發(fā)布時間：2018-06-23 22:26

  本文選題：自擬柔肝熄風(fēng)湯 + 肝陽上亢型偏頭痛　； 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：本課題通過采用標(biāo)準(zhǔn)對照的研究方法與隨機(jī)、平行對照的臨床試驗(yàn)設(shè)計,系統(tǒng)觀察自擬柔肝熄風(fēng)湯在肝陽上亢型偏頭痛患者預(yù)防性治療中的有效性和安全性,并通過自擬柔肝熄風(fēng)湯與已知有效的偏頭痛預(yù)防性治療藥物鹽酸氟桂利嗪膠囊的療效對比,進(jìn)一步驗(yàn)證自擬柔肝熄風(fēng)湯對肝陽上亢型偏頭痛預(yù)防性治療的臨床療效,并對其安全性作出客觀的評價。為自擬柔肝熄風(fēng)湯在偏頭痛預(yù)防性治療中的推廣作初步的臨床研究,為中醫(yī)藥在偏頭痛預(yù)防性治療中的運(yùn)用提供一種,安全有效的方法。方法：本課題共觀察120例于開封市中醫(yī)院腦病科門診就診的肝陽上亢型偏頭痛患者。采用SPSS軟件產(chǎn)生隨機(jī)數(shù)字及編碼,按1：1的比例設(shè)對照組和試驗(yàn)組,其中試驗(yàn)組60例,對照組60例,試驗(yàn)組與對照組療程均為8崩,療程結(jié)束后隨訪4周。試驗(yàn)組的偏頭痛患者內(nèi)服自擬柔肝熄風(fēng)湯以用于偏頭痛的預(yù)防性治療(中藥配方顆粒,廣東一方制藥有限公司,產(chǎn)品批號：1308816,有效期至2016年7月),每日1劑,200-300m1開水沖服,每日2次；對照組的偏頭痛患者口服鹽酸氟桂利嗪膠囊以用于預(yù)防性治療,由西安楊森制藥有限公司生產(chǎn)(國藥準(zhǔn)字H10930003),主要成分：鹽酸氟桂利嗪,1次10mg,每日1次。治療結(jié)束后依據(jù)偏頭痛患者記錄的頭痛日記,觀察并詳細(xì)記錄治療開始前4周與治療結(jié)束后4周內(nèi)頭痛發(fā)作次數(shù),頭痛發(fā)作時間,頭痛疼痛程度評分、伴隨癥狀及頭痛影響測定—6(HIT-6)得分,并根據(jù)頭痛發(fā)作次數(shù)；治療結(jié)束后4周內(nèi)頭痛發(fā)作總時間；數(shù)字疼痛量表測定法頭痛程度的平均評分；頭痛癥狀積分及頭痛影響測定—6(HIT-6)得分來判定藥物的臨床治療效果。結(jié)果：經(jīng)過對試驗(yàn)組與對照組偏頭痛患者治療結(jié)束后4周內(nèi)頭痛發(fā)作次數(shù)、頭痛發(fā)作總時間、數(shù)字疼痛量表測定法頭痛程度的平均評分、頭癰癥狀積分及頭痛影響測定—6(HIT-6)得分的統(tǒng)計學(xué)分析,結(jié)果表明自擬柔肝熄風(fēng)湯能明顯降低偏頭痛肝陽上亢型患者的頭痛次數(shù)、減少頭痛持續(xù)時間、減輕頭痛程度,改善患者頭痛發(fā)作時的癥狀及頭痛對患者生活的負(fù)面影響。在偏頭痛治療效果方面,試驗(yàn)組總有效率為90.00%,對照組總有效率為65.00%,兩組治療效果之間的差異具有統(tǒng)計學(xué)意義(P=0.010.05),說明自擬柔肝熄風(fēng)湯在肝陽上亢型偏頭痛患者預(yù)防性治療中的療效強(qiáng)于對照組藥物。在治療后4周內(nèi)頭痛持續(xù)時間、頭痛程度、癥狀積分及頭痛影Ⅱ響測定—6(HIT-6)得分方面,試驗(yàn)組與對照組之間的差異具有統(tǒng)計學(xué)意義(P時間=0.010.05；P程度=0.000.05；P評分=0.000.05;PHIT-6=0.000.05),說明試驗(yàn)組藥物在減少頭痛持續(xù)時間、減輕偏頭痛患者頭痛發(fā)作時頭痛程度,降低偏頭痛患者頭痛發(fā)作時癥狀積分,改善患者頭痛發(fā)作時的癥狀及頭痛對患者生活的負(fù)面影響方面的治療效果優(yōu)于對照組藥物。在治療后4周內(nèi)頭痛發(fā)作次數(shù)方面,試驗(yàn)組與對照組之間的差異無統(tǒng)計學(xué)意義(P=0.100.05),說明在改善偏頭痛患者頭痛發(fā)作次數(shù)方面,試驗(yàn)組的藥物與對照組藥物的治療效果相同。在治療過程中試驗(yàn)組與對照組的偏頭痛患者均無不良反應(yīng)及不良事件的發(fā)生,說明試驗(yàn)組與對照組的藥物在治療過程中安全性相當(dāng)。結(jié)論：自擬柔肝熄風(fēng)湯能顯著改善肝陽上亢型偏頭痛患者的癥狀、體征及頭痛對生活的負(fù)面影響,是一種安全有效的可用于肝陽上亢型偏頭痛預(yù)防性治療的方藥。
[Abstract]:Objective: to systematically observe the efficacy and safety of the self-designed Soft Liver Xifeng Decoction in the preventive treatment of migraine patients with hyperactivity of liver Yang type by using a standard controlled study method and a randomized, parallel controlled clinical trial design, and through the self-designed suppressing Soft Liver extinguishing Decoction and the known effective migraine prophylactic treatment of fluorine hydrochloride. To compare the curative effect of Cinnarizine Capsules, further verify the clinical curative effect of self-made Soft Liver Xifeng Decoction on the prophylactic treatment of migraine with hyperactivity of liver Yang, and make an objective evaluation on its safety. Methods: to provide a safe and effective method. Methods: a total of 120 cases of hyperhyperhyperactivity migraine in the clinic of encephalopathy of Kaifeng City Chinese medicine hospital were observed. Random numbers and codes were produced by SPSS software. The control group and test group were set up according to the proportion of 1:1, including 60 cases in the experimental group, 60 cases in the control group, and the course of treatment in the experimental group and the control group. 8 avalanche, followed up for 4 weeks after the end of the course. The migraine patients in the experimental group were given a self-designed Soft Liver quenching Soup for the preventive treatment of migraine (traditional Chinese medicine formula, Guangdong Fang Pharmaceutical Co., Ltd., product batch number: 1308816, valid to July 2016), 1 doses per day, 200-300m1 boiling water, 2 times a day, and a control group of migraine patients. Oral Flunarizine Hydrochloride Capsules for prophylactic treatment, produced by the Xi'an Janssen Pharmaceutical Ltd (Chinese medicine quasi word H10930003), the main ingredient: flunarizine hydrochloride, 1 times 10mg, 1 times a day. After the treatment, the headache diary recorded by the migraine patients was observed and recorded in detail in the first 4 weeks before the treatment and the first 4 weeks after the end of the treatment. The number of pain attacks, the time of the headache, the score of the headache and pain, the score of 6 (HIT-6), the number of headache attacks, the total time of the headache within 4 weeks after the end of the treatment, the average score of the headache degree in the digital pain scale, the score of headache symptoms and the determination of the influence of headache - 6 (HIT-6) Results: the results showed that the number of headache episodes, the total time of headache attack, the average score of headache in the digital pain scale, the score of head carbuncle and the influence of headache, and the impact of headache on the score of 6 (HIT-6) were analyzed in the test group and the control group, and the results showed that the score of the headache was determined in 4 weeks. The self-designed Decoction of suppressing the liver and extinguishing the wind can obviously reduce the number of headache in the patients with migraine liver hyperactivity, reduce the duration of the headache, reduce the degree of headache, and improve the negative effects of the symptoms and headache on the patient's life. In the treatment effect of migraine, the total effective rate of the experimental group is 90%, the total effective rate of the control group is 65%, two. The difference between the therapeutic effects of the group was statistically significant (P=0.010.05), indicating that the therapeutic effect of the self-made Soft Liver Xifeng Decoction in the prophylactic treatment of migraine patients with hyperactivity of liver yang hyperactivity was better than that of the control group. The duration of the headache, the degree of headache, the score of the symptoms and the score of the headache shadow - 6 (HIT-6) in the 4 weeks after the treatment were compared with the experimental group. The differences between the groups were statistically significant (P time =0.010.05; P degree =0.000.05; P score =0.000.05; PHIT-6=0.000.05), indicating that the drug in the test group reduced the duration of the headache, alleviated the degree of headache in the migraine headache, reduced the symptom score of migraine headache, and improved the symptoms of the patient's headache attack. There was no significant difference in the number of headache attacks between the experimental group and the control group within 4 weeks after 4 weeks of treatment (P=0.100.05), indicating the therapeutic effect of the drug and the control group in the improvement of the number of migraine attacks in patients with migraine. In the course of treatment, both the experimental group and the control group had no adverse reactions and adverse events, indicating that the drugs in the test group and the control group were safe in the course of treatment. Conclusion: the self-designed Soft Liver quenching decoction can significantly improve the symptoms, signs and headache of the patients with migraine in the liver yang hyperactivity type migraine. Ringing is a safe and effective prescription for the prevention of migraine with hyperactivity of liver yang.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.7

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