偏头痛分型论治多中心临床观察及疗效分析

目的评价中医药分型论治偏头痛的效果。方法采用多中心、随机对照方法进行临床研究。选取偏头痛患者194例,随机分为三组：肝阳证组91例,口服颅痛饮为基础方加减治疗,后服养血清脑颗粒;痰浊证组36例,口服半夏白术天麻汤为基础方加减治疗,后使用二陈丸或正天丸;血瘀证组67例,口服桃红四物汤为基础方加减治疗,后使用中成药正天丸。疗程均为16周,停药后12和24周各随访1次,观察治疗前后头痛各项指标。结果三组头痛发作天数治疗后4周、治疗后16周的组间差异有统计学意义（P=0.038和P=0.012）;三组发作次数只有治疗后16周的组间差异有统计学意义（P=0.044）;总持续时间治疗后4周、治疗后16周的组间差异有统计学意义（P=0.034和P=0.005）;三组在中医证候疗效方面的有效率分别为84.62%、80.00%和88.33%,差异无统计学意义（P〉0.05）。结论肝阳证以颅痛饮为基础方、痰浊证以半夏白术天麻汤为基础方、血瘀证以桃红四物汤为基础方加减治疗均能明显改善偏头痛患者的临床症状,并起到一定的预防治疗作用。

Multi-center clinical study and efficacy analysis on the treatment of migraine with syndrome differentiation classification

Objective To evaluate the clinical efficacy of treatment for migraine with syndrome differentiation classification of TCM. Methods In multi-center randomized controlled experiment ,194 patients with migraine were randomly divided into 91 Live-yang hyperactivity, treated with Lutongyin decoction, then Yangxueqingnao grain; 36 Phlegm-damp stagnating , treated with Banxiabaishutianma decoction, then Erchen pill or Zhengtianwan; 67 Blood stasis, treated with Taohongsiwu decoction, then Zhengtianwan. The treatment lasted 16 weeks, Follow-up after stop treatment 12 and 24 weeks.The migraine indicators were observed before and after treatment. Results There is significant difference among the groups after 4 and 16 weeks therapy in the number of migraine days （P=0.038 and P=0.012）、 the frequency of headache attacks（P=0.034 and P=0.005）, but the migraine duration times were significant（P0.05） after 16 weeks therapy ,while there is no significant difference（P0.05） in the migraine efficacy of TCM syndrome affect which was 84.62%,80.00% and 88.33% respectively. Conclusion Live-yang hyperactivity treated with Lutongyin decoction,Phlegm-damp stagnating treated with Banxiabaishutianma decoction,and Blood stasis treated with Taohongsiwu decoction are all effective in treating and preventing migraine clinically.