活血行气汤治疗血管性头痛284例疗效观察

Treatment of Vascular Headache with Decoction for Promoting Blood and Qi Circulation

本文应用自拟的活血行气汤治疗高海拔地区血管性头痛284例,治愈96例(32.4％),显效172例(62％),无效16例(5.6％),总有效率为94.4％。服药期间患者无不良反应,疗程最短5天,最长45天,平均为12天。治疗前后并对患者进行舌尖及甲皱微循环检查,发现治疗前患者多有微循环障碍。治疗后微循环血管清晰度增高,管袢开放数目增多,色泽变红,异形管袢数目明显减少,管袢渗出及出血减少或消失,血流速度增快。以上数据经统计学处理P<0.01。说明活血行气汤可改善患者的微循环,推测这是该方取得较好临床疗效的主要原因。该观察也提示微循环障碍是血管性头痛病变过程中的一个重要病理变化,因而认为舌尖甲皱微循环检查可作为血管性头痛的诊断及活血化瘀法治疗的一项较好的观察指标。

Two hundred and eighty-four cases of vascular haedache patients in high-altitude district were treated with Decoction for Promoting Blood and Qi Circulation, which is designed and prepared by the authors. In this group of patients 96(32.4％)were cured, 172 (62％) were markedly effective and 16 (5.6％) were ineffective, the total effective rate being 94.4％. The courses of treatment ranged from 5 to 45 days, the mean course being 12 days, and there were no adverse reaction observed during the treatment. The tongue-tip and nail fold microcirculation of the patients were observed before and after treatment, and after treatment marked improvement was observed (P<0.01), indicating that this decoction helps to improve microcirculation. These results suggest that microcirculation obstruction may be one of the important pathological changes of vascular headache. Thus examination on tongue-tip and nail fold microcirculation is considered as the reference for the diagnosis of vascular headache and for the therapeutic effect of promoting blood circulation to remove blood stasis.