Objective

2

To observe the efficacy of addition and subtraction therapy of Chuanxiong Chatiaosan combined with acupuncture for acute migraine attack with syndrome of wind phlegm blocking collaterals and to investigate its effect on neurovascular active medium.

Method

2

One hundred and thirty-four patients were randomly divided into control group（67 cases） and observation group （67 cases）by random number table. During the treatment， 63 patients completed the study in control group （loss to follow-up in 2 cases， and elimination in 2 cases）. 64 patients completed the study in observation group （loss to follow-up in 3 cases）. Patients in both groups got ibuprofen sustained release tablets， 1 tablet/time， 2 times/day， Zolmitriptan tablets， 2.5 mg/time， 1 time/day， which were stopped when symptoms got relieved. Patients in control group got acupuncture treatment， 1 time/day， and Zhengtian pills by oral administration， 6 g/time， 2 times/day. Based on the treatment of acupuncture in control group， patients in observation group additionally received addition and subtraction therapy of Chuanxiong Chatiaosan， 1 dose/day， with a treatment course of 10 days in both groups. Before treatment， at the first day （2， 4 ， 12 ， 24 h） and second to tenth day after the treatment， scores of pain visual analoguescale （VAS） were graded； before and after treatment， scores of duration and degree of headache， concomitant symptoms， number of headache attacks， syndrome of wind phlegm blocking collaterals， migraine specific quality of life scale （MSQ） were graded. Levels of nitric oxide （NO）， endothelin-1 （ET-1）， calcitonin gene-related peptide （CGRP）， 5-hydroxytryptamine （5-HT）， and

β

endorphin （

β

-EP） were detected before and after treatment.

Result

2

The clinical efficacy in observation group was better than that in control group （

Z

=2.115，

P

<

0.05）. At the second and fourth hour after treatment， VAS scores were decreased in both groups， but there was no statistically significant difference between two groups. At the 12

th

and 24

th

hour after treatment， VAS scores were increased as compared with those at the previous time point （

P

<

0.01）， and VAS scores in observation group at the 12

th

and 24

th

hour were lower than those in control group （

P

<

0.01）， but there was no statistically significant difference in onset time for pain， effective rate for pain at second hour after treatment and the disappearance rate of pain at the third day after treatment. Time to pain relief in observation group was shorter than that in control group （

P

<

0.01）. Degree of headache， duration of headache， number of headache attacks and accompanying symptoms were all lower than those in control group， while scores of MSQ and the total score of MSQ were all higher than those in control group （

P

<

0.01）. Recurrence rate of pain in observation group was 18.75% （12/64）， lower than 36.51% （23/63） in control group at the 24

th

hour （

P

<

0.05）. Disappearance rate of pain in observation group was 70.31% （45/64） and 90.63% （58/64） at the fifth day and tenth day after treatment， higher than 52.38% （33/63） and 76.19% （48/63） in control group （

P

<

0.05）. Levels of NO，

β

-EP and 5-HT were higher than those in control group （

P

<

0.01）， while levels of CGRP and ET-1 were lower than those in control group （

P

<

0.01）.

Conclusion

2

Chuanxiong Chatiaosan combined with acupuncture in the treatment of acute migraine attack in patients， has equivalent effect in terms of rapid pain relief， but with advantages of long-lasting analgesic effect， low recurrence rate， high pain relief rate and disappearance rate. In addition， it can also regulate neurovascular active mediators， more effectively control acute migraine attack， and improve the quality of life of patients， with a better clinical efficacy.