中医辨证疗法治疗老年前庭性偏头痛患者的临床观察

Clinical observation on the treatment of vestibular migraine in elderly patients with traditional Chinese medicine syndrome differentiation therapy

目的观察中医辨证疗法对老年前庭性偏头痛患者临床症状改善的有效性。方法回顾性收集2021年10月—2023年12月于苏州市中西医结合医院治疗的122例老年前庭性偏头痛患者的临床数据,根据是否使用中医辨证疗法将其分为对照组和观察组。对照组患者接受常规治疗,而观察组在常规治疗的基础上加用中医辨证疗法。检测并比较2组治疗前后血清降钙素基因相关肽(CGRP)和5-羟色胺(5-HT)水平变化;评估2组眩晕障碍量表(DHI)、头痛评分和中医证候积分的变化;记录并比较2组的不良反应及眩晕复发情况;分析DHI评分、头痛评分与中医证候积分之间的相关性。结果治疗前2组患者血清CGRP和5-HT水平差异均无统计学意义(P>0.05);治疗后2组患者血清CGRP水平均低于同组治疗前,而血清5-TH水平均高于同组治疗前,观察组患者血清CGRP水平低于对照组,而血清5-TH水平高于对照组,差异均有统计学意义(P<0.05)。治疗后观察组眩晕复发次数明显少于对照组(P<0.05)。治疗前2组患者DHI评分、头痛评分、中医证候积分差异均无统计学意义(P>0.05);治疗后2组患者DHI评分、头痛评分、中医证候积分均低于同组治疗前,而观察组患者DHI评分、头痛评分、中医证候积分均低于对照组(P<0.05)。DHI评分、头痛评分与中医证候积分呈正相关(P<0.05)。结论中医辨证疗法可有效缓解老年前庭性偏头痛的临床症状,具有一定的临床应用价值。

Objective To observe the effectiveness of traditional Chinese medicine(TCM)syndrome differentiation therapy in improving clinical symptoms of of elderly patients with vestibular migraine.Method The clinical data of 122 elderly patients with vestibular migraine treated in Integrated Traditional Chinese and Western Medicine Hospital of Suzhou City from October 2021 to December 2023 were retrospectively collected.They were divided into control group and observation group based on whether TCM syndrome differentiation therapy was used.The control group received routine treatment,while the observation group received TCM syndrome differentiation therapy in addition to routine treatment.The levels of serum calcitonin gene-related peptide(CGRP)and 5-hydroxytryptamine(5-HT)before and after treatment were detected and compared between the two groups.The changes of Dizziness Disorder Inventory(DHI)score,headache score and TCM syndrome score of the two groups were evaluated.The adverse reactions and recurrence of dizziness were recorded and compared between the two groups.The correlation among DHI score,headache score and TCM syndrome score was analyzed.Results There was no statistically significant difference in the levels of serum CGRP and 5-HT between the two groups before treatment(P>0.05).After treatment,the serum CGRP levels of both groups were lower than those of the same group before treatment,while serum 5-TH levels were higher than those of the same group before treatment(P<0.05).The serum CGRP level of the observation group after treatment was lower than that of the control group,and the serum 5-TH level was higher than that of the control group,with statistical significances(P<0.05).After treatment,the number of recurrent dizziness in the observation group was significantly lower than that in the control group(P<0.05).There was no statistically significant difference in DHI score,headache score,and TCM syndrome score between the two groups before treatment(P>0.05).After treatment,the DHI score,headache score,and TCM syndrome score of the two groups were lower than those of the same group before treatment,while the DHI score,headache score,and TCM syndrome score of the observation group were lower than those of the control group(P<0.05).DHI score and headache score were positively correlated with TCM syndrome score(P<0.05).Conclusion TCM syndrome differentiation therapy can effectively alleviate the clinical symptoms of elderly patients with vestibular migraine,and has certain clinical application value.