调肝法论治原发性头痛临床研究
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摘要
目的:观察调肝论治法指导下中药多靶点治疗方案治疗原发性头痛的临床疗效。方法:将90例原发性头痛患者随机分为对照组和治疗组,各45例。对照组给予单纯西药治疗,治疗组在对照组治疗基础上,联合应用调肝论治法指导下中药多靶点治疗方案,比较两组头痛、焦虑抑郁及睡眠质量的改善情况,观察两组治疗前后血清过氧化物酶体增殖物激活受体γ(peroxisome proliferator activated receptorγ,PPARγ)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、溶血磷脂酸(lysobisphosphatidic acids,LPA)水平及脑神经递质水平变化情况。结果:治疗组有效率97.8%,对照组有效率86.7%,治疗组疗效显著优于对照组(P<0.01);两组均能显著降低患者BECK焦虑量表(Beck anxiety inventory,BAI)评分、BECK抑郁量表(Beck depression inventory,BDI)评分、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评分(P<0.01),治疗组显著优于对照组(P<0.01);两组均能显著提高患者血清PPARγ水平、降低血清MMP-9和LPA水平(P<0.01),且治疗组显著优于对照组(P<0.01)。两组均能显著提高患者5-羟色胺(5-hydroxytryptamine,5-HT)、去甲肾上腺素(norepinephrine,NE)水平,降低多巴胺(dopamine,DA)水平(P<0.01),治疗组显著优于对照组(P<0.01)。结论:调肝论治法指导下的中药多靶点治疗方案效果优于单纯西药治疗,效果显著。
Objective: To observe the clinical efficacy of traditional Chinese medicine multi-targettreatment program for primary headache under the guidance of " regulating liver therapy". Methods: 90 patients with primary headache were randomly divided into control group and treatment group,45 cases in each group. The control group was treated with western medicine alone. On the basis of the treatment of control group,the treatment group was combined with traditional Chinese medicine multi-target treatment under the guidance of egulating liver theory therapy. The improvement of headache,anxiety,depression and sleep quality were compared between the two groups. The changes of serum peroxisome proliferator activated receptorγ( PPARγ),matrix metalloproteinase-9( MMP-9),lysobisphosphatidic acids( LPA) and brain neurotransmitter levels were observed before and after treatment. Results:The effective rate of the treatment group was 97. 8% and that of the control group was 86. 7%. The curative effect of the treatment group was significantly better than that of the control group( P < 0. 01); both groups could significantly reduce the scores of Beck anxiety inventory( BAI),Beck depression inventory( BDI),Pittsburgh sleep quality index( PSQI),and the treatment group( P <0. 01). It was significantly better than the control group( P < 0. 01). Both groups significantly increased serum PPARγ levels and decreased serum MMP-9 and LPA levels( P < 0. 01),and the treatment group was significantly better than the control group( P <0. 01). Both groups significantly increased the levels of brain neurotransmitters and decreased dopamine( DA) levels in patients with 5-hydroxytryptamine( 5-HT) and norepinephrine( NE)( P < 0. 01). The treatment group was significantly better than the control group( P < 0. 01). Conclusion: The effect of the multi-target treatment of traditional Chinese medicine under the guidance of the " regulating liver therapy" is better than that of western medicine alone.
Objective: To observe the clinical efficacy of traditional Chinese medicine multi-targettreatment program for primary headache under the guidance of " regulating liver therapy". Methods: 90 patients with primary headache were randomly divided into control group and treatment group,45 cases in each group. The control group was treated with western medicine alone. On the basis of the treatment of control group,the treatment group was combined with traditional Chinese medicine multi-target treatment under the guidance of egulating liver theory therapy. The improvement of headache,anxiety,depression and sleep quality were compared between the two groups. The changes of serum peroxisome proliferator activated receptorγ( PPARγ),matrix metalloproteinase-9( MMP-9),lysobisphosphatidic acids( LPA) and brain neurotransmitter levels were observed before and after treatment. Results:The effective rate of the treatment group was 97. 8% and that of the control group was 86. 7%. The curative effect of the treatment group was significantly better than that of the control group( P < 0. 01); both groups could significantly reduce the scores of Beck anxiety inventory( BAI),Beck depression inventory( BDI),Pittsburgh sleep quality index( PSQI),and the treatment group( P <0. 01). It was significantly better than the control group( P < 0. 01). Both groups significantly increased serum PPARγ levels and decreased serum MMP-9 and LPA levels( P < 0. 01),and the treatment group was significantly better than the control group( P <0. 01). Both groups significantly increased the levels of brain neurotransmitters and decreased dopamine( DA) levels in patients with 5-hydroxytryptamine( 5-HT) and norepinephrine( NE)( P < 0. 01). The treatment group was significantly better than the control group( P < 0. 01). Conclusion: The effect of the multi-target treatment of traditional Chinese medicine under the guidance of the " regulating liver therapy" is better than that of western medicine alone.
引文
[1]尹恝,周亮,吕田明,等.经颅多普勒超声、脑电图及焦虑情绪与难以分类原发性头痛关系的临床研究[J].中华神经医学杂志,2015,11(10):1166.
[2]头痛分类和诊断专家共识组.头痛分类与诊断专家共识[J].中华神经科杂志,2007,40(7):493-496.
[3]贾建平,陈生弟.神经病学[M].北京:人民卫生出版社,2014:157-158
[4]BECK A T,EPSTEIN N,BROWN G,et al.An inventory for measuring clinical anxiety:psychometric properties[J].J Consult Clin Psychol,1988,56:893-897.
[5]BECK A T,STEER R A.Internal consistencies ofthe original and revised Beck Depression Inventory[J].J Clin Psychol,1984,40:1365-1367.
[6]师云波,于欢,吴冬燕,等.不安腿综合征的主观睡眠质量评估及多导睡眠图研究[J].中国临床神经科学,2014,22(3):284.
[7]程学英,王剑锋,刘奔.原发性头痛的最新国际分类[J].神经疾病与精神卫生,2005,6(5):398-400.
[8]李焰生.头痛与抑郁焦虑障碍共病[J].中华内科杂志,2008,47(5):436-437.
[9]沈映君.中药药理学[M].上海:上海科学技术出版社,1997:36-175.
[10]宋世明.丹珍头痛胶囊治疗血管性头痛临床观察 112例疗效分析[J].医学信息,2014,27(8):150-151.
[11]张洪,胡元元,方瑗,等.偏头痛患者血清一氧化氮测定的临床意义[J].中国疼痛医学杂志,2001,7(2):72-73.
[12]丁文才李付勇任占秀,等.偏头痛患者血清中过氧化物酶体增殖物激活受体 γ 水平研究[J].中华临床医师杂志,2015,22(7):9857-9858.
[13]王明霞.不同时期和不同亚型偏头痛患者血清基质金属蛋白酶-9水平的临床研究[J].临床和实验医学杂志,2015,14(9):730.
[14]林百荣.偏头痛患者先兆期、发作期和缓解期的颈动脉系统血统血液动力学的研究[J].临床神经病学杂志,2000,13(4):227-228.
[15]毛燕,崔慧娟,王玉才.救脑汤治疗偏头痛急性期(血瘀证)的疗效及对中医证候积分和血清LPA、TNF-α水平的影响[J].中国中医急症,2016,25(2):228.
[16]赵娜,任凤龙.偏头痛并发焦虑抑郁等精神心理症状的相关因素分析[J].中国实用神经疾病杂志,2015,18(1):82-83.
[17]李佳,李雷俊,张晋碚.抑郁症中枢神经递质功能的脑涨落图分析[J].中国神经精神疾病杂志,2009,35(4):219-245.
[2]头痛分类和诊断专家共识组.头痛分类与诊断专家共识[J].中华神经科杂志,2007,40(7):493-496.
[3]贾建平,陈生弟.神经病学[M].北京:人民卫生出版社,2014:157-158
[4]BECK A T,EPSTEIN N,BROWN G,et al.An inventory for measuring clinical anxiety:psychometric properties[J].J Consult Clin Psychol,1988,56:893-897.
[5]BECK A T,STEER R A.Internal consistencies ofthe original and revised Beck Depression Inventory[J].J Clin Psychol,1984,40:1365-1367.
[6]师云波,于欢,吴冬燕,等.不安腿综合征的主观睡眠质量评估及多导睡眠图研究[J].中国临床神经科学,2014,22(3):284.
[7]程学英,王剑锋,刘奔.原发性头痛的最新国际分类[J].神经疾病与精神卫生,2005,6(5):398-400.
[8]李焰生.头痛与抑郁焦虑障碍共病[J].中华内科杂志,2008,47(5):436-437.
[9]沈映君.中药药理学[M].上海:上海科学技术出版社,1997:36-175.
[10]宋世明.丹珍头痛胶囊治疗血管性头痛临床观察 112例疗效分析[J].医学信息,2014,27(8):150-151.
[11]张洪,胡元元,方瑗,等.偏头痛患者血清一氧化氮测定的临床意义[J].中国疼痛医学杂志,2001,7(2):72-73.
[12]丁文才李付勇任占秀,等.偏头痛患者血清中过氧化物酶体增殖物激活受体 γ 水平研究[J].中华临床医师杂志,2015,22(7):9857-9858.
[13]王明霞.不同时期和不同亚型偏头痛患者血清基质金属蛋白酶-9水平的临床研究[J].临床和实验医学杂志,2015,14(9):730.
[14]林百荣.偏头痛患者先兆期、发作期和缓解期的颈动脉系统血统血液动力学的研究[J].临床神经病学杂志,2000,13(4):227-228.
[15]毛燕,崔慧娟,王玉才.救脑汤治疗偏头痛急性期(血瘀证)的疗效及对中医证候积分和血清LPA、TNF-α水平的影响[J].中国中医急症,2016,25(2):228.
[16]赵娜,任凤龙.偏头痛并发焦虑抑郁等精神心理症状的相关因素分析[J].中国实用神经疾病杂志,2015,18(1):82-83.
[17]李佳,李雷俊,张晋碚.抑郁症中枢神经递质功能的脑涨落图分析[J].中国神经精神疾病杂志,2009,35(4):219-245.