天智颗粒联合加巴喷丁胶囊治疗复发性脑梗死恢复期紧张型头痛患者的临床疗效研究

Clinical Efficacy of Tianzhi Granules Combined with Gabapentin Capsules on Patients with Tension-type Headache during Recovery Period of Recurrent Cerebral Infarction

背景复发性脑梗死患者恢复期内常合并紧张型头痛、焦虑和失眠,三者互相促进,治疗比较棘手,如不及时治疗,可造成紧张型头痛慢性化。目前尚未发现治疗复发性脑梗死恢复期紧张型头痛的特效药物。目的观察天智颗粒联合加巴喷丁胶囊治疗复发性脑梗死恢复期紧张型头痛患者的临床疗效。方法选取2019年6月-2020年12月在新乡医学院附属商丘市第一人民医院神经内科门诊治疗的复发性脑梗死恢复期紧张型头痛患者68例为研究对象,按照随机数字表法将其分为对照组和观察组,各34例。对照组患者给予加巴喷丁胶囊进行治疗,观察组患者在对照组治疗的基础上采用天智颗粒进行治疗,所有患者治疗4周。比较两组患者治疗后2周、治疗后4周临床疗效和治疗前、治疗后2周、治疗后4周头痛指标[视觉模拟评分法(VAS)评分、头痛发作频率、伴随症状评分]、焦虑指标[汉密尔顿焦虑量表(HAMA)评分]、睡眠质量指标[匹兹堡睡眠质量指数(PSQI)量表评分]及不良反应发生情况。结果观察组患者治疗后2周、治疗后4周临床疗效优于对照组(P <0.05)。治疗方法与时间在VAS评分上存在交互作用(P <0.05);治疗方法与时间在头痛发作频率、伴随症状评分上不存在交互作用(P>0.05)。治疗方法在VAS评分、伴随症状评分上主效应不显著(P>0.05);治疗方法在头痛发作频率上主效应显著(P <0.05)。时间在VAS评分、头痛发作频率、伴随症状评分上主效应显著(P <0.05)。观察组患者治疗后2周、治疗后4周VAS评分、头痛发作频率及治疗后4周伴随症状评分低于对照组(P <0.05)。对照组、观察组患者治疗后2周、治疗后4周VAS评分、头痛发作频率分别低于本组治疗前(P <0.05);观察组患者治疗后4周VAS评分、头痛发作频率分别低于本组治疗后2周(P <0.05);对照组患者治疗后4周伴随症状评分低于本组治疗前(P <0.05);观察组患者治疗后2周、治疗后4周伴随症状评分分别低于本组治疗前,治疗后4周伴随症状评分低于本组治疗后2周(P <0.05)。治疗方法与时间在HAMA评分上存在交互作用(P <0.05);治疗方法、时间在HAMA评分上主效应显著(P <0.05)。观察组患者治疗后2周、治疗后4周HAMA评分低于对照组(P <0.05)。对照组、观察组患者治疗后2周、治疗后4周HAMA评分分别低于本组治疗前,治疗后4周HAMA评分分别低于本组治疗后2周(P <0.05)。治疗方法与时间在PSQI量表评分上不存在交互作用(P>0.05);治疗方法、时间在PSQI量表评分上主效应显著(P <0.05)。观察组患者治疗后2周、治疗后4周PSQI量表评分低于对照组(P <0.05)。对照组、观察组患者治疗后2周、治疗后4周PSQI量表评分分别低于本组治疗前,治疗后4周PSQI量表评分分别低于本组治疗后2周(P <0.05)。两组患者均未见明显不良反应。结论天智颗粒联合加巴喷丁胶囊治疗复发性脑梗死恢复期紧张型头痛患者的疗效确切,其可减轻患者头痛程度,减少头痛发作频率及伴随症状,缓解患者焦虑程度,改善睡眠质量,且安全性好。

Background Patients with recurrent cerebral infarction often have tension-type headaches,anxiety,and insomnia during the recovery period.The three diseases promote each other,and treatment is difficult.If they are not treated in time,headaches often become chronic.At present,no specific medicine has been found for the treatment of tension-type headache during the recovery period of recurrent cerebral infarction.Objective To observe the clinical efficacy of Tianzhi granules combined with gabapentin capsules on patients with tension-type headache during recovery period of recurrent cerebral infarction.Methods From June 2019 to December 2020,68 patients with tension-type headache during recovery period of recurrent cerebral infarction who were treated at the Neurology Department of the First People’s Hospital of Shangqiu City Affiliated to Xinxiang Medical University were selected as the research objects,and they were divided into control group and observation group according to random number table method,34 cases in each group.The patients in the control group were treated with gabapentin capsules,and the patients in the observation group were treated with Tianzhi granules on the basis of the treatment of the control group.All patients were treated for 4 weeks.The clinical efficacy 2 weeks and 4 weeks after treatment,headache indicators[Visual Analogue Scale(VAS)score,headache attack frequency,accompanying symptom score],anxiety indicator[Hamilton Anxiety Scale(HAMA)score]and sleep quality indicator[Pittsburgh Sleep Quality Index(PSQI)scale score]before treatment and 2 weeks and 4 weeks after treatment,and the occurrence of adverse reactions were observed and compared between the two groups.Results Two weeks and four weeks after treatment,the clinical efficacy of patients in the observation group was better than that in the control group(P<0.05).There was an interaction between treatment method and time on VAS score(P<0.05).There was no interaction between treatment method and time on headache attack frequency and accompanying symptom score(P>0.05).The main effect of treatment method on VAS score and accompanying symptom score was not significant(P>0.05);and the treatment method had a significant main effect on the headache attack frequency(P<0.05).The treatment time had a significant main effect on VAS score,headache attack frequency,and accompanying symptom score(P<0.05).The VAS score,headache attack frequency 2 weeks and 4 weeks after treatment,and accompanying symptom score 4 weeks after treatment in the observation group were significantly lower than those in the control group(P<0.05).The VAS score,headache attack frequency 2 weeks and 4 weeks after treatment in the control group and observation group were significantly lower than those before treatment,respectively(P<0.05).The VAS score,headache attack frequency 4 weeks after treatment in the observation group were significantly lower than those 2 weeks after treatment(P<0.05).The accompanying symptom score 4 weeks after treatment in the control group was significantly lower than that before treatment(P<0.05).In the observation group,the accompanying symptom score 2 weeks and 4 weeks after treatment was significantly lower than that before treatment,the accompanying symptom score 4 weeks after treatment was significantly lower than that 2 weeks after treatment(P<0.05).There was an interaction between treatment method and time on HAMA score(P<0.05).The treatment method and time had a significant main effect on the HAMA score(P<0.05).The HAMA score 2 weeks and 4 weeks after treatment in the observation group was lower than that in the control group(P<0.05).In the control group and the observation group,the HAMA score 2 weeks and 4 weeks after treatment was lower than that before treatment,and the HAMA score 4 weeks after treatment was lower than that 2 weeks after treatment,respectively(P<0.05).There was no interaction between treatment method and time on the PSQI scale score(P>0.05).The main effect of treatment method and time on the PSQI scale score was significant(P<0.05).The PSQI scale score 2 weeks and 4 weeks after treatment of the observation group was lower than that of the control group(P<0.05).In the control group and the observation group,the PSQI scale score 2 weeks and 4 weeks after treatment was lower than that before treatment,and the PSQI scale score 4 weeks after treatment was lower than that 2 weeks after treatment,respectively(P<0.05).There was no obvious adverse reactions in the two groups.Conclusion Tianzhi granules combined with gabapentin capsules are effective in the treatment of patients with tensiontype headache during recovery period of recurrent cerebral infarction.It can reduce the degree of headaches,the frequency of headache attacks and accompanying symptoms,relieve the patients’anxiety,improve the quality of sleep,and has good safety.