α-硫辛酸改善胰岛素抵抗患者偏头痛症状

Alpha lipoic acid in the improvement of migraine symptoms in patients with insulin resistance

目的探讨α-硫辛酸(ALA)对胰岛素抵抗(IR)患者偏头痛症状的改善作用。方法选择2015年1月至2016年12月接受治疗的IR偏头痛患者80例作为研究对象,按照数字表法随机分为试验组(n=40)和对照组(n=40)。试验组患者给予ALA联合常规改善IR用药治疗,对照组患者给予常规改善IR用药治疗。比较两组患者在治疗前临床特征的差异,治疗前后头痛发作频率、发作持续时间、发作程度、炎性细胞因子水平的差异;治疗后临床疗效、药物不良反应发生情况的差异。结果两组患者治疗前在临床特征方面差异无统计学意义(P>0. 05),两组对象具有可比性。治疗后,两组患者头痛频率积分、头痛程度积分、头痛持续时间积分方面显著低于治疗前(P<0.05),试验组显著低于对照组(P<0. 01)。治疗后,两组患者血清肿瘤坏死因子(TNF)-α、C-反应蛋白、白细胞介素(IL)-6水平显著低于治疗前(P<0. 01),试验组显著低于对照组(P<0. 01)。试验组治疗总有效率为80. 00%,显著高于对照组的50. 00%(P<0. 01)。两组患者治疗后均未见恶心、腹痛、腹泻等消化道症状发生,肝肾功能也未见异常。结论 ALA联合常规改善IR用药治疗可显著改善IR患者炎性细胞因子水平及头痛症状,临床疗效明确,安全可靠。

Objective To investigate the improvement of migraine symptoms in patients with insulin resistance( IR) by alpha lipoic acid( ALA). Methods A total of 80 IR patients with migraine who received treatment at Yan’an University Affiliated Hospital from January 2015 to December 2016 were selected and divided into experimental group and control group randomly( n = 40,each). The experimental group patients received ALA combined with IR routine treatment,and control group patients received IR routine treatment,both groups were treated for one month. The clinical characteristics before the treatment,the frequency,duration,degree of migraine attack and levels of inflammatory cytokines before and after the treatment,and the clinical efficacy and adverse drug reactions after the treatment were compared between two groups.Results The headache frequency score,headache degree score and headache duration score of the two groups were significantly lower than those before treatment( all P<0. 05),and those scores were lower in experimental group after the treatment( all P<0. 05). The level of tumor necrosis factor-α( TNF-α),C-reactive protein( CRP) and interleukin( IL)-6 of the two groups were significantly lower than those before treatment( all P<0. 05),and they were lower in experimental group compared with control group after the treatment( all P < 0. 05). The clinical efficacy in experimental group was significantly higher than that in control group( 80. 00% vs 50. 00%,P < 0. 05). No digestive tract symptoms such as nausea,abdominal pain and diarrhea were found in both groups after treatment,and no abnormal liver and kidney functions were observed. Conclusion ALA combined with IR routine treatment could improve the inflammatory cytokines level and migraine symptoms in patients with IR,which has a significant clinical efficacy and reliable safety.