【作者】 韦启志；

【导师】 陈少玫；

【作者基本信息】 福建中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 目的：①探讨痰瘀互阻型头痛与血清同型半胱氨酸(Homocysteine,HCY)之间的相关性；②观察三虫半夏白术天麻汤对痰瘀互阻型头痛的疗效及其对血清HCY的影响。资料与方法：选择符合纳入标准的痰瘀互阻型头痛患者176例,首先进行头痛积分及头痛中医证候评分,检测血清HCY;第二步,纳入HCY检测值大于15umol/l的患者80例进行干预研究,随机分为2组。观察组42例予三虫半夏白术天麻汤,对照组38例予“西比灵、叶酸片、甲钴胺、维生素”口服治疗；第三步,监测干预2周、4周患者HCY水平、头痛积分及中医证候积分的变化情况。结果：①176例痰瘀互阻型头痛患者中115例(65.3%)HCY值高于正常值的上限,其中医证候综合积分与血清HCY水平进行相关性检验,统计学结果有显著意义(P<0.01),提示痰瘀互阻型头痛与HCY水平具有显著相关性；②两组患者临床疗效(头痛积分及中医.证候积分疗效),经秩和检验,观察组明显优于对照组(P<0.01)；0在对HCY值的影响方面,两组干预4周后HCY值较干预前明显降低(秩和检验,P<0.01)；干预2周后观察组HCY降低幅度明显低于对照组(P<0.01)；干预4周后,两组HCY降低幅度无显著差异(P>0.05)。结论：1、痰瘀互阻型头痛与血清HCY值具有显著相关性；2、“三虫半夏白术天麻汤”可改善痰瘀互阻型头痛患者头痛症状及中医证候,疗效较对照组显著,且在治疗剂量下无明显毒副作用和不良反应；3、三虫半夏白术天麻汤可在一定程度上降低痰瘀互阻型头痛患者HCY水平,在治疗4周后HCY降低幅度较对照组无显著差异。更多还原

【Abstract】 Objective:To observe the therapeutic effects of "Sanchong banxia baizhu tianma Decoction" in treating headache Patients with Phlegm and Blood Stasis Syndrome and to research the association between homocysteine and this type headache.Subjects and Methods:176 cases of headache patients with Phlegm and Blood Stasis Syndrome whose HCY value is greater than 15umol/1 were chosen and randomly divided into the observation group with 42 cases and the control group with 38 cases. Both groups were given therapeutic intervention.The observation group was given "Sanchong banxia baizhu tianma Decoction", and the control group was treated by "Sibelium, Folic Acid,vitB6 and vitB12";And then,the clinic effect,the changes of HCY levels, headache points and TCM syndrome Points of both groups were obersered.Results:Headache with Phlegm and Blood Stasis Syndrome with HCY levels were positively correlated.(P<0.01);The obvious effective rate and the total effective rate in the observation group were superior to the control group.(P<0.01).Meanwhile,there was no significant difference between the two group in HCY reduction ranges after 4 weeks’treatment (P>0.05).Conclusions:1.Headache with Phlegm and Blood Stasis Syndrome and serum HCY had a significant correlation.2."Sanchong banxia baizhu tianma Decoction" can improve TCM symptoms and headache score obviously in headache patients with phlegm and blood stasis Syndrome, its efficacy is better than the control group dramatically;and it had no significant adverse reactions.3."Sanchong banxia baizhu tianma Decoction" can reduce HCY levels in headache patients with phlegm and blood stasis syndrome, after 4 weeks of treatment, HCY reduced rate compared with the control group no significant difference.更多还原