标题：黄帝内针联合氟桂利嗪治疗偏头痛疗效观察

      作者：许艺娴 1，陈醉 2，胡冬梅 1，周晓燕 1    1.广州市天河区中医医院，广东 广州 510655；2.广州市老年医院(广州市老人院)，广东 广州 510550

      卷次： 2024年35卷1期

      【摘要】 目的 研究黄帝内针联合氟桂利嗪治疗偏头痛的临床疗效。方法 选取2022年5月至2023年5月广州市天河区中医医院内科治疗的 70例慢性偏头痛患者作为研究对象，按随机数表法分为观察组和对照组各35例。对照组患者给予氟桂利嗪治疗，观察组患者在对照组治疗的基础上给予黄帝内针治疗，两组患者均连续治疗4周。比较两组患者的临床疗效(采用中医证候评分)，治疗前后的偏头痛每周发生天数、次数、偏头痛发作持续时间(采用头痛日记法)和头痛程度{[采用头痛视觉模拟量表(VAS-H)]以及生活质量[采用头痛影响测试量表-6(HIT-6)]}；于治疗前后采用经颅多普勒超声检测并比较两组患者的脑血流动力学情况[大脑前动脉(ACA)、中动脉(MCA)、后动脉(PCA)的血流速度]。随访4周比较两组患者的偏头痛复发率。结果 观察组患者的治疗总有效率和显效率分别为94.29%、74.29%，明显高于对照组的71.43%、42.86%，差异均有统计学意义(P<0.05)；观察组患者治疗后的偏头痛发作次数、天数及发作持续时间分别为(1.37±1.33)次、(0.91±0.85) d，(1.03±0.91) h，明显少(短)于对照组的(2.37±1.73)次、(1.37±0.84) d、(2.03±1.12) h，差异均有统计学意义(P<0.05)；观察组患者治疗后的VAS-H、HIT-6与中医证候评分分别为(1.34±1.30)分、(36.31±5.17)分、(5.91±4.88)分，明显低于对照组的(2.49±1.60)分、(42.91±5.15)分、(8.91±3.94)分，差异均具有统计学意义(P<0.05)；观察组患者治疗后的ACA、MCA、PCA分别为(89.15±4.15) cm/s、(99.69±3.19) cm/s、(68.61±4.20) cm/s，明显慢于对照组的(92.97±3.67) cm/s、(108.56±6.94) cm/s、(75.59±6.07) cm/s，差异均有统计学意义(P<0.05)；随访 4周，观察组患者的复发率为 11.43%，明显低于对照组的48.57%，差异有统计学意义(P<0.05)。结论 黄帝内针联合氟桂利嗪能够有效改善偏头痛患者的症状与生活质量，其作用与调节患者脑血流动力学紊乱有关。
      【关键词】 偏头痛；黄帝内针；氟桂利嗪；肝阳上亢；血流动力学；疗效
      【中图分类号】 R441.1 【文献标识码】 A 【文章编号】 1003—6350（2024）01—0062—05

Effect of Huangdineizhen and Flunarizine in treating migraine.
XU Yi-xian 1, CHEN Zui 2, HU Dong-mei 1, ZHOUXiao-yan 1. 1. Guangzhou Tianhe Hospital of Traditional Chinese Medicine (TCM), Guangzhou 510655, Guangdong,CHINA; 2. Guangzhou Geriatric Hospital (Guangzhou Home for the Aged), Guangzhou 510550, Guangdong, CHINA
【Abstract】 Objective To study the effect of Huangdineizhen and Flunarizine in treating migraine.Methods Sev-enty patients with chronic migraine from Department of Internal Medicine, Guangzhou Tianhe Hospital of TCM fromMay 2022 to May 2023 were collected. The patients were divided into an observation and a control group according torandom number table, with 35 patients in each group. Patients in the control group were treated with Flunarizine, whilethose in the observation group were additionally treated with Huangdineizhen based on the treatment of the controlgroup, for 4 weeks. The clinical effect (evaluated by TCM syndrome score), the days and frequency of migraine occur-rence per week, and duration of the migraine (observed by the headache diary), as well as the pain intensity [evaluatedby the Visual Analogue Scale of headache (VAS-H)] and quality of life [headache impact test-6 (HIT-6)], were com-pared between the two groups before and after treating. The cerebral hemodynamics [the blood flow velocity of anterior(ACA), middle (MCA), and posterior (PCA) cerebral artery] were tested by the transcranial Doppler sonography. After4-week follow-up, the recurrence rate of the migraine were compared between the two groups. Results The total ef-fective rate and the remarkable effective rate of the observation group were 94.29% and 74.29%, which were significant-ly higher than 71.43% and 42.6% of the control group (P<0.05). After treatment, the frequency, days, and duration of mi-graine in the observation group were (1.37±1.33) times, (0.91±0.85) d, (1.03±0.91) h, which were significantly less than(2.37±1.73) times, (1.37±0.84) d, (2.03±1.12) h in the control group (P<0.05). The scores of VAS-H, HIT-6, and TCMsyndrome in the observation group were (1.34±1.30) points, (36.31±5.17) points, (5.91±4.88) points after treatment,which were significantly lower than (2.49±1.60) points, (42.91±5.15) points, (8.91±3.94) points in the control group (P<0.05). The ACA, MCA, and PCA of the observation group after treatment were (89.15±4.15) cm/s, (99.69±3.19) cm/s,(68.61±4.20) cm/s, which were significantly less than (92.97±3.67) cm/s, (108.56±6.94) cm/s, (75.59±6.07) cm/s in thecontrol group (P<0.05). During the follow-up, the recurrence rate of the observation group was 11.43%, significantlylower than 48.57% of the control group (P<0.05). Conclusion Huangdineizhen combined with flunarizine could effec-tively improve the symptoms and quality of life of patients with migraine, which was related to the regulation of the cere-bral hemodynamic disorder.
      【Key words】 Migraine; Huangdineizhen; Flunarizine; Hyperactivity of liver-yang; Hemodynamics; Clinical ef-fect