脑安滴丸治疗偏头痛临床适应症状群的临床研究

Clinical Resarch on Clinical Adaptability Symptom Cluster of Naoan Pills in the Treatment of Migraine

目的探讨脑安滴丸治疗偏头痛的中医临床适应症状群,分析中医临床适应症状群临床应用的可行性。方法选取2015年7月—2017年5月就诊于北京中医药大学东直门医院神经内科门诊及通过招募的偏头痛病人43例,研究过程中脱落3例,最终进入符合方案数据集(PPS)40例,治疗4周后,对中医头痛情况及全身四诊信息进行评价,应用Logistic回归分析方法,研究脑安滴丸治疗偏头痛的中医临床适应症状群。结果偏头痛治疗4周时,偏头痛的各个症状中头痛起止无常、时轻时重、光线暗时可缓解,与治疗前比较有统计学意义(P<0.05);偏头痛随访8周时,偏头痛的各个症状中巅顶头痛、乳房胀痛、多梦时,与治疗前比较有统计学意义(P<0.05);随访4周、8周时头痛发作次数、头痛发作天数较减半率较治疗4周时明显增加(P<0.05)。结论中医临床适应症状群是以中医病机为内涵,中医症状及现代医学症状为表现的概念,可以准确判断偏头痛的中医适应症状群及禁忌症状群,对于中成药的合理使用具有指导意义。

Objective To investigate the clinical adaptability symptom cluster of Naoan pill for treating migraine headache,and to verify the feasibility of clinical application of the symptom cluster.Methods Forty-three migraine patients were selected.Three cases dropped out during the trial,and finally 40 cases were enrolled.After 4 weeks treatment,the symptoms of headache and the four diagnostic information of traditional Chinese medicine(TCM)were evaluated.Logistic regression analysis was used to study the clinical adaptability symptom cluster of TCM for treating migraine.Results Compared with before treatment,thesymptoms of migraine headache with start-stop capricious,sometimes light and sometimes heavy,migraine relieve when light is dark were statistically significant after 4 weeks treatment(P<0.05);Compared with duta before treatment,the symptoms of migraine headache accompanied by parietal headache,breast pain,more dreams were improved too at follow-up 8 weeks(P<0.05);Follow-up 4,8 weeks,the difference in halving rate of headache episodes times and halving rate of headache attack days were significantly increased than those in treatment of 4 weeks(P<0.05).Conclusion The clinical symptom cluster of TCM was a concept of TCM pathogenesis,TCM symptoms and modern medical symptoms as performance,could accurately determine the symptoms of migraine headache syndrome.