龙胆泻肝汤加减对三叉神经痛显微血管减压术后肝火型头痛患者的临床观察

Intervention Value of Longdan Xiegan Decoction on Patients with Hepatogenous Headaches after Trigeminal Neuralgia Microvascular Decompression

目的探讨龙胆泻肝汤加减对三叉神经痛显微血管减压术后肝火型头痛患者的干预价值。方法选取2019年1月—2022年6月期间河北省人民医院行三叉神经痛显微血管减压术后引发肝火型头痛患者80例作为研究对象,按随机数字表法分为对照组和观察组,每组各40例。对照组采取常规治疗,观察组在对照组基础上加用龙胆泻肝汤加减治疗。治疗2周后,观察比较两组患者临床疗效、并发症,治疗前后中医症状积分、头痛发作频率、持续时间及镇痛评分及炎性因子[C-反应蛋白(Creactive protein,CRP)、白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TFN-α)]水平。结果治疗后观察组总有效率95.00%(38/40)明显高于对照组77.50%(31/40),差异有统计学意义(P<0.05)。治疗后两组患者中医症候两目发胀、头晕目眩、口干舌苦各项评分均低于治疗前,差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者头痛发作次数、持续时间、VAS评分较治疗前降低,差异有统计学意义(P<0.05);且观察组明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎性因子CRP、IL-6、TFN-α水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组并发症发生率2.50%(1/40)低于对照组7.50%(3/40),差异无统计学意义(P>0.05)。结论龙胆泻肝汤加减运用于三叉神经痛显微血管减压术后肝火型头痛患者中,能减低患者中医症状评分,改善患者头痛症状,减低炎性反应,提高患者治疗总有效率。

Objective To investigate the intervention value of Longdan Xiegan Decoction on patients with hepat⁃ogenous headaches after trigeminal neuralgia microvascular decompression.Methods A total of 80 patients with hepatoge⁃nous headaches after trigeminal neuralgia microvascular decompression admitted to Hebei Provincial People′s Hospital from January 2019 to June 2022 were taken as the research object and divided into control group and observation group accord⁃ing to the random number table method,with 40 cases in each group.The control group was treated with conventional treat⁃ment,while the observation group was treated with Longdan Xiegan Decoction on the basis of the control group.After treat⁃ment of two weeks,the clinical treatment efficacy,complications,traditional Chinese medicine(TCM)symptom score,head⁃ache frequency,duration,analgesic score,and levels of inflammatory factors,including creactive protein(CP),interleukin-6(IL-6),and tumor necrosis factor-α(TFN-α)were compared between the two groups.Results The total effective rate of the observation group was 95.00%(38/40),significantly higher than that of the control group(77.50%,31/40)(P<0.05).After treatment,the TCM scores of eye distension,dizziness,dry mouth,and bitter tongue in the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).After treatment,the headache frequency,duration,and visual analogue analgesia(VAS)scores in the two groups were significantly lower than those before treatment,and the observation group was lower than the control group(P<0.05).After treatment,the levels of CRP,IL-6,and TFN-αin the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).The incidence of complications in the observation group(2.50%,1/40)was lower than that in the control group(7.50%,3/40),but there was no statistical significance between the two groups(P>0.05).Conclusion The application of Longdan Xiegan Decoction in patients with hepatogenic headaches after trigeminal neural⁃gia microvascular decompression can reduce the TCM symptom score of patients,improve the headache symptoms,reduce the inflammatory response,and enhance the total effective rate of treatment.