加减吴茱萸汤配合针刺少阳经穴对偏头痛寒凝血瘀证临床疗效的影响

Effect of Modified Wuzhuyu Decoction(加减吴茱萸汤)Combined with Acupuncture at Acupoints of Shaoyang on Migraine Patients with Cold and Blood Stasis Obstructing Meridian Syndrome

目的观察加减吴茱萸汤配合针刺少阳经穴对偏头痛寒凝血瘀证的临床疗效。方法90例患者随机分为对照组和观察组,其中81例患者纳入符合方案集(PPS),对照组41例,给予口服加减吴茱萸汤颗粒;观察组40例,在对照组基础上配合针刺少阳经穴,两组同时可服用必要的止痛剂;分别在入组时、入组4周、8周12周及治疗后4周观察两组头痛发作频率(次数、天数)、持续时间及疼痛程度等,应用重复测量方差分析及广义估计方程进行统计分析。结果两组治疗后,头痛发作频率、持续时间及疼痛程度在组内效应分析(时间因素)均有显著改善(P<0.05);观察组在治疗12周和随访时,在减轻头痛次数方面均显著优于对照组(组间主效应分析),随时间延长有显著优于对照组的趋势(组间×时间交互作用)(P<0.05);疼痛程度方面,观察组较对照组亦能明显减轻患者疼痛程度(P<0.05),但止痛剂使用次数两组无差异,有一定优于对照组的趋势;在疼痛持续时间和头痛天数方面,观察组随时间延长未见到明显优于对照组的趋势,但疼痛持续时间观察组在组间主效应分析上显著优于对照组(P<0.05)。结论加减吴茱萸汤配合针刺少阳经穴对偏头痛寒凝血瘀证有显著临床疗效,且该方案用药少、针刺方案简单易行,易于操作和推广。

Objective To observe the efficacy of Modified Wuzhuyu Decoction(加减吴茱萸汤)combined with acupuncture at acupoints of Shaoyang on migraine patients with cold and blood stasis obstructing meridian syndrome.Method A total of 90 patients were randomly divided into control group and observation group.Eighty-one patients were brought into Per Protocol Set(PPS),in which 41 cases were in the control group and 40 cases were in the observation group.Patients in the control group were treated with Modified Wuzhuyu Decoction while those in the observation group received acupuncture at acupoints of Shaoyang on the basis of the control group.Both groups could take necessary analgetics.The pain attack frequency,duration and pain of migraine were observed at the time point of grouping,4th week,8th week,12th week and follow-up 4 weeks after treatment.Repeated measures and general linear model were used for the statistical analysis.Results After treatment,the pain attack frequency,duration and pain of migraine were all decreased significantly in both groups in the test of Within-Subject Effects.In the observation group,the pain attack frequency was decreased remarkably compared with that of the control group at 12th week and follow-up(Test of Between-Subject Effects).The pain was alleviated significantly in the observation group compared with that in the control group(general linear model).However,no significant difference was found in analgesics consumption and duration between two groups,but there was a reduced trend in the observation group.There was no better tendency of pain duration and headache days in the observation group,but there was a remarkable difference of pain duration between two groups(Test of Between-Subject Effects).Conclusion The combination treatment of Modified Wuzhuyu Decoction and acupuncture at acupoints of Shaoyang is effective for migraine patients with cold and blood stasis obstructing meridian syndrome.Moreover,this treatment programme is not so complicated that it is easy to apply and worthy of promotion.