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近年中藥治療經行頭痛之文獻回顧

Reviews of Traditional Chinese Medicine for Menstrual Migraine

摘要


目的:從隨機臨床試驗的近年中文文獻中,探討與分析中藥治療經行頭痛的療效。方法:以佛教慈濟醫療財團法人圖書館電子資源系統使用「中國知網」(National Knowledge Infrastructure, CNKI),以「經行頭痛」、「月經偏頭痛」為關鍵字,2015年至2020年9月為發表年份,搜尋「中醫藥」類別下相關中文文獻,並進行分析。結果:依上述條件搜尋共得論文101篇,排除系統性回顧15篇、病例報告32篇及醫家經驗22篇後,收錄隨機分配試驗文獻32篇。再進一步排除20篇針灸介入之論文,以及1篇針對兩組中藥對照療效評估之論文,最終僅納入西醫常規治療對照單純中藥介入治療、西醫常規治療對照西醫合併中藥介入治療,共11篇文獻。結論:月經偏頭痛的中藥治療多在月經來潮前即開始服用,可顯著降低偏頭痛不適,但因臨床病例數不足或療效評價方式不一,缺乏有效說服力,因此仍需透過進一步大型研究加以證實。另外,虛證之經行頭痛治療,不可忽略瀉法的使用。

關鍵字

經行頭痛 月經偏頭痛 中醫 中藥

並列摘要


Objective: This article purposes to discuss and analyze the effect of Chinese medicine on menstrual migraine by reviewing Chinese literature of randomized clinical trials (RCT) in recent years. Methods: We used menstrual migraine as the key word and undertook researches, through electronic resources federated search system of Buddhist Tzu Chi Medical Foundation Library, on the National Knowledge Infrastructure (CNKI) database in the category of traditional Chinese medicine from 2015 to September, 2020, and analyzed these articles. Results: A total of 101 studies were included in this review. 32 RCTs were admitted, and 15 systemic reviews, 32 case reports, and 22 expert opinions were excluded. Moreover, literatures on acupuncture and comparison of two Chinese prescriptions were ruled out. Finally, 11 RCTs were adopted, including Western medicine contrasting to Chinese medicine or Western medicine contrasting to combination of both Chinese and Western medicine. Conclusion: The intervention of Chinese medicine in menstrual migraine usually started before menstruation, and could subside the symptom significantly. Because the clinical trials that have published were limited and there was no unified curative effect standard, we need further large-scale experimental study to prove the result. In addition, we could not ignore the method of draining to remedy the vacuity pattern of menstrual migraine.

參考文獻


GBD 2015 Neurological Disorders Collaborator Group (2017), Global, regional, and national burden of neurological disorders during 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurology, 16(11), 877-897.
Stewart, W. F., Wood, C., Reed, M.L., Roy, J. & Lipton, R.P. (2008). Cumulative lifetime migraine incidence in women and men. Cephalalgia, 28(11), 1170-1178.
李軍、牛爭平(2020)。不同生理階段女性偏頭痛病人體內激素水準變化對頭痛發作的影響。中西醫結合心腦血管雜誌,11,1728-1732。
張璐(清)。張氏醫通(初版)。大陸:人民衛生出版社。
蕭塤(清)。女科經綸(初版)。大陸:中醫古籍出版社。

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