| Objective: 1.Literature research: To explore the theoretical origin of treating tension-type headache from the spleen and stomach,summarize the pathogenesis of tension-type headache from the spleen and stomach,and analyze and summarize the medication rule of internal injury headache with similar characteristics of tension-type headache from the spleen and stomach in ancient Chinese medicine,so as to provide theoretical and medication basis for treating tension-type headache from the spleen and stomach.2.Clinical research: To evaluate the clinical efficacy and safety of Jiawei Shengyang Yiwei Decoction in the treatment of tension-type headache through clinical controlled trials,and to provide new ideas and methods for clinical differentiation and treatment of tension-type headache.Methods: 1.Literature research:(1)With the terms of "internal injury headache","headache" and "head wind",the medical records of medical classics,prescriptions,comprehensive medical books,clinical syndromes and medical theories in the electronic database of the Chinese Medical Code were retrieved.From the search results,items related to the spleen and stomach which accord with the clinical characteristics of tension headache were further screened,including the pathogenesis and treatment of spleen and stomach deficiency and excess,and summarized respectively.(2)With "tension headache" as the key word,we retrieve the databases of China How Net,Wanfang and Weipu,and "tension type headache" and "TTH" as the keywords to retrieve the Pub Med database,and further screen the contents related to spleen and stomach for analysis and discussion.2.Clinical research: A total of 80 patients with tension-type headache who met the inclusion criteria were randomly divided into two groups.41 patients in the treatment group were treated with modified Shengyang Yiwei Decoction and basic treatment of Western medicine,while 39 patients in the control group were treated with basic treatment of Western medicine for one month.The headache index score and TCM syndrome score of the two groups before and after treatment were observed,and the clinical efficacy of the two groups was evaluated and compared.Results: 1.Literature research results: Among the pathogenesis of tension headache related to spleen and stomach,deficiency syndrome is "deficiency of Qi and blood,loss of brain orifice","deficiency of temper(yang),absence of Qingyang","deficiency of spleen and stomach qi,upstream of yin and fire".The pathogenesis of excess syndrome is "upstream of phlegm and dampness","stagnation of diet".The pathogenesis of deficiency and excess syndrome is "deficiency of spleen,endogenous phlegm and turbidity","deficiency of stomach,and stagnation of turbidity and yin"."Spleen deficiency and blood stasis";The prescriptions for treating tension headache based on syndrome differentiation of spleen and stomach are Shunqi and Zhongtang(Sanitary Baojian),Jia Secret and Zhongtang(Treatment of Syndrome Causes and Pulse),Buzhong Yiqi Decoction(Introduction to Medicine),Tiaozhong Yiqi Decoction(Orchid Room Secret Storage),Tiaozhong Yiqi Decoction(Shoushibaoyuan),Xiongshu Decoction(Selected Essentials of Traditional Chinese Medicine)for spleen and stomach syndrome.》 Xiongxin Daotan Decoction(Selected Essentials of Medical Prescriptions),Modified Erchen Decoction(Unknown Necessity of Medicine),Pingwei Baohe Decoction(Treatment of Symptoms and Pulse),Banxia Baizhu Tianma Decoction(Spleen and Stomach Theory),Huangqi Yiqi Decoction(Shoushibaoyuan);The medication characteristics are as follows: deficiency syndrome is mainly nourishing spleen and stomach,excess syndrome is mainly drying dampness and phlegm,deficiency and excess syndrome is both reinforcing qi and invigorating spleen,dryness and dampness and phlegm,and auxiliary medication is using wind medicine to promote clearance,clear headache,relieve Yin and fire,and treat blood simultaneously.2.Clinical research results:(1)In terms of the number of headache attacks,the degree of headache,and the duration of headache: the treatment group had significant statistical differences(P < 0.01),indicating that the treatment group can significantly reduce the number of headaches and the degree of pain.And duration;the control group before and after treatment,the three were statistically significant(P less than 0.05),indicating that the control group can reduce the number of headaches,the degree of pain and duration.Taken together,the difference between the treatment group before and after treatment is more obvious,which is better than the control group in reducing the number of headache attacks,pain degree and duration;(2)in the headache index score: before and after treatment in the two groups in the headache index In the sub-group,the differences were statistically significant(P less than 0.01),indicating that the headache index scores of both groups were significantly lower;the difference between the two groups after treatment was statistically significant(P<0.01).It indicated that the treatment group had a better effect on the reduction of headache index score than the control group;(3)in the evaluation of headache index efficacy: 2 cases in the treatment group recovered basically,19 cases were markedly effective,14 cases were effective,3 cases were ineffective,and the total effective rate was 92.11%.In the control group,0 cases recovered,12 cases were markedly effective,16 cases were effective,9 cases were ineffective,and the total effective rate was 75.68%.Comparing the two groups,the difference was statistically significant(P<0.05),indicating that the treatment group was better than the control group in improving the headache index;(4)in the symptom score of TCM syndrome: treatment group before and after treatment In terms of TCM symptom scores,the differences were statistically significant(P less than 0.01),indicating that the symptoms of the treatment group such as wrap,dizziness,abdominal distension,poor appetite,fatigue and fatigue were significantly improved.There was a statistically significant difference in the scores of headache and fainting symptoms between the control group before and after treatment(P<0.01).The difference was statistically significant in the scores of fatigue symptoms(P<0.05).There was no statistically significant difference in the scores of the symptoms of stagnation and stagnation(P < 0.05),indicating that the headache and fainting symptoms of the control group were significantly improved,the symptoms of fatigue and fatigue were generally improved,and the symptoms of abdominal distension and hypothyroidism were not observed.Improvement;(5)In terms of TCM syndrome scores: the differences between the groups before and after treatment were statistically significant,indicating that the treatment group and The group had an improvement on TCM syndrome scores;after treatment,the difference was statistically significant,indicating that the treatment group was significantly better than the control group in improving TCM syndrome scores;(6)Evaluation of TCM syndrome efficacy Aspects: The treatment group was cured in 3 cases,clinically effective in 15 cases,clinically effective in 17 cases,clinically ineffective in 3 cases,with a total effective rate of 92.11%;control group clinically cured in 0 cases,clinically effective in 3 cases,clinically effective in 22 cases,clinically ineffective 12 For example,the total effective rate is 67.57%.There was a statistically significant difference between the two groups(P<0.01),indicating that the TCM syndrome score improvement in the treatment group was significantly better than the control group.Conclusion: Through literature research,it is concluded that the pathogenesis of deficiency and excess of spleen and stomach is closely related to tension-type headache.The theoretical basis of treatment of tension-type headache from spleen and stomach is adequate,and the medication idea is to take into account both the specimen and the main methods are strengthening spleen and stomach,resolving phlegm and dampness,supplemented by tonifying the head and orific;Through the clinical research results,it is concluded that Jiawei Shengyang Yiwei Decoction can significantly reduce the headache index,the number of headache attacks,the degree of headache,the duration of headache and the integral of TCM syndromes.It is an effective prescription for treating tension headache with spleen-stomach deficiency and phlegm-dampness obstruction syndrome,and there is no obvious adverse reaction in the treatment process.It is worth further clinical promotion. |
