中医中药辨证施治治疗脑血管痉挛性头痛临床分析

Clinical analysis of traditional Chinese medicine syndrome differentiation in the treatment of cerebral vasospasm headache

目的分析中医中药辨证施治治疗脑血管痉挛性头痛临床效果。方法50例脑血管痉挛性头痛患者,根据数字表随机分为对照组和观察组,每组25例。对照组的患者给予常规西医治疗,观察组在对照组的治疗基础上增加中医中药辨证施治。比较两组患者痉挛性头痛症状改善时间、睡眠改善时间、住院时间、治疗效果以及治疗前后头痛视觉模拟评分、脑血管平均流速、简明健康状况调查量表(SF-36)评分、血液流变学指标。结果观察组患者痉挛性头痛症状改善时间(6.24±1.21)d、睡眠改善时间(6.41±1.12)d、住院时间(8.21±2.21)d均短于对照组的(9.52±2.21)、(10.53±2.21)、(11.12±3.11)d,差异均具有统计学意义(P<0.05)。治疗后,两组头痛视觉模拟评分、脑血管平均流速均改善,且观察组患者头痛视觉模拟评分(1.02±0.12)分低于对照组的(2.45±0.15)分,脑血管平均流速(102.19±6.45)cm/s高于对照组的(95.41±6.21)cm/s,差异均具有统计学意义(P<0.05)。治疗后,两组患者SF-36评分均改善,且观察组患者生理功能、情感功能、社会功能评分以及总分均高于对照组,差异均具有统计学意义(P<0.05)。治疗后,两组患者红细胞聚集指数、全血粘度、血浆粘度水平均改善,且观察组患者红细胞聚集指数(2.11±0.11)、全血粘度(5.12±0.51)mPa·s、血浆粘度(0.81±0.19)mPa·s均低于对照组的(2.42±0.21)、(7.42±0.59)mPa·s、(1.34±0.34)mPa·s,差异均具有统计学意义(P<0.05)。观察组总有效率100.00%高于对照组的68.00%,差异具有统计学意义(P<0.05)。结论中医中药辨证施治对于脑血管痉挛性头痛的治疗效果确切,可有效改善患者临床症状,提高脑血管血流速度,改善睡眠质量和生活质量,值得推广和应用。

Objective To analyze the clinical effect of traditional Chinese medicine syndrome differentiation in the treatment of cerebral vasospasm headache.Methods A total of 50 patients with cerebral vasospasm headache were divided into control group and observation group according to random numerical table,with 25 cases in each group.The control group was treated with conventional Western medicine,and the observation group was treated with traditional Chinese medicine syndrome differentiation based on the control group.The improvement time of spasmodic headache,sleep improvement time,hospitalization time,therapeutic effect,headache visual analogue scale,average cerebral blood flow velocity,36-item short-form health survey(SF-36)score,and hemorheology indexes before and after treatment were compared between the two groups.Results The improvement time of spasmodic headache(6.24±1.21)d,sleep improvement time(6.41±1.12)d and hospitalization time(8.21±2.21)d of the observation group were shorter than(9.52±2.21),(10.53±2.21),(11.12±3.11)d of the control group,and the difference was statistically significant(P<0.05).After treatment,the headache visual analogue scale score and cerebral blood flow velocity of the two groups were better than those before treatment;the headache visual analogue scale score(1.02±0.12)points of the observation group was lower than(2.45±0.15)points of the control group,and cerebral blood flow velocity(102.19±6.45)cm/s was higher than(95.41±6.21)cm/s of the control group.All the difference was statistically significant(P<0.05).After treatment,the SF-36 score of the two groups were better than those before treatment,and the physiological function,emotional function,social function score and total score of the observation group were higher than those of control group.All the difference was statistically significant(P<0.05).After treatment,the red blood cell aggregation index,whole blood viscosity and plasma viscosity of the two groups were better than those before treatment,the red blood cell aggregation index(2.11±0.11),whole blood viscosity(5.12±0.51)mPa·s,plasma viscosity(0.81±0.19)mPa·s of the observation group were lower than(2.42±0.21),(7.42±0.59)mPa·s and(1.34±0.34)mPa·s of the control group.All the difference was statistically significant(P<0.05).The total effective rate 100.00%of the observation group was higher than 68.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion Traditional Chinese medicine syndrome differentiation has affirmative effect on cerebral vasospasm headache,which can effectively improve patients’clinical symptoms,increase cerebral blood flow velocity,improve sleep quality and quality of life.It is worth popularizing and applying.