目的：
比較不同嚴重度及誘發因子間的偏頭痛與中醫診斷之關聯性。
方法：
在2012年2月到2013年2月間，從頭痛門診收案279位偏頭痛患者，排除71位後，有208位進入研究。偏頭痛診斷乃依據頭痛國際分類第二版，可分為陣發性及慢性偏頭痛、和藥物過度使用頭痛；而失能程度乃是由【偏頭痛失能評估量表】所評，可分為四級；也登錄了12種常見的偏頭痛誘發因子。中醫診斷是用經絡問卷和寺澤節年氣虛血瘀量表。
結果：
收案208個病人中，有129位陣發性偏頭痛，62位慢性偏頭痛，及17位藥物過度使用頭痛。少陽頭痛是最常發生的(48.1%)。有108位有氣虛，14位血瘀，有6人兼具。在慢性偏頭痛組，氣虛盛行率跟分數都是最高的。氣虛血瘀的發生率與分數，均是在重度失能這組最高。用羅吉斯迴歸計算，氣虛與血瘀都可以預測重度的失能，但是慢性偏頭痛只能用血瘀來推測。有氣虛的人以女性居多，有血瘀的人則比較年輕發病。
每個人平均有3.5個誘發因子。有疲勞這個因子的組，有比較高的氣虛分數，有血瘀的有較多誘發因子數。氣虛血瘀分數均與因子數目成正比。
結論：
本研究證實氣虛血瘀與偏頭痛嚴重度及因子數目都有很強的關係，而經絡則無。慢性偏頭痛及女性較與氣虛有關，而血瘀者易年輕發病且有較易誘發。
Objectives: To compare the Traditional Chinese Medicine (TCM) diagnosis among different severity of migraine and those with different triggers
Methods: We collected 279 migraine patients from a headache special clinic during February 2012 to February 2013. After we excluded 71 patients, 208 migraineurs completed the study eventually. Migraine was diagnosed according to the ICHD-2 criteria and classified into episodic migraine (EM), chronic migraine (CM), and medication-overuse headache (MOH). Their disability was evaluated by the Migraine Disability Assessment (MIDAS) score, and further classified into four grades. Twelve items of migraine triggers were in a self-administered questionnaire. Patients who had other superimposed other headaches or received TCM therapy recently was excluded. We used meridian questionnaire and Terasawa’s “Qi Deficiency and Blood Stasis Syndrome (BSS) scale” for TCM diagnosis.
Results: A total number of 208 patients were enrolled, including 129 EM, 62 CM, and 17MOH. Shaoyang headache is most common (48.1%). There are 108 migraineurs with Qi Deficiency, 14 had BSS, and other 6 had both. Both the prevalence and the score of Qi Deficiency was the highest in CM. Both the frequencies and scores of Qi Deficiency and BSS were the highest in grade IV. After multiple logistic regression, both Qi deficiency and BSS could predict severe MIDAS group, while only BSS could predict CM. Subjects with Qi deficiency had female predominance, while patients with BSS had younger onset.
All patients had a mean of 3.5 triggers. The migraineurs with triggers of fatigue had higher Qi deficiency score, while patients with BSS had prominent triggers and more abundant trigger numbers. Both Qi deficiency and BSS score had positive correlation with trigger numbers.
Conclusions: Our study demonstrates both Qi Deficiency and BSS, but not meridians, are strongly correlated with migraine severity and trigger numbers. Chronic migraine and female migraineurs have close relationship with Qi Deficiency, while migraineurs with BSS tend to occurred younger and have more triggers.
