温经养血膏治疗血虚寒凝型经行头痛的临床研究

发布时间：2018-06-20 08:00

本文选题：经行头痛 + 温经养血膏　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：经行头痛发病率高,患者为此所付出的经济和精神上的代价也相当大,极大影响妇女健康、工作、生活,受到当今医学界关注。但目前关于经行头痛的发病机制尚无定论,目前中西医领域用于经行头痛的治疗方案局限性较大,治疗方法急需新的突破。所以,探索有效的针对经行头痛的治疗手段具有的临床意义十分重大。而现代女性贪寒饮冷的生活习惯易致血虚寒凝经行头痛,针对血虚寒凝的病机,应用具有温经散寒通脉作用的当归四逆汤加减方治疗血虚寒凝所致经行头痛切中病机。鉴于中药煎煮不便的不足,基于当归四逆汤加减制成温经养血膏,既取膏方无须煎煮、易存易携的优点,又能使当归四逆汤的疗效更加温和持久,尤适合于快节奏生活的现代女人,确保了患者的依从性。本课题通过进行前瞻、随机对照临床试验研究来评价和比较温经养血膏与安慰剂对照方案对于经行头痛的有效性,为临床治疗经行头痛提供更为方便有效的方案。方法：本研究采用前瞻性随机对照临床试验研究方法,按照病例纳入标准,选择广东省中医院门诊符合纳入标准的轻至中度型血虚寒凝型经行头痛病例38例,各病人随机分为治疗组23例、对照组15例,以温经养血膏作为试验药物,选不含药物成分的胶囊安慰剂作为空白对照药物。治疗组服药方法为经期第五天开始口服,20ml, qd,连续服用3个月,对照组服药方法为经期第五天开始口服,2粒,tid,连续服用3个月。治疗过程中,对照组病例脱落1例,病例最终完成收集37例。其中治疗组23例,对照组14例。通过对治疗前、后,治疗组及对照组的头痛VAS评分、头痛指数、中医证候评分、五羟色胺、前列腺素F2α、前列腺素E2来综合评价温经养血膏对血虚寒凝型经行头痛的疗效。结果：1.经行头痛指数治疗有效率方面,治疗组的总有效率87%；对照组的总有效率21.4%,两组有效率经秩和检验提示有统计学意义(P0.05)。2.经行头痛的中医症状积分治疗有效率方面,治疗组的总有效率78.3%；对照组的总有效率7.1%,两组有效率经秩和检验提示有统计学意义(P0.05)。3.头痛VAS评分,治疗组治疗前、后头痛指数差值经秩和检验提示差异有统计学意义(P0.05),对照组治疗前、后头痛指数经秩和检验提示差异无统计学意义(P0.05),两组差值经秩和检验提示有统计学意义(P0.05)。4.头痛指数评分,治疗组治疗前、后头痛指数经秩和检验提示有统计学意义(P＜0.05),对照组治疗前、后头痛指数经秩和检验提示差异无统计学意义(P.05),两组差值经秩和检验提示有统计学意义(P0.05)。5.中医的症状积分,治疗组治疗前、后积分经秩和检验提示有统计学意义(P0.05),对照组治疗前、后积分经秩和检验提示差异无统计学意义(P0.05),两组差值经秩和检验提示有统计学意义(P0.05)。6.五羟色胺,两组治疗前后差值经秩和检验提示差异无统计学意义(P0.05)。7.前列腺素F2 α,两组治疗前后差值经秩和检验提示差异无统计学意义(P0.05)。8.前列腺素E2,两组治疗前后差值经秩和检验提示差异无统计学意义(P0.05)。结论：温经养血膏对血虚寒凝型经行头痛的VAS评分及头痛指数有明显改善,同时对于伴随的中医证候改善明显,对五羟色胺、前列腺素F2 α、前列腺素E2的含量无明显改善,温经养血膏治疗血虚寒凝型经行头痛未见不良反应,是临床上治疗本病的有效方法。
[Abstract]:Objective: the incidence of headache is high, and the economic and spiritual cost of the patient is also very high, which greatly affects the health, work and life of women. However, there is no definite conclusion about the pathogenesis of the headache. At present, the treatment scheme for the headache is limited and the treatment is very limited. The law is in urgent need of new breakthroughs. Therefore, it is of great significance to explore effective treatment methods for the menstrual headache. And the cold living habits of modern women are easy to cause blood deficiency and cold coagulating menstrual headache. In view of the pathogenesis of blood deficiency and cold coagulation, the treatment of blood deficiency and cold coagulation with the four inverse Decoction of Angelica sinensis with the effect of warm meridian and cold through pulse is applied to the treatment of blood deficiency and cold coagulation. In view of the inconveniences of headache cutting, in view of the inadequacy of the inconvenience of decocting traditional Chinese medicine, it is based on the reduction of the decoction of Danggui four reverse soup to make the warm blood nourishing cream, not only to take the advantage of decocting, easy to carry, but also to make the curative effect of the four inverse soup of Angelica sinensis more mild and lasting, especially for the modern woman of fast rhythm life, to ensure the compliance of the patient. Prospective, randomized controlled clinical trials to evaluate and compare the effectiveness of Wen Jing Yangxue ointment and placebo control for the menstrual headache and provide a more convenient and effective solution for the clinical treatment of menstrual headaches. Method: This study adopted a prospective randomized controlled clinical trial, and selected the case in Guangdong Province in accordance with the case. 38 cases of mild to moderate blood deficiency and cold coagulating type headache cases were met in the hospital outpatient clinic. The patients were randomly divided into 23 cases in the treatment group and 15 cases in the control group. The control group was treated with Wen Jing Yangxue ointment as the test drug, and the capsules without drug components were selected as the blank control drugs. The treatment group was taken orally for fifth days of menstrual period, 20ml, QD For 3 months, the control group took oral administration for fifth days, 2 grains, TID, and continued to take 3 months. In the course of the treatment, 1 cases were lost in the control group and 37 cases were collected. The treatment group was 23 cases, and the control group was 14. The headache index, headache index, TCM syndrome were passed before treatment, after treatment, treatment group and control group. Score, five hydroxytryptamine, prostaglandin F2 A and prostaglandin E2 were used to evaluate the effect of Wen Jing Yangxue ointment on blood deficiency cold coagulating type headache. Results: 1. the total effective rate of the treatment group was 87%, the total effective rate of the control group was 21.4%, and the two groups of effective rates were statistically significant (P0.05).2. meridian through the rank sum test. The total effective rate of TCM symptoms of headache was 78.3%, the total effective rate of the treatment group was 78.3%, the total effective rate of the control group was 7.1%, and the two groups had a statistical significance (.3.) headache VAS score by rank and test. The difference of the post pain index difference between the treatment group and the control group was statistically significant (P0.05) and the control group was treated before treatment (P0.05). Before treatment, there was no statistical significance (P0.05) with the rank sum test, and the difference value of the two groups was statistically significant (P0.05).4. headache index score. The post pain index was statistically significant before treatment in the treatment group (P < 0.05). Before treatment, the back head pain index was indicated by the rank sum test. The difference was not statistically significant (P.05). The difference between the two groups was statistically significant (P0.05) with statistical significance (P0.05). Before treatment, the post integral was statistically significant (P0.05) by rank sum test (P0.05). There was no statistical significance (P0.05) for the difference between the rank sum test before the treatment of the control group (P0.05), and the difference value was tested by rank sum test. The difference was statistically significant (P0.05).6. five hydroxytryptamine, and the difference between the two groups before and after treatment was not statistically significant (P0.05).7. prostaglandin F2 alpha, and the difference between the two groups before and after treatment was not statistically significant (P0.05).8. prostaglandin E2, and there was no statistical difference between the two groups before and after treatment with no statistical difference. Significance (P0.05). Conclusion: Wen Jing Yangxue ointment improved the VAS score and headache index of blood deficiency cold coagulant type headache, and improved evidently for the accompanying TCM syndrome. There was no obvious improvement on the content of five hydroxytryptamine, prostaglandin F2 A and prostaglandin E2, and there was no adverse reaction in the treatment of blood deficiency and cold coagulating type with headache. It is an effective method for clinical treatment of this disease.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.115

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