通窍活血汤加减治疗原发性三叉神经痛的疗效

Efficacy of Tongqiao Huoxue decoction （通窍活血汤） in the treatment of patients with primary trigeminal neuralgia

目的 观察通窍活血汤加减治疗原发性三叉神经痛的临床疗效.方法 采用随机对照方法,选择门诊原发性三叉神经痛患者60例,随机分成中药组和西药组,每组各30例.中药组给予通窍活血汤辩证加减,临卧服,每日1剂.西药组给予维生素B1片与卡马西平片口服.两组均以7d为1个疗程,总疗程28 d.观察两组患者治疗前及治疗后l周和4周时VAS、疼痛持续发作时间、总有效率、不良反应;随访5个月内复发情况.结果 两组间在治疗1周时患者疼痛程度、持续发作时间比较无统计学差异（P＞0.05）;治疗4周时中药组在重度疼痛程度、持续发作时间方面低于西药组（P＜0.05）;中药组总有效率为90.0％（27/30例）,西药组总有效率为73.3％（22/30例）,两组间比较有统计学差异（P＜0.05）;治疗后5个月内中药组复发率为10％（3/30例）,西药组复发率为26.7％（8/30例）,中药组低于西药组（P＜0.05）;西药组服药后出现8例不良反应.中药组未见不良反应（P＜0.05）.结论 在辨证论治基础上灵活运用通窍活血汤加减治疗原发性三叉神经痛疗效确切,安全.

Objective To observe the clinical efficacy of modified Tongqiao Huoxue decoction in the treatment of patients with primary trigeminal neuralgia.Methods Sixty patients with primary trigeminal neuralgia were randomly divided into Chinese medicine and western medicine groups,30 cases in each group.The patients in Chinese medicine group were treated with Tongqiao Huoxue decoction taken before sleeping daily.Western medicine group were treated with vitamin B1 and carbamazepine,7 ds as a course of treatment in the two groups.VAS,duration of attack,total effective and side effects were observed in the two groups before treatment,and at 1 and 4 weeks after treatment.Results No significant difference was found in the degree of pain and duration of attack between the two groups （P〉 0.05） after one course treatment,but there was a difference after 4 course treatment with significantly lower in the Chinese medicine group than those in the western medicine group （P〈 0.05）.The total effective rate in the Chinese medicine group was 90%（27/30 cases）,and 73.3% （22/30 cases） in the western medicine group （P 〈 0.05）.The recurrence rate was 10% （3/30 cases）,and 26.7% （8/30 cases） in the Chinese medicine group and western medicine group respectively after 5 months follow-up （P〈 0.05）,The incidence of adverse reactions was 8 patients in western medicine group and none in Chinese medicine group （P〈 0.05）.Conclusion The modified Tongqiao Huoxue decoction based on syndrome differentiation is effective in the treatment of primary trigeminal neuralgia.