氟桂利嗪胶囊加熄风化痰方联合电针治疗风痰上扰型偏头痛的临床观察

Clinical Observation on Flunarizine Capsules Plus Xifeng Huatan Formula Combined with Electroacupuncture for the Treatment of Migraine with Upward Attack of Wind-phlegm Syndrome Type

【目的】观察氟桂利嗪胶囊加熄风化痰方联合电针治疗风痰上扰型偏头痛的临床疗效。【方法】将110例风痰上扰型偏头痛患者随机分为治疗组和对照组,每组各55例,对照组给予氟桂利嗪胶囊联合熄风化痰方口服治疗,治疗组在对照组治疗的基础上,给予足少阳头颈部穴位电针治疗,共治疗4周。治疗4周后,评价2组临床疗效,观察2组患者治疗前后偏头痛症状评分的变化情况,以及颅内动脉血流速度,包括椎动脉(VA)、基底动脉(BA)、大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)平均血流速度的情况。比较2组患者治疗前后血清核转录因子κB(NF-κB)、环氧合酶2(COX-2)和白细胞介素1β(IL-1β)、降钙素基因相关肽(CGRP)、内皮素1(ET-1)水平和血清一氧化氮(NO)水平的变化情况。【结果】(1)治疗后,2组患者的偏头痛症状评分,包括疼痛程度评分、疼痛持续时间评分、发作频率评分以及偏头痛症状总分均明显改善(P<0.05),且治疗组在改善偏头痛症状各项评分方面明显优于对照组,差异均有统计学意义(P<0.05)。(2)治疗后,2组患者的颅内动脉血流速度,包括VA、BA、ACA、MCA、PCA平均血流速度均明显改善(P<0.05),且治疗组在改善颅内动脉各项血流速度方面均明显优于对照组,差异均有统计学意义(P<0.05)。(3)治疗后,2组患者的血清NF-κB、COX-2、IL-1β水平明显改善(P<0.05),且治疗组在改善血清NF-κB、COX-2、IL-1β水平方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的血清CGRP、ET-1、NO水平明显改善(P<0.05),且治疗组在改善血清CGRP、ET-1、NO水平方面明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗组总有效率为92.73%(51/55),对照组为72.73%(40/55)。治疗组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】氟桂利嗪胶囊加熄风化痰方联合电针治疗风痰上扰型偏头痛,可有效缓解患者的偏头痛症状,降低脑动脉平均血流速度,下调NF-κB、COX-2、IL-1β分泌,改善血管舒缩功能紊乱有关,疗效显著。

Objective To observe the clinical efficacy of Flunarizine Capsules plus Xifeng Huatan Formula combined with electroacupuncture in the treatment of migraine with upward attack of wind-phlegm syndrome type.Methods A total of 110 patients with upward attack of wind-phlegm type migraine were randomly divided into the treatment group and the control group,55 patients in each group.The control group was given oral treatment of Flunarizine Capsules combined with the Xifeng Huatan Formula,and additionally,the treatment group was given electroacupuncture treatment of foot Shaoyang points at the head and neck on the basis of the control group.And both groups were treated for 4 weeks.After 4 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in migraine symptom scores and the mean blood flow velocity of intracranial arteries,including vertebral artery(VA),basilar artery(BA),anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA),were observed in the two groups before and after treatment.The changes in serum nuclear transcription factor-κB(NF-κB),cyclooxygenase 2(COX-2)and interleukin 1β(IL-1β),calcitonin gene-related peptide(CGRP),endothelin 1(ET-1)levels and serum nitric oxide(NO)level in the two groups of patients were compared before and after treatment.Results(1)After treatment,the migraine symptom scores,including pain degree score,pain duration score,attack frequency score and total migraine symptom scores in both groups of patients were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving the migraine symptom scores,the difference being statistically significant(P<0.05).(2)After treatment,the mean blood flow velocities of intracranial arteries,including VA,BA,ACA,MCA,and PCA,in both groups of patients were significantly iproved(P<0.05),and the treatment group was significantly superior to the control group in improving various blood flow velocities of intracranial arteries,the difference being statistically significant(P<0.05).(3)After treatment,the serum NF-κB,COX-2 and IL-1βlevels in the two groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving serum NF-κB,COX-2 and IL-1βlevels,the difference being statistically significant(P<0.05).(4)After treatment,the serum CGRP,ET-1 and NO levels of the two groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving the serum CGRP,ET-1 and NO levels,the difference being statistically significant(P<0.05).(5)The overall effective rate was 92.73%(51/55)in the treatment group and 72.73%(40/55)in the control group.The efficacy of the treatment group was superior to that of the control group,the difference being statistically significant(P<0.05).Conclusion Flunarizine Capsules plus Xifeng Huatan Formula combined with electroacupuncture in the treatment of migraine with upward attack of wind-phlegm syndrome type can effectively alleviate patients’migraine symptoms,reduce the mean blood flow velocity of cerebral arteries,down-regulate NF-κB,COX-2 and IL-1βsecretion and improve vasomotor dysfunction with significant therapeutic effect.