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纸质出版日期:2016
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吉贞料, 卢桂兰, 王高岸. 通络清空汤辨治偏头痛急性发作期的疗效及作用机制[J]. 中国实验方剂学杂志, 2016,22(19):154-158.
JI Zhen-liao, LU Gui-lan, WANG Gao-an. Efficacy and Action Mechanism of Tongluo Qingkong Decoction in Treating Migraine Within Acute Attack Period Based on Differentiation[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(19): 154-158.
吉贞料, 卢桂兰, 王高岸. 通络清空汤辨治偏头痛急性发作期的疗效及作用机制[J]. 中国实验方剂学杂志, 2016,22(19):154-158. DOI: 10.13422/j.cnki.syfjx.2016190154.
JI Zhen-liao, LU Gui-lan, WANG Gao-an. Efficacy and Action Mechanism of Tongluo Qingkong Decoction in Treating Migraine Within Acute Attack Period Based on Differentiation[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(19): 154-158. DOI: 10.13422/j.cnki.syfjx.2016190154.
目的:探讨通络清空汤辨治偏头痛急性发作期的临床疗效及对血清5-羟色胺(5-HT),P物质(SP),内皮素(ET),同型半胱氨酸(Hcy)和一氧化氮(NO)水平的影响。方法:将121例符合要求的患者随机按数字表法分为观察组60例和对照组61例。对照组采用布洛芬片和苯甲酸利扎曲普坦片治疗;观察组西医治疗同对照组,加用通络清空汤辨证治疗。两组疗程均为4周。评价即时镇痛效应,采用偏头痛残疾程度评估问卷(MIDAS)评价生活质量,对头痛程度、发作次数、持续时间、伴随症状等主要症状进行评分,检测治疗前后5-HT,SP,ET,NO和Hcy水平。结果:观察组即时疗效有效率为83.33%,高于对照组的63.93%(P<0.05);观察组近期临床疗效总有效率为93.33%,优于对照组的80.33%(P<0.05);治疗后2,3,5,7 h观察组VAS评分均低于对照组(P<0.05,P<0.01);治疗后观察组主要症状,MIDAS评分低于对照组(P<0.01);与健康对照组比较,两组偏头痛患者治疗前5-HT水平均明显下降,SP,ET,NO和Hcy水平明显升高(P<0.01),治疗后观察组5-HT水平高于对照组(P<0.01);治疗后观察组SP,ET,NO和Hcy水平均低于对照组(P<0.01)。结论:在西医常规治疗的基础上,采用通络清空汤辨证治疗偏头痛急发作期患者能快速止痛,减少疼痛发作,改善生活质量,即时疗效和近期疗效均优于单纯西医治疗,其作用机制可能与调节神经-内分泌因子和血管内皮功能有关。
Objective: To discuss the clinical effect of Tongluo Qingkong decoction in treating migraine within the acute attack period based on differentiation and its influence on serum levels of 5-hydroxytryptamine (5-HT)
substance P (SP)
endothelin (ET)
homocysteine (Hcy) and nitric oxide (NO). Method: One hundred and twenty-one eligible patients were randomly divided into observation group (60 cases) and control group (61 cases) by number tablet. Control group took Changchun sustained release capsules and Ibuprofen tablets. In addition to the therapy of control group
patients in observation group were additionally administered with modified Tongluo Qingkong decoction based on differentiation. Courses of treatment in two groups continued for 4 weeks. Immediate analgesic effect was valuated
and migraine disability assessment questionnaire (MIDAS) was adopted to evaluate quality of life. Main symptoms
such as degree of headache
onset frequency
duration and symptoms
were scored. Levels of 5-HT
SP
ET
NO and Hcy were detected. Result: The effect rate of immediate curative effect in observation group was 83.33%
which was superior to 63.93%in control group (P<0.05). After treatment
the effect rate of short-term clinical effect in observation group was 93.33%
which was superior to 80.33%in control group (P<0.05). At the 2
3
5 and 7 h after treatment
score of VAS in observation group was lower than that in control group (P<0.01 or P<0.05). And after treatment
scores of MIDAS and main symptoms in observation group were lower than those in control group (P<0.01). Compared with the healthy control group
the lovels of 5-HT in the two groups before treatment were significantly decreased
and levels of SP
ET
NO and Hcy were higher than those in healthy control group (P<0.01). And level of 5-HT in observation group was higher than that in control group (P<0.01). Levels of SP
ET
NO and Hcy were lower than those in control group (P<0.01). Conclusion: In addition to the medicine western routine therapy
Tongluo Qingkong decoction based on differentiation can be adopted to relieve pain quickly
reduce frequency of pain attack
improve qualities of live within the acute attack period
with superior immediate curative effect and short-term effect to the pure western medicine therapy. Its action mechanism may be correlated with the regulation of nerve-endocrine factors and vascular endothelial functions.
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