祛痰平肝熄风法辨治脑血管痉挛性头痛患者的临床疗效

Treating Cerebral Vasospasm Headache with the Method of Eliminating Phlegm, Calming the Liver and Extinguishing Wind

目的探讨祛痰平肝熄风法辨治脑血管痉挛性头痛患者的临床疗效。方法选取2019年2—8月大连市金州区中医医院神经内科收治的脑血管痉挛性头痛患者100例作为研究对象,按随机数字表法分为对照组和试验组,各50例。对照组患者予以盐酸氟桂利嗪胶囊治疗,试验组患者在对照组基础上采用自拟祛痰熄风汤加减治疗。比较两组患者治疗前后中医证候评分、视觉模拟评分法(VAS)、头痛评分表、内皮素-1(ET-1)、白细胞介素-6(IL-6)及临床疗效。结果治疗后,两组患者头晕、头痛、耳鸣、肢体困重评分及VAS评分、头痛评分、ET-1、IL-6低于治疗前,且试验组患者头晕、头痛、耳鸣、肢体困重评分及VAS评分、头痛评分、ET-1、IL-6明显低于对照组,差异有统计学意义(P<0.05)。试验组治疗有效率为90.00%,显著高于对照组的70.00%,差异有统计学意义(P<0.05)。结论祛痰熄风汤联合西医治疗可有效加速血液循环、延缓斑块形成速率、遏制炎症反应,发挥镇痛、消炎等作用,缓解血管痉挛患者头晕头痛等,提高治疗有效率。

Objective To investigate the clinical efficacy of eliminating phlegm, calming the liver and extinguishing wind in the treatment of patients with cerebral vasospasm headache. Methods A total of 100 inpatients admitted to Neurology Department of Jinzhou Hospital of Traditional Chinese Medicine from February 2019 to August 2019 were selected as the research objects. By random number table method, they were divided into a control group and a test group, with 50 cases in each group. Patients in the control group were treated with flunarizine hydrochloride capsules, and patients in the test group were treated with self-made Qutan Xifeng Decoction plus flunarizine hydrochloride capsules. The scores of TCM syndromes, visual analogue scoring method(VAS), headache score scale, endothelin-1(ET-1), interleukin-6(IL-6) and clinical efficacy were compared between the 2 groups of patients before and after treatment. Results After the treatment, the dizziness, headache, tinnitus, limb sleepiness score, VAS pain score, headache score and ET-1 and IL-6 levels of the patients were lower than those before treatment. The dizziness, headache, tinnitus, limb sleepiness score, VAS score, headache score, ET-1 and IL-6 of the test group were significantly lower than those of the control group, and the difference was statistically significant(P<0.05). The treatment effective rate of the test group was 90.00%, which was significantly higher than that of the control group of 70.00%, and the difference was statistically significant(P<0.05). Conclusion Qutan Xifeng Decoction combined with Western medicine treatment can effectively accelerate blood circulation, delay the rate of plaque formation, curb inflammation, exert analgesic and anti-inflammatory effects, relieve dizziness and headache and other adverse reactions in patients with vasospasm, and improve clinical effectiveness.