Modified Banxia Baizhu Tianmatang Combined with Acupuncture for Migraine (Wind-phlegm Upset Syndrome) Observe

Quan-cheng ZHENG; Jian-hao LIU; Yu ZHANG; Ling-hui ZENG; Xin-yi HUANG; Yong-yun FU

doi:10.13422/j.cnki.syfjx.20200934

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Modified Banxia Baizhu Tianmatang Combined with Acupuncture for Migraine (Wind-phlegm Upset Syndrome) Observe

Clinic | 更新时间：2021-02-09

- Modified Banxia Baizhu Tianmatang Combined with Acupuncture for Migraine (Wind-phlegm Upset Syndrome) Observe
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 27, Issue 3, Pages: 111-116(2021)
- 作者机构：
  
  1.三亚市中医院，海南三亚 572003
  2.北京中医药大学东直门医院，北京 100700
  3.海南省中医院，海口 570203
  4.海南省人民医院，海口 570311
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20200934
  CLC： R289;R246;R747;R747.2;
- Published：05 February 2021，
  
  Published Online：18 June 2020，
  
  Received：14 May 2020，
- 稿件说明：
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郑全成,刘建浩,张宇等.半夏白术天麻汤加减联合针刺治疗偏头痛风痰上扰证的观察[J].中国实验方剂学杂志,2021,27(03):111-116.

ZHENG Quan-cheng,LIU Jian-hao,ZHANG Yu,et al.Modified Banxia Baizhu Tianmatang Combined with Acupuncture for Migraine (Wind-phlegm Upset Syndrome) Observe[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(03):111-116.
郑全成,刘建浩,张宇等.半夏白术天麻汤加减联合针刺治疗偏头痛风痰上扰证的观察[J].中国实验方剂学杂志,2021,27(03):111-116. DOI： 10.13422/j.cnki.syfjx.20200934.

ZHENG Quan-cheng,LIU Jian-hao,ZHANG Yu,et al.Modified Banxia Baizhu Tianmatang Combined with Acupuncture for Migraine (Wind-phlegm Upset Syndrome) Observe[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(03):111-116. DOI： 10.13422/j.cnki.syfjx.20200934.

摘要

目的

观察半夏白术天麻汤加减联合针刺治疗偏头痛风痰上扰证的临床疗效及对神经血管活性肽和血管内皮激活介质的调节效应。

方法

将150例患者按随机数字表法分成对照组和观察组各75例，两组采用针刺治疗，1次/d，连续6次，休息1 d。对照组服用半夏白术天麻汤安慰剂颗粒，10 g/次，2次/d。观察组内服半夏白术天麻汤，1剂/d。两组疗程均为治疗4周。记录治疗后0.5 ，1 ，2 ，6 ，12，24和48 h的疼痛视觉模拟（VAS）评分，并计算6，12，24 h内的疼痛缓解率，72 h内的疼痛消失率和疼痛复发率；记录治疗前4周、治疗4周和治疗后4周偏头痛发作次数、头痛持续时间和头痛程度；进行治疗前后伴随症状、风痰上扰证、头痛影响测定-6（HIT-6）和偏头痛残疾程度评估问卷（MIDAS）评分；检测治疗前后降钙素基因相关肽（CGRP），一氧化氮（NO），内皮素-1（ET-1），垂体腺苷酸环化酶激活肽（PACAP），S100B蛋白，P 物质（SP），血管性血友病因子（vWF）和纤维蛋白原（FIB）水平；进行安全性评价。

结果

两组患者治疗后各时点VAS评分均逐渐下降（

0.01），观察组在治疗后6，12，24，48 h的VAS评分均低于同期对照组（

0.01）；观察组治疗后6，12 h的疼痛缓解率为67.14%（47/70），87.14%（61/70），72 h 疼痛消失率为92.86%（65/70），分别高于对照组的50.00%（34/68），70.59%（48/68），79.41%（54/68）；观察组疼痛复发率为21.43%（15/70），低于对照组的39.71%（27/68）（

0.05）；观察组在用药和停药期间，偏头痛发作次数、头痛持续时间、头痛程度均低于对照组（

0.01）；观察组伴随症状、风痰上扰证，HIT-6和MIDAS评分均低于对照组（

0.01）；观察组患者临床疗效优于对照组（

=2.106，

0.05）；观察组CGRP，PACAP，S100B蛋白，SP，ET-1，vWF和FIB水平均低于对照组，NO水于高于对照组（

0.01）。

结论

半夏白术天麻汤加减联合针刺治疗风痰上扰偏头痛患者具有较好的即时镇痛效应，在持续镇痛和减少头痛再发生方面效果显著，并可减轻偏头痛症状和伴随症状，减轻偏头痛对日常生活的影响和残疾程度，其作用机制可能与调节神经血管活性肽类物和血管内皮物质有关。

Abstract

Objective

To observe theclinical efficacy of modified Banxia Baizhu Tianmatang combined with acupuncture on migraine with wind phlegm disturbance syndrome， and the regulatory effect on neurovasoactive peptide and vascular endothelial activator.

Method

Two hundred and fifty patients were randomly divided into control group （75 cases） and observation group （75 cases）. Patients in Two group got acupuncture for 6 times， 1 time/day， after a day of rest， they got placebogranules of Banxia Baizhu Tianmatang， 10 g/time， 2 times/day. Patients in observation group got Banxia Baizhu Tianmatang， 1 dose/day， and also the same acupuncture with the therapyof control group. And the treatment lasted for 4 weeks. At the half， 1

， 2

， 6

， 12

， 24

， and 48

hour after treatment， VAS were scored， rate of pain relief within 6， 12， and 24 hours， disappearance rate and recurrence rate of pain within 72 hours， migraine attack times， headache duration and headache degree before 4 weeks of treatment， during the treatment and after the treatment were recorded. Before and after treatment， accompanying symptoms， wind phlegm disturbance syndrome， headache impact test version-6 （HIT-6） and the migraine disability assessment questionnaire （MIDAS） were scored. And levels of calcitonin gene-related peptide （CGRP）， nitric oxide （NO）， endothelin-1 （ET-1）， pituitary adenylate cyclase activating peptide （PACAP）， S100B protein， substance P（SP）， von Willebrand factor （vWF） and fibrinogen （FIB） were detected. And safety was evaluated.

Result

VAS in two groups decreased at different time points （

0.01）， and VAS in observation group at 6

， 12

， 24

and 48

hour after treatment were lower than those in control group （

0.01）. The rate of pain relief in observation group at 6

and 12

hours after treatment and the disappearance rate of pain at 72

hour were 67.14%（47/70）， 87.14% （61/70） and 92.86% （65/70）， which were higher than 50.00% （34/68）， 70.59% （48/68） and 79.41% （54/68） in control group. The recurrence rate of pain in observation group was 21.43% （15/70）， which was lower than 39.71% （27/68） in control group （

0.05）. During the treatment and drug withdrawal， times of migraine attack， headache duration and headache degree were all less than those in control group （

0.01）. Scores of accompanying symptoms， wind phlegm disturbance syndrome， HIT-6 and MIDAS were all lower than those in control group （

0.01）. The clinical effect was better than that in control group （

=2.106，

0.05）. Levels of CGRP， PACAP， S100B protein， SP， ET-1， vWF and FIB were lower than those in control group， while level of NO was higher than control group （

0.01）.

Conclusion

Modified Banxia Baizhu Tianmatang combined with acupuncture had a better instant analgesic effect， with a significant effect on continuing analgesia and reducing headache recurrence. It can also alleviate migraine symptoms and accompanying symptoms， andreduce the impact of migraine on daily life and the degree of disability. Its mechanism may be related to the regulation of neurovasoactive peptides and vascular endothelial substances. It is worth for further study.

关键词

偏头痛风痰上扰证半夏白术天麻汤针刺神经血管活性肽类物血管内皮物质

Keywords

migrainewind phlegm disturbance syndromeBanxia Baizhu Tianmatangacupuncturevasoactive peptidesvascular endothelial substances

references

吴杭飞，毕晓莹，梅莉倩，等.神经内分泌网络在偏头痛共病抑郁中的研究进展［J］.中华神经科杂志，2019，52（12）：1073-1077.

周霞，孙中武.偏头痛的发病机制及诊治进展［J］.中华全科医学，2019，17（5）：714-715.

蒋仙国.偏头痛发病机制及治疗新进展［J］.神经病学与神经康复学杂志，2019，15（2）：80-88.

中华医学会疼痛学分会头面痛学组.中国偏头痛防治指南［J］.中国疼痛医学杂志，2016，22（10）：721-727.

卢婷婷，杨新民，张艳艳，等.针刺改善偏头痛症状和脑血流速度的Meta分析［J］.中国循证医学杂志，2019，19（6）：665-672.

宁艳哲，邹忆怀，张勇，等.中医药干预偏头痛的临床研究进展［J］.中西医结合心脑血管病杂志，2018，16（21）：3133-3135.

欧降红，阿不来提·艾则孜，万雪梅.加味半夏白术天麻汤对痰浊上扰型偏头痛患者的疗效及内皮素-1及一氧化氮水平的影响［J］.湖南中医药大学学报，2016，36（7）：65-67.

陈少玫，韦启志，奚胜艳，等.三虫半夏白术天麻汤对偏头痛大鼠脑组织5-HT1B/1D受体表达影响的实验研究［J］.中国中医急症，2016，25（10）：1874-1876.

HEADACHE CLASSIFICATION COMMITTEE OF THE INTERNATIONAL HEADACHE SOCIETY （IHS）. The international classification of headache disorders，3 rd edition （beta version）［J］.Cephalalgia， 2013，33（9）：629‐808.

中华中医药学会.中医内科常见病诊疗指南·西医疾病部分［M］.北京：中国中医药出版社，2008：286-291.

中华医学会疼痛学分会·头面痛学组.中国偏头痛诊断治疗指南［J］.中国疼痛医学杂志，2011，17（2）：65-86.

李聪，胡纪可，郭耀光，等.川芎茶调散加减配合针刺治疗偏头痛急性发作期风痰阻络证及对神经血管源性活性介质的影响［J］.中国实验方剂学杂志：2020，26（18）：170-177.

李琳琳，林晶，古再努尔·克来木江，等.中医药治疗偏头痛的研究进展［J］.新疆中医药，2019，37（4）：130-133.

蔡之幸，王重卿.偏头痛从“风”论治初探［J］.上海中医药大学学报，2017，31（2）：10-12.

OHLSSON L， KRONVALL E， STRATTON J，et al.Fremanezumab blocks CGRP induced dilatation in human cerebral， middle meningeal and abdominal arteries［J］.J Headache Pain， 2018，19（1）：66-70.

王迎双，肖哲曼.偏头痛生物标志物的研究进展［J］.临床神经病学杂志，2019，32（6）：463-467.

ASHIN A M， HANSEN J M， DO T P，et al.Migraine and the trigeminovascular system-40 years and counting［J］.Lancet Neurol，2019，18（8）：795‐804.

TIETJEN G E， COLLINS S A. Hypercoagulability and migraine［J］.Headache，2018，58（1）：173‐183.

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