天宁饮治疗偏头痛的疗效评价及机理探析

Efficacy Evaluation and Mechanism Discussion of Migraine Treated with Tianning Decoction

目的通过观察不同药物治疗对偏头痛患者头痛症状及血清5-HT、CGRP的影响,了解天宁饮的疗效及作用机理。方法将120例偏头痛患者随机分为3组,治疗组口服天宁饮,对照1组按不同证型给予汤药,对照2组口服盐酸氟桂利嗪胶囊。观察3组患者用药前后头痛的改善情况及血清5-HT、CGRP的变化。结果 (1)治疗后3组患者头痛各积分均有下降,与治疗前相比,差异有统计学意义(P<0.01);治疗组治疗后各参数与对照组相比,差异有统计学意义(P<0.01或P<0.05),对照组组间比较,差异无统计学意义(P>0.05)。(2)治疗组总有效率为92.5%,对照组总有为效率77.5%、72.5%,经统计学分析,差异有统计学意义(P<0.05),对照组组间相比,差异无统计学意义(P>0.05)。(3)治疗组血清5-HT含量升高及CGRP含量降低程度高于对照组(P<0.01),对照组组间比较,差异无统计学意义(P>0.05)。结论天宁饮可明显减轻头痛症状,对5-HT及CGRP水平的调节作用强于分证论治及盐酸氟桂利嗪。

Objective To explore the efficacy and function mechanism of tianning decoction through the observation of the impacts on headache,serum 5- HT and CGRP in the patients of migraine treated with different medicines. Methods One hundred and twenty cases of migraine were randomized into three groups. In a treatment group,tianning decoction was taken orally. In a control No. 1 group,the decoction was prescribed according to different patterns / syndromes. In a control No. 2 group,flunarizine hydrochloride capsules were taken orally. The improvement in headache and the changes in serum 5- HT and CGRP were observed before and after medication in the patients of the three groups. Results 1. After treatment,every headache score was reduced as compared with that before treatment in the patients of the three groups,indicating the significant difference（ P〈 0. 01）. Every parameter in the treatment group was different significantly as compared with that in the control group after treatment,indicating the significant difference（ P 〈0. 01 or P 〈0. 05）. The difference was not significant within the control groups（ P 〉0. 05）. 2. The total effective rate was 92. 5% in the treatment group and was 77. 5% and 72. 5% in each of the control groups separately,without significant difference in comparison（ P 〉0. 05）. 3. In the treatment group,serum 5- HT was increased and CGRP was decreased,which was superior to the control groups（ P 〈0. 01）. The difference was not significant within the control groups（ P〉 0. 05）. Conclusion Tianning decoction alleviates apparently headache and regulates the levels of 5- HT and CGRP,which is better than the treatment according to the pattern / syndrome differentiation and flunarizine hydrochloride.