朱彬彬 黄春荣 黄琼 成慧慧 萧韵雅

【摘 要】 目的：观察自拟通窍理气汤联合颞三针治疗创伤后偏头痛的疗效及对患者生活质量的影响。方法：选取创伤后偏头痛患者84例为研究对象，随机分为两组各42例，对照组采取常规西药治疗，观察组于对照组疗法的基础上应用自拟通窍理气汤联合颞三针治疗。治疗8周后，观察两组治疗前后的心理状态、睡眠质量及生活质量，于治疗8周的全过程中多点监测两组患者偏头痛发病频率与疼痛程度的差异性，绘制重复度量轮廓图，分析两组偏头痛发病频率与疼痛程度在整体治疗过程中的趋势变化。结果：治疗后两组SAS、SDS、PSQI评分与平均每次头痛发作时间均较前改善（P<0.05），并且治疗后观察组上述各项指标均优于对照组（P<0.05）；治疗后两组SF-36的8个维度评分均较前改善（P<0.05），并且治疗后观察组优于对照组（P<0.05）；治疗后两组发作频率均呈逐渐下降趋势，但观察组下降趋势大于对照组，治疗后6周时两组间出现统计学差异（P<0.05）；治疗后两组发作频率均呈逐渐下降趋势，但观察组下降趋势大于对照组，治疗后2周时两组间出现统计学差异（P<0.05）。结论：自拟通窍理气汤联合颞三针治疗创伤后偏头痛疗效较好，能够有效改善患者的生活质量，缓解焦虑与抑郁症，提高患者的睡眠质量，值得临床推广应用。

【关键词】 创伤；偏头痛；生活质量；焦虑；抑郁

【中图分类号】R641 【文献标志码】 A【文章編号】1007-8517（2018）13-0113-05

Abstract：Objective To observe the curative effect of migraine Tongqiao Qi Decoction Combined with treatment of post-traumatic niesanzhen and influence on the quality of life of patients.Methods This study included 84 cases of migraine patients after trauma admitted in our hospital， were divided into two groups， the observation group in the control group based on the application of "Tongqiao therapy Qi Decoction Combined with niesanzhen treatment； in 8 weeks after treatment， the two groups were observed before and after treatment， the sleep quality and psychological state the difference in quality of life， the whole process of 8 weeks of treatment in multi-point monitoring in two groups of patients with migraine frequency and severity of pain， repeated measure drawing contour map， analysis of two groups of migraine frequency and degree of pain in the trend of change in the process of overall treatment.Results After treatment， the scores of SAS， SDS， PSQI and the time of headache seizure in the two groups were all improved compared with that before（P<0.05）， and the above indexes in the observation group were better than those in the control group（P<0.05）. After treatment， the scores of 8 dimensions of the two groups of SF-36 were all improved（P<0.05）， and the observation group was better than the control group after treatment（P<0.05）.The frequency of seizures decreased gradually in the two groups after treatment， but the trend of decline in the observation group was larger than that in the control group. There was a significant difference between the two groups at the 6 week after treatment（P<0.05）. Seizure frequency decreased， but the observation group decreased more than the control group， after 2 weeks after treatment began and there was significant difference between the two groups（P<0.05）.Conclusion The curative effect of migraine with ideal Tongqiao decoction combined with Qi niesanzhen treatment after trauma， can effectively improve the quality of life of patients， relieve anxiety and depression， improve the sleep quality of patients， is worthy of promotion in clinical treatment.

Keywords：Trauma； Migraine； Quality of life； Anxiety；Depression

随着我国经济社会的发展，因交通事故、高空坠落、意外伤害等因素造成的不同程度创伤发生率逐年升高，创伤后继发偏头痛的发生率也随之上升，创伤后继发偏头痛的形成机制较为复杂，但临床上多认为与创伤造成的局部神经、细胞等损伤相关[1-3]。创伤后继发偏头痛可给患者造成较大的痛苦，重症者甚至可能致残。偏头痛可直接导致患者的睡眠质量下降，影响患者日常生活、工作等，长期可致免疫功能下降、营养不良而诱发诸多疾病。同时继发于创伤后的反复发作甚至是频繁发作的疼痛症状在给患者造成的上述身体方面痛苦的基础上，还可给患者造成较大的心理压力，患者易出现焦虑、抑郁等心理症状[4-6]。……