辨证分型治疗偏头痛40例临床观察

Clinical Observation on 40 Cases of Migraine Treated by Syndrome Differentiation

[目的]观察辨证分型治疗偏头痛疗效。[方法]将40例门诊患者辨证分型治疗。肝郁血虚,疏郁补血汤(柴胡10g,香附18g,鸡血藤30g,川芎6g,天麻10g,女贞子、蔓荆子各12g,当归15g,白芍30g,甘草6g);阴虚阳亢,滋阴潜阳汤(石决明15g,钩藤20g,牡丹皮12g,~川牛膝10,地黄~生24g,天麻、白芍各12g,羚羊^(粉分冲)2g,甘草6g,栀子、夏枯草各13g);痰热内扰,清热祛痰汤(天竺黄10g,菊花15g,半夏~清、蔓荆子、僵蚕各12g,黄芩10g,全蝎8g,橘红、茯苓、栀子各12g,枳壳10g,竹茹13g,甘草6g);寒凝血瘀,散寒祛瘀汤(川芎12g,蔓荆子15g,全蝎8g,白芷6g,吴茱萸2g,丹参24g,赤芍13g,甘草~炙6g);1剂/d,水煎400mL,200mL/次,早晚温服,连续治疗2周为1疗程。观测临床表现、疼痛程度评分、头痛发作次数、头痛持续时间、伴随症状评分、不良反应。连续治疗1疗程(4周),判定疗效。[结果]平均发作次数、疼痛程度、头痛持续时间治疗后明显短于治疗前(P<0.01)。伴随症状积分治疗后明显低于治疗前(P<0.01)。[结论]辨证分型治疗偏头痛,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the efficacy of syndrome differentiation in treating migraine. [Methods] 40 outpatients were divided into two groups according to syndrome differentiation. Liver depression and blood deficiency, Shuyu Buxue decoction（疏郁补血汤）（Chaihu 10 g, Xiangfu 18 g, Jixueteng 30 g, Chuanxiong 6 g,Tianma 10 g, Nvzhenzi, Manjingzi each 12 g, Danggui 15 g, Baishao 30 g, Gancao 6 g）; Yin deficiency and Yang hyperactivity, Ziyin Qianyang decoction（滋阴潜阳汤）（Shijueming 15 g, Gouteng 20 g, peony peony 12 g,achyranthes bidentata 10 g, Dihuang 24 g, Tianma, Baishao each 12 g, Lingyangfen 2 g, Gancao 6 g, Zhizi,Xiagucao each 13 g）; phlegm-heat disturbance, heat-clearing and expelling phlegm soup（清热祛痰汤）（Tianzhuhuang 10 g, Juhua 15 g, Qingbanxia, Manjingzi, Jiangcan each 12 g, Huangqin 10 g, Quanxie 8 g,Juhong, Fuling, Zhizi each 12 g, Zhiqiao 10 g Zhuru 13 g, Gancao 6 g）; cold coagulation and blood stasisdispersing decoction（散寒祛瘀汤）（Chuanxiong 12 g, Manjingzi 15 g, Quanxie 8 g, Baizhi 6 g, Wuzhuyu 2 g,Danshen 24 g, Chishao 13 g, Zhigancao 6 g）; 1 dose/d, decoction 400 mL, 200 mL/time, warm in the morning and evening, continuous treatment for 2 weeks as a course of treatment. Clinical manifestations, pain scores,headache attacks, headache duration, accompanying symptom scores, adverse reactions were observed.Continuous treatment for 1 courses（4 weeks）, to determine the curative effect. [Results] The average attack times, pain degree and headache duration after treatment were significantly shorter than those before treatment（P〈0.01）. Concomitant symptom scores were significantly lower than those before treatment（P〈0.01）. [Conclusion] The treatment of migraine with syndrome differentiation has satisfactory curative effect,no serious adverse reactions, and is worthy of promotion.