本文選題：偏頭痛　切入點(diǎn)：伏邪　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景:偏頭痛是神經(jīng)內(nèi)科常見(jiàn)的疾病,其發(fā)病率高,治愈率低,給患者及家人的日常生活帶來(lái)極大影響,使患者困擾不已。由于偏頭痛病機(jī)復(fù)雜,目前研究尚不能完全闡明疾病發(fā)作過(guò)程,且偏頭痛發(fā)作具備鮮明的個(gè)體差異性,西藥對(duì)偏頭痛的療效并不樂(lè)觀。傳統(tǒng)中醫(yī)學(xué)對(duì)偏頭痛的病因病機(jī)及治療研究歷史悠久,在緩解病情,減少發(fā)作次數(shù),減輕頭痛程度、改善生活質(zhì)量等方面積累了豐富的臨床經(jīng)驗(yàn)。目前中醫(yī)學(xué)者多從肝、腎、風(fēng)、瘀、虛角度論治偏頭痛。導(dǎo)師臨床觀察偏頭痛的發(fā)病特點(diǎn)及癥狀表現(xiàn),回顧《黃帝內(nèi)經(jīng)》伏邪理論,總結(jié)現(xiàn)代臨床對(duì)其理論發(fā)展及應(yīng)用,認(rèn)為偏頭痛反復(fù)發(fā)作,遷延不愈與伏邪有關(guān),偏頭痛治療不當(dāng)或失治誤治,正氣不能抗邪外出,邪氣內(nèi)伏(痰、瘀、寒)、甚者痰瘀交阻,或久病入絡(luò),成痰瘀互阻之勢(shì)。偏頭痛常因感受外邪(風(fēng)、寒、濕)引動(dòng)、或因情郁煩勞、飲食不節(jié)而發(fā)。伏邪(痰、瘀、寒)內(nèi)伏、正氣不足為偏頭痛發(fā)病基礎(chǔ),外邪、憂思郁怒、勞累困頓、飲食失節(jié)為發(fā)病誘因,預(yù)防偏頭痛發(fā)作重在扶正透邪。研究目的:對(duì)偏頭痛的診療進(jìn)行概述;從伏邪角度認(rèn)識(shí)偏頭痛的病因病機(jī);觀察透邪平肝止痛方預(yù)防無(wú)先兆型偏頭痛急性發(fā)作的療效;為結(jié)合伏邪致病理論預(yù)防偏頭痛急性發(fā)作提供治療方案。研究方法:本試驗(yàn)采用隨機(jī)對(duì)照試驗(yàn)研究方法進(jìn)行研究。治療組服口服透邪平肝止痛方加減,每日1劑,早晚沖服。對(duì)照組口服鹽酸氟桂利嗪膠囊5mg,qn。服藥時(shí)間均為4周。研究期間患者記錄頭痛日記,重點(diǎn)記錄頭痛發(fā)作狀況,包括頭痛發(fā)作時(shí)間、程度、緩解方式、不良反應(yīng)等,試驗(yàn)結(jié)束完善偏頭痛CRF量表。研究結(jié)果:治療組和對(duì)照組實(shí)際完成病例均為27例,試驗(yàn)前對(duì)兩組受試者年齡、性別、病程、頭痛程度比較均無(wú)明顯差異,治療后療效評(píng)價(jià)結(jié)果如下:1.療效比較:治療組臨床治愈1例(3.70%),顯效12例(44.44%),有效10例(37.04%),無(wú)效4例(14.800%),總有效率85.1 8%;對(duì)照組臨床治愈0例(00%),顯效2例(7.40%),有效19例(70.37%),無(wú)效6例(22.222%),總有效率77.78%。治療組總有效率優(yōu)于對(duì)照組,兩組間有差異。2.治療后兩組中醫(yī)癥候評(píng)分比較:治療組治療后評(píng)分為8.74±5.86分;對(duì)照組治療后評(píng)分為13.15±6.99分。治療后治療組中醫(yī)證候改善情況優(yōu)于對(duì)照組。3.治療后兩組生活質(zhì)量評(píng)分比較:治療后治療組評(píng)分為16.52± 10.44分;對(duì)照組評(píng)分為26.78±11.90分。試驗(yàn)結(jié)束后對(duì)照組生活質(zhì)量評(píng)分高于對(duì)照組,說(shuō)明治療組在提高患者生活質(zhì)量方面優(yōu)于對(duì)照組。4.治療過(guò)程中兩組均未發(fā)生嚴(yán)重藥物不良反應(yīng)。研究結(jié)論:透邪平肝止痛方對(duì)肝陽(yáng)上亢型無(wú)先兆型偏頭痛的預(yù)防有效率高于鹽酸西替利嗪膠囊;透邪平肝止痛方可在一定程度上降低肝陽(yáng)上亢型無(wú)先兆型偏頭痛患者的發(fā)作頻次,減輕頭痛程度,減少頭痛發(fā)作持續(xù)時(shí)間,提高患者生活質(zhì)量,尤其在改善患者中醫(yī)癥候方面,較西比靈有顯著區(qū)別;透邪平肝止痛方預(yù)防無(wú)先兆型偏頭痛發(fā)作有一定的療效,且不存在明顯不良反應(yīng),基于伏邪理論預(yù)防偏頭痛值得進(jìn)一步深入研究。
[Abstract]:Background: migraine is a common neurological disease, high incidence, low cure rate, brings great influence to the patients and the family's daily life, make the patient troubled. Due to migraine pathogenesis is complex, the current research is still not fully elucidated the onset of disease process, and migraine have distinct individual difference, efficacy of Western medicine the migraine is not optimistic. The traditional Chinese medicine on migraine pathogenesis and therapy study on etiology of disease has a long history, in the remission of the disease, reduce the number of attacks, alleviate headache degree, improve the quality of life and has accumulated rich clinical experience. At present, Chinese scholars from the liver, kidney, blood stasis, deficiency of wind, angle of migraine. Clinical characteristics and symptoms of tutor migraine clinical observation, Review < Neijing > Fuxie theory, summarizes the modern clinical development of its theory and application, that repeated attacks of migraine, delayed healing Related to migraine foxier, improper treatment or wrongly treated, could not resist the evil out of righteousness, evil in V (phlegm, blood stasis, cold), or phlegm blood stasis, or chronic illness into the network, from phlegm and blood stasis. Migraine often due to feelings of evils (wind, cold, wet) move, or trouble work because of feeling depressed, improper diet and hair. Fuxie (phlegm, blood stasis, cold) in volts, the deficiency of vital qi is the basic pathogenesis of migraine, evils, anxiety and rage, tired exhausted, improper diet as predisposing factors, prevention of migraine attacks on Fuzheng evil. Objective: summarizing the diagnosis and treatment of migraine; etiology and pathogenesis of migraine from the angle of Fuxie; observe pathogenic liver efficacy in the prevention of acute migraine without aura type pain; as a combination of Fuxie theory of disease prevention of acute migraine treatment. Methods: This study used a randomized controlled trial methods were studied. The treatment group take orally evil Calm the liver pain decoction, 1 dose daily morning and evening with. Control group was treated with Flunarizine Hydrochloride Capsules 5mg qn., taking time for 4 weeks. During the study of patients with headache diary, mainly recording the headache, including headache, degree, ease, adverse reaction, the end of the experiment to improve the migraine CRF scale. Results: the treatment group and control group, the actual completion of cases were 27 cases, before the test of two groups of subjects with age, gender, disease duration, severity of headache showed no obvious differences, the following clinical evaluation results after treatment: 1. comparison of efficacy: 1 cases of the treatment group were cured (3.70%), 12 cases (44.44%), effective in 10 cases (37.04%), invalid in 4 cases (14.800%), the total efficiency of 85.18%; control group 0 cases were cured, 2 cases were cured (00%) (7.40%), effective in 19 cases (70.37%), invalid in 6 cases (22.222%), the total efficiency of 77.78%. total effective rate in the treatment group than the control group between the two groups. Comparison of TCM syndrome score of the two groups after treatment: the differences of.2. scores of treatment group was 8.74 + 5.86; the control group after treatment score was 13.15 + 6.99. After treatment, the symptoms of the treatment group improved better than the control group.3. after treatment in two groups of quality of life score comparison: the treatment group score was 16.52 + 10.44; the control group score was 26.78 + 11.90. At the end of the experiment, the control group quality of life score higher than the control group, the treatment group in improving the quality of life of patients than the control group.4. during the treatment of the two groups were no serious adverse drug reactions occurred. Conclusion: prevention of pathogenic liver pain of migraine without aura liver yang hyperactivity type of efficiency is higher than that of Cetirizine Hydrochloride Capsules; evil can calm the liver pain frequency to a certain extent, reduce the hyperactivity of liver Yang in patients without migraine attacks, alleviate headache degree, reduce the head The duration of pain, improve the quality of life of patients, especially in the improvement of TCM symptoms, compared with flunarizine significantly different pathogenic liver pain; prevention of migraine without aura attack has certain curative effect, and has no obvious adverse reactions, Fuxie theory is worthy of further research on the prevention of migraine.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R277.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張凱博;李興志;;慢性偏頭痛的微創(chuàng)治療進(jìn)展[J];中風(fēng)與神經(jīng)疾病雜志;2017年04期

2 王圣潔;孫美娜;趙靜雨;韓延華;;韓延華教授治療腎虛肝郁型經(jīng)行頭痛臨床經(jīng)驗(yàn)[J];浙江中醫(yī)藥大學(xué)學(xué)報(bào);2016年06期

3 裴培;劉璐;趙洛鵬;曲正陽(yáng);唐楚英;王麟鵬;;5-HT能神經(jīng)通路參與偏頭痛的機(jī)制研究進(jìn)展[J];中國(guó)現(xiàn)代應(yīng)用藥學(xué);2016年04期

4 任珊;陳志剛;;頭痛寧方治療偏頭痛臨床研究[J];中國(guó)中醫(yī)藥信息雜志;2016年04期

5 韓芳;李雙;孫凡;曹克剛;;偏頭痛的現(xiàn)代醫(yī)學(xué)治療現(xiàn)狀[J];中西醫(yī)結(jié)合心腦血管病雜志;2016年01期

6 陳雪吟;王祥瑞;;偏頭痛的非藥物治療進(jìn)展[J];中國(guó)疼痛醫(yī)學(xué)雜志;2015年12期

7 孫玉潔;;癲癇從伏邪論治探析[J];湖北中醫(yī)雜志;2015年10期

8 李羚;劉志華;郭燕;;腦電圖檢查在偏頭痛和頭痛性癲癇診斷的價(jià)值[J];中外醫(yī)學(xué)研究;2015年27期

9 周俊霞;;動(dòng)態(tài)腦電圖在頭痛型癲vN和偏頭痛鑒別診斷中的應(yīng)用[J];現(xiàn)代電生理學(xué)雜志;2015年03期

10 黃英;王媛媛;劉麗娟;吳克明;;從伏邪理論探討多囊卵巢綜合征的治療思路[J];云南中醫(yī)中藥雜志;2015年07期

相關(guān)會(huì)議論文 前2條

1 陳春富;李嬰嬰;;偏頭痛患者家族性及臨床特點(diǎn)的研究[A];中華醫(yī)學(xué)會(huì)第十八次全國(guó)神經(jīng)病學(xué)學(xué)術(shù)會(huì)議論文匯編（下）[C];2015年

2 張建華;張婧;;偏頭痛性眩暈生活質(zhì)量調(diào)查[A];中國(guó)轉(zhuǎn)化醫(yī)學(xué)和整合醫(yī)學(xué)研討會(huì)論文綜合刊[C];2015年

相關(guān)重要報(bào)紙文章 前1條

1 彭華;趙忠新;黃流清;;具有遺傳性的周期性偏頭痛[N];家庭醫(yī)生報(bào);2009年

相關(guān)碩士學(xué)位論文 前1條

1 李世強(qiáng);偏頭痛患者的癥狀分布特點(diǎn)和發(fā)病因素研究[D];北京中醫(yī)藥大學(xué);2015年

，

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