天麻饼穴位敷贴治疗肝阳上亢型高血压头痛的临床研究

Clinical Study on Acupoint Application of Gastrodia Cake in the Treatment of Hypertensive Headache with Liver-yang Hyperactivity Type

目的 探讨中药制剂“天麻饼”穴位敷贴治疗肝阳上亢型高血压头痛的临床疗效及安全性。方法 采用随机、对照、平行研究,选取符合纳入标准的肝阳上亢型高血压头痛患者41例,对照组20例,治疗组21例。对照组予西医标准治疗4周,治疗组在对照组治疗基础上加用“天麻饼”穴位敷贴治疗2周,干预2、4周后,分别比较2组患者血压值、中医证候积分、头痛评分、头痛持续时间、头痛发作频率的变化。结果 干预2、4周后,2组患者血压均显著降低(P<0.01),组间差异均无统计学意义(P>0.05);干预2、4周后,2组患者头痛评分均显著降低(P<0.01),且干预2周后治疗组优于对照组(P<0.01);干预2、4周后,2组中医证候积分均降低(P<0.05,P<0.01),且治疗组在改善头痛症状方面均优于对照组(P<0.01),其中干预4周后治疗组在改善总积分方面优于对照组(P<0.05);干预2、4周后,2组患者头痛频次均显著降低(P<0.01)、治疗组均优于对照组(P<0.01,P<0.05);干预2、4周后,对照组头痛持续时间均较干预前差异无统计学意义,治疗组头痛持续时间均显著降低(P<0.05),其中治疗2周后治疗组优于对照组(P<0.01);干预2周后对照组总有效率70%,治疗组总有效率95%,治疗组头痛疗效优于对照组(P<0.01),干预4周后对照组总有效率70%,治疗组总有效率90%,治疗组头痛疗效优于对照组(P<0.01);治疗期间2组均未出现不良反应。结论 “天麻饼”穴位敷贴能改善肝阳上亢型高血压的头痛评分、头痛频率、头痛持续时间,疗效显著,且独立于降压作用、作用持久,同时具有良好的用药安全性,值得临床推广。

Objective:To study the clinical effect and safety of acupoint application of Gastrodia Cake in the treatment of hypertensive headache with liver-yang hyperactivity.Methods:A randomized,controlled and parallel study was conducted to select 41 patients with hypertensive headache with liver-yang hyperactivity,20 in the control group and 21 in the treatment group.The control group was treated with standard western medicine for 4 weeks and the treatment group was treated with the acupoint application of Gastrodia Cake for 2 weeks on the basis of the treatment of the control group.After 2 and 4 weeks of intervention,the changes of blood pressure,TCM syndrome score,headache score,headache duration and headache attack frequency of the two groups were compared respectively.Results:After 2 and 4 weeks of intervention,the blood pressure of the two groups was significantly decreased(P<0.01),and there was no statistical significance between groups(P>0.05).After 2 and 4 weeks of intervention,the headache scores in the two groups were significantly decreased(P<0.01),and the treatment group was better than the control group(P<0.01).After 2 and 4 weeks of intervention,the TCM syndrome scores of the two groups were decreased(P<0.05,P<0.01),and the treatment group was better than the control group in improving headache symptoms(P<0.01),and the treatment group was better than the control group in improving total scores after 4 weeks of intervention(P<0.05).After 2 and 4 weeks of intervention,the headache frequency of the two groups was significantly decreased(P<0.01),and the treatment group was better than the control group(P<0.01,P<0.05).After 2 and 4 weeks of intervention,there was no significant difference in the duration of headache in the control group compared with that before intervention while the duration of headache in the treatment group was significantly reduced(P<0.05),and the treatment group was better than the control group after 2 weeks of treatment(P<0.01).After 2 weeks of intervention,the total effective rate of the control group was 70%,and that of the treatment group was 95%,and the curative effect of the treatment group was better than that of the control group(P<0.01).After 4 weeks of intervention,the total effective rate of the control group was 70%,and the that of the treatment group was 90%,and the curative effect of the treatment group was better than that of the control group(P<0.01).There were no adverse reactions in both groups during treatment.Conclusion:Acupoint application of Gastrodia Cake can improve headache score,headache frequency and headache duration of the patients with liver-yang hyperactivity and has significant curative effect,independent of antihypertensive effect and long-lasting effect,and meanwhile possesses good medication safety and is worthy of clinical promotion.