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Objective To explore the clinical efficacy of Toutongning capsule combined with nimodipine in the treatment of 76 patients with primary vascular headache.Methods 76 patients with primary vascular headache were selected as the research subjects.According to the different surgery,the patients were randomly divided into control group (n =38) and observation group (n =38).The control group was given compound Danshen injection,while the observation group was given Toutongning capsule combined with nimodipine.The efficacy,the peak systolic velocity(Vs) and pulsatility index(PI) of each vessel,the time of stopping pain,recurrence rate and adverse reaction were compared between the two groups.Results The total effective rate of the observation group was 94.74％,which was higher than 84.21％ of the control group,the difference was statistically significant (x2 =4.785,P ＜ 0.05).The MCA,ACA,BA,VA value of Vs and PI,the time of stopping pain and recurrence rate in the observation group were better than those in the control group (t =5.385,6.834,7.407,6.651,4.032,5.716,6.203,5.016,4.785,x2 =5.473,all P ＜ 0.05).There were no significant differences between the two groups in PCA value of Vs and PI and adverse reaction(t =0.283,0.037,x2 =0.314,all P ＜ 0.05).Conclusion Toutongning capsule combined with nimodipine in the treatment of primary vascular headache has high application value and significant effect,and it can promote cerebral circulation,blood flow,time of stopping pain and recurrence rate,so it is worthy of clinical popularization and application.
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Las cefaleas vasculares secundarias conforman el grupo 6 de la clasificación de la Sociedad Internacional de Cefaleas, las más importantes son la hemorragia subaracnoidea, el infarto cerebral, la trombosis venosa cerebral, la hemorragia intracerebral y el síndrome de Sturge-Weber. La cefalea puede ser el primer síntoma de una alteración vascular cerebral, por lo cual es importante considerar siempre esa posibilidad cuando llega un paciente con cefalea intensa, para establecer un diagnóstico y un tratamiento oportuno, que puede salvar la vida de los pacientes. Las neuroimágenes son una herramienta de gran ayuda para el diagnóstico de estas enfermedades. En este artículo se describen las manifestaciones clínicas, la fisiopatología, los métodos de diagnóstico y el tratamiento de estas alteraciones.
In the classification of the International Society of Headaches, secondary headaches atributed to vascular disorders are included in the Group 6, the most important are subarachnoid hemorrhage, cerebral infarction, venous cerebral thrombosis, intracerebral hemorrhage and the Sturge-Weber syndrome. The headache can be the first symptom of a cerebral vascular alteration, and for this reason it is important to consider always this possibility in patients with severe pain, to establish an opportune diagnosis and treatment which can save the live of the patient. Neuroimages are helpful tools for the diagnosis of these disorders. In the present review are described the clinical manifestations, pathophysiology, diagnoses and treatment of these alterations.
Subject(s)
Humans , Pain , Cerebral Hemorrhage , Subarachnoid Hemorrhage , NeurologyABSTRACT
@#Objective To investigate the involvement of sympathetic nerve system in the transmission of nociceptive information related to vascular headache. Methods Fos expression in the midbrain periaqueductal grey (PAG) induced by electrical stimulation of dural matter near the superior sagittal sinus (SSS) of the rat was determined before and after the extirpation of the superior cervical ganglion (SCG) using standard avidin-biotin immunohistochemistry. Results Fos immunoreactive positive neurons were detected in the ventrolateral PAG, and were bilateral symmetry. Fos expression was (133.3±12.5) in SCG extirpated group, and higher than that in sham-operated group (76.0±11.3). Conclusion The sympathetic system may be involved in the transmission of nociceptive information through PAG, associated with vascular headache such as migraine.
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To review the general situation of acupuncture in treating vascular headache between 1949-2004 in an attempt to promote acupuncture practice, clinical references concerning acupuncture treatment of vascular headache were analyzed on the basis of Chinese Modern Acupuncture Database. From 1956, these references increased annually and steadily. In clinical practice, needling is cardinally used, and the acupoints are selected adjacent to diseased part and on syndrome differentiation.
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Purpose: This study is to observe the therapeutic effect of puncturing acupoints Dazhui (GV 14), Fengchi (GB 20), Jiaji (Ex-B 2), Waiguan (TE 5), Qiuxu (GB 40) and Zhaohai (KI 6) on vascular headache. Methods: 68 cases of vascular headache were divided into treatment group including 38 cases and control group including 30 cases. The patients in treatment group were treated by puncturing Dazhui (GV 14), Fengchi (GB 20), Jiaji C26 (Ex-B 2),Waiguan (TE 5), Qiuxu (GB 40) through Zhaohai (KI 6) and patients in control group were asked to take Pizotifen orally. Results: After 2 courses of treatments, 35 cases got effect in treatment group, and 22 cases got effect in control group, the therapeutic effect in treatment group was superior to that in control group (P＜ 0.05). Conclusions: Puncturing Dazhui (GV 14), Fengchi (GB 20), Jiaji C26(Ex-B 2), Waiguan (TE 5), Qiuxu (GB 40) and Zhaohai (KI 6)is effective for the vascular headache.
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Purpose: In order to explore the clinical effect in acupuncture treatment of vascular headache. Methods: 93 cases of vascular headache were randomly auocated into acupuncture group (n= 30), treated by puncturing Fengchi (GB 20), Ashi point and Sanyinjiao (SP 6) on the sick side, acupuncture plus needle-embedding group (n= 36), treated by basic acupuncture treatment plus needle-embedding method in Taiyang (Ex-HN 5) and Xuanzhong (GB 39) on the sick side, and control group (n = 27), treated with oral administration of 5 mg Sibelium,twice a day, for observation of the changes in the clinical symptoms before and after treatments in the patients of three groups. Results: After treatment, the clinical symptoms in the patients of three groups were relieved or disappeared. The recent therapeutic effect was better in acupuncture plus needle-embedding group than in the control group (P＜ 0.05), and there was no significant difference (P＞ 0.05) between the acupuncture plus needle-embedding group and acupuncture group and there was no significant difference (P ＞ 0.05) between acupuncture group and control group, either. The long-term therapeutic effect was better in the acupuncture plus needle-embedding group than in the control group (P＜ 0.01), in the acupuncture group than in the control group (P ＜ 0.05), and there was no significant difference between the acupuncture plus needle-embedding group and acupuncture group. Conclusion: Acupuncture treatment of vascular headache offers a better recent and long-term therapeutic effect, and acupuncture plus needle-embedding method is much better in the therapeutic effect.
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Se realizó un ensayo clínico aleatorizado fase II temprana, abierto, secuencial para evaluar la eficacia de los remedios homeopáticos en los pacientes que acudieron a consulta por cefalea vascular primaria al cuerpo de guardia del Policlínico "Carlos J. Finlay" y a la consulta de medicina natural y tradicional del Hospital "Octavio de la Concepción y de la Pedraja" en el período comprendido entre octubre de 1997 hasta noviembre de 1998. La muestra se recogió de 60 pacientes entre los 15 y 60 años de edad, a los que se les aplicó una encuesta. Los datos se procesaron de forma computarizada y se expusieron en textos y gráficos. Mediante esta terapéutica se logró la desaparición de la cefalea en el 85% y su alivio en el 15% de los pacientes. De 142 síntomas neurovegetativos combinados se logró la desaparición de 121 (85.2%) y el alivio de 21 (14.7%); por los resultados obtenidos se concluye considerando el esquema propuesto como útil, eficaz e inócuo.
An open early phase II ramdomized clinical trial was carried out to evaluate homeopathic medications in patients treated for primary vascular cephalea at the emergency room of "Carlos Juan Finlay" Clinic and at the Natural and Traditional Medicine Department in the Öctavio de la Concepcion y de la Pedraja" Hospital from October 1997 to November 1998. The sample was taken from 60 patients aged 15 to 60 years. Data were collected and processed in a computer and later represented into graphics and charts. Due to the afore mentioned, cephalea dissapeared in 85% of patients while 15% relieved. 121 out of the 142 combined neurovegetative symptoms dissapear and 21 aliviated. Taking into account these results, it can be said that the suggested treatment is useful, accurate and inoccous.