Zhongmeng Hospital from December 2022 to December 2023.The patients were divided into two groups based on treatment:40 patients in the control group received conventional migraine treatment,while 40 patients in the observation group received modified Toutong Shuning Decoction.The primary outcomes,including overall efficacy,pain severity(assessed using the Numeric Rating Scale,NRS),cerebral blood flow velocity[peak systolic velocity(V_(ACA),V_(MCA),V_(PCA))of the affected anterior cerebral artery(ACA),middle cerebral artery(_(MCA)),and posterior cerebral artery(_(PCA))],and levels of inflammatory factors[interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)],as well as the incidence of adverse reactions during treatment,were recorded and compared.Results:The overall efficacy in the observation group was significantly higher than in the control group(P<0.05).After treatment,both groups showed a reduction in NRS scores and an increase in V_(ACA),V_(MCA),and V_(PCA).The observation group had lower NRS scores and higher V_(ACA),V_(MCA),and V_(PCA)than the control group,with significant differences(P<0.01).IL-6 and hs-CRP levels decreased in both groups,and were significantly lower in the observation group(P<0.05,P<0.01).The incidence of adverse reactions was similar between the two groups(P>0.05).Conclusion:Modified Toutong Shuning Decoction can improve the overall efficacy in treating migraine with blood stasis obstructing collaterals syndrome,enhance cerebral blood flow,reduce inflammation,and effectively alleviate acute pain during migraine attacks.Additionally,the combination therapy does not increase adverse reactions,demonstrating ideal safety.

关 键 词：偏头痛 瘀血阻络证 头痛舒宁方 脑血流速度 

分 类 号：R255[医药卫生—中医内科学]