自拟平肝熄风汤联合盐酸氟桂利嗪胶囊治疗肝阳化风型偏头痛临床研究

Clinical Study of Using Self-made Pinggan Xifeng Decoction Combined with Flunarizine Hydrochloride Capsules in the Treatment of Hyperactive Liver-Yang Causing Wind Type Migraine

目的:探讨自拟平肝熄风汤联合盐酸氟桂利嗪胶囊治疗肝阳化风型偏头痛的临床疗效。方法:选取2017年1月~2019年12月商洛职业技术学院附属医院收治的偏头痛患者80例,中医证型均为肝阳化风型,随机数字表法分为对照组(n=40)和研究组(n=40)。对照组给予盐酸氟桂利嗪胶囊治疗,研究组给予自拟平肝熄风汤联合盐酸氟桂利嗪胶囊治疗,两组均连续治疗8周。治疗后统计两组的临床治疗总有效率;比较两组治疗前后的中医证候积分、视觉模拟评分法(VAS)评分、头痛发作次数、头痛持续时间及血清降钙素基因相关肽(CGRP)、内皮素-1(ET-1)、同型半胱氨酸(Hcy)水平和大脑前动脉(ACA)血流速度、大脑后动脉(PCA)血流速度、大脑中动脉(MCA)血流速度。另外比较两组治疗过程中不良反应发生率。结果:研究组的临床治疗总有效率明显比对照组高(χ^(2)值=5.165,P=0.023)。两组治疗后中医证候积分、VAS评分、头痛发作次数、头痛持续时间及血清CGRP、ET-1水平及ACA血流速度、PCA血流速度、MCA血流速度均明显比治疗前小(P<0.05),血清Hcy水平均明显比治疗前高(P<0.05),同时研究组治疗后中医证候积分、VAS评分、头痛发作次数、头痛持续时间及血清CGRP、ET-1水平及ACA血流速度、PCA血流速度、MCA血流速度均明显比对照组小(P<0.05),血清Hcy水平明显比对照组高(P<0.05)。治疗期间,两组不良反应发生率比较,差异无统计学意义(χ^(2)值=0.457,P=0.499)。结论:自拟平肝熄风汤联合盐酸氟桂利嗪胶囊治疗肝阳化风证偏头痛的临床疗效显著,能够减轻临床症状,舒张血管,改善脑血流速度,且安全性较好。

Objective:To investigate the clinical efficacy of using Self-made Pinggan Xifeng Decoction combined with Flunarizine Hydrochloride Capsules in the treatment of hyperactive liver-Yang causing wind type migraine.Methods:According to the random table method,80 cases of patients with migraine with hyperactivity of liver-Yang were divided into a controlled group(n=40)and a research group(n=40).The patients in the controlled group were treated with Flunarizine Hydrochloride Capsules,while the patients in the research group were treated with Self-made Pinggan Xifeng Decoction combined with Flunarizine Hydrochloride Capsules,the two groups were treated for 8 weeks.The clinical total effective rate of the two groups after treatment was compared.The TCM syndrome integral,VAS scores,headache numbers,headache duration times and serum levels of CGRP,ET-1,Hcy and ACA blood flow velocity,PCA blood flow velocity,MCA blood flow velocity of the two groups of patients before and after treatment were determined.In addition,the adverse reaction incidence of two groups of patients were observed.Results:The total effective rate of the research group was significantly higher than that of the controlled group(χ^(2)=5.165,P=0.023).The TCM syndrome integral,VAS scores,headache numbers,headache duration times and serum levels of CGRP,ET-1 and ACA blood flow velocity,PCA blood flow velocity,MCA blood flow velocity of the two groups were significantly lower than before treatment,the serum levels of Hcy of the two groups were significantly higher than before treatment,and that of the research group were significantly better than that of the controlled group(P<0.05).During treatment,there was no significantly difference of the adverse reaction rate of the two groups(χ^(2)=0.457,P=0.499).Conclusion:The clinical curative effect of using Self-made Pinggan Xifeng Decoction combined with Flunarizine Hydrochloride Capsules in the treatment of migraine with hyperactive liver-Yang causing wind is significantly,which can significantly reduce the clinical symptoms,diastolic blood vessel,improve cerebral blood flow speed,and has good safty.