消痛平风汤治疗先兆偏头痛的临床效果

Effect of Xiaotong Pingfeng Decoction on migraine with aura

摘要:

目的探讨消痛平风汤治疗偏头痛的疗效。方法选取2013 年1 月-2015 年6 月青海红十字医院收治的先兆偏头痛患者112 例。依据随机数表法分为观察组（消痛平风汤）和对照组（盐酸氟桂利嗪胶囊），观察并记录两组患者的临床疗效、血液流变学参数、血浆5- 羟色胺（5-HT）、β- 内啡肽（β-EP）、降钙素基因相关肽（CGRP）、神经肽Y（NPY）水平及不良反应。结果观察组56 例，总有效率为80.36%；对照组56 例，总有效率为62.50%。治疗前，两组患者的偏头痛积分差异无统计学意义（P >0.05）。治疗结束后，两组患者的偏头痛积分差异有统计学意义（P <0.05），观察组低于对照组。治疗前，两组患者的血液流变学参数差异无统计学意义（P >0.05）。治疗后，观察组患者的全血黏度、红细胞比容、纤维蛋白原水平与对照组比较，差异均有统计学意义（P <0.05），观察组低于对照组，两组患者的血小板差异无统计学意义（P >0.05）。治疗前，两组患者的5-HT、β-EP、CGRP、NPY 水平差异无统计学意义（P >0.05）。治疗后，观察组患者5-HT、β-EP、CGR、PNPY 水平水平与对照组比较，差异有统计学意义（P <0.05），5-HT、β-EP、CGRP 观察组高于对照组，NPY 观察组低于对照组。观察组乏力1 例，嗜睡2 例，恶心、呕吐2 例，口干1 例，不良反应总发生率为10.71%；对照组乏力4例，嗜睡4 例，恶心、呕吐3 例，皮疹1 例，口干3 例，总发生率为26.79%，两组比较，差异具有统计学意义（P <0.05）。结论消痛平风汤能够改善偏头痛患者血液流变学，提高5-HT、β-EP、CGRP 水平，避免NPY 过多分泌，并进一步降低不良反应发生率。

Abstract:

Objective To explore the curative effect of Xiaotong Pingfeng Decoction on migraine. Methods Between January 2013 and June 2015, 112 patients with migraine with aura were treated in our hospital. According to the random number table method they were divided into observation group (Xiaotong Pingfeng Decoction) and control group (Flunarizine Hydrochloride Capsules). Clinical curative effect, hemorheological parameters and plasma levels of serotonin (5-HT), beta-endorphin (β-EP), calcitonin gene-related peptide (CGRP) and neuropeptide Y (NPY), and adverse reactions were observed and recorded in the two groups. Results In the 56 cases of the bservation group, the total effective rate was 80.36%; while in the 56 cases of the control group, the total effective rate was 62.50%. Before treatment, the migraine integral had no significant difference between the two groups (P >0.05). After treatment, the migraine score of the observation group was significantly lower than that of the control group (P < 0.05). Before treatment, hemorheological parameters of the two groups were not significantly different (P >0.05). After treatment, blood viscosity, hematocrit and fibrinogen levels in the observation group were significantly lower than those in the control group (P < 0.05), but there was no significant difference in platelet between the two groups (P > 0.05). Before treatment, there was no significant difference in 5-HT, β-EP, CGRP or NPY level between the two groups (P > 0.05). After treatment, 5-HT, β-EP and CGRP levels of the observation group were significantly higher than those of the control group (P < 0.05), while NPY level was lower than that of the control group (P < 0.05). In the observation group, there were weakness in 1 case, drowsiness in 2 cases, nausea and vomiting in 2 cases, and thirst in 1 case, the overall incidence of adverse reactions was 10.71%; in the control group, there were fatigue in 4 cases, sleepiness in 4 cases, nausea and vomiting in 3 cases, rash in 1 case, and thirst in 3 cases, the total rate of adverse reactions was 26.79%, the difference was statistically significant (P < 0.05). Conclusions Xiaotong Pingfeng Decoction can significantly improve hemorheology in patients with migraine, increase serotonin,β-EP and CGRP levels, avoid excessive secretion of NPY, and further reduce the incidence of adverse reactions.