针药结合治疗急性发作期偏头痛肝阳上亢证临床研究

Clinical Research on Combination of Acupuncture and Medicine on Acute Episode of Migraine with Liver-Yang Excess Syndrome

目的:观察针药结合治疗急性发作期偏头痛肝阳上亢证的临床疗效,及对血清5-羟色胺和降钙素基因相关肽水平的影响。方法:将88例急性发作期偏头痛肝阳上亢证患者按随机数字表法分为对照组44例和治疗组44例,对照组口服天麻钩藤颗粒治疗,开水冲服,每次10 g,每日3次;同时给予盐酸氟桂利嗪胶囊治疗,口服,每次10 mg,每日2次;治疗组在对照组基础上加用针刺治疗,取患侧风池、百会、悬颅、侠溪、行间等腧穴,常规针刺得气后,采用平补平泻手法,留针30 min,每日1次,每周5次,两组患者均连续治疗4周。治疗后比较两组中医症状评分;记录两组每周头痛次数、头痛持续时间以及视觉模拟评分法值等情况;检测两组血清5-羟色胺和降钙素基因相关肽水平。结果:治疗组治疗后中医症状各指标评分均明显低于对照组(P<0.01);治疗组有效率为93.18%,对照组有效率为70.45%,两组比较,差异有统计学意义(χ2=6.188,P<0.05)。治疗组治疗后头痛发作次数、视觉模拟评分法值以及持续时间均显著少于对照组(P<0.01);治疗组治疗后血清血清5-羟色胺水平明显高于对照组,而降钙素基因相关肽水平明显低于对照组,以上比较差异均有统计学意义(P均<0.01)。结论:针药结合治疗急性发作期偏头痛肝阳上亢证可明显改善患者临床症状,提高临床治疗效果,升高血清5-羟色胺水平和降低降钙素基因相关肽水平可能与之相关。

Objective：To observe the clinical efficacy of combination of acupuncture and medicine on acute episode of migraine with liv-er-yang excess type and its influences of levels of serum 5-hydroxytryptophane（5-HT）and calcitonin gene-related peptide（CGRP）. Methods：88 patients of acute episode of migraine with liver-Yang excess syndrome were randomly divided into treatment group and con-trol group,44 cases for each according to random number table method. The control group were given with Tianma Gouteng granules o-rally with boiling water（10 g per time,tid）and flunarizine hydrochloride capsule（10 mg per time,bid）. Based on control group,treat-ment group received acupuncture treatment with reinforcing-reducing method of 30 min per time and qd（5 times a week）. Selected suf-fering side Fengchi（GB20）,Baihui（GV 20）,Xuanlu（GB5）,Xiaxi（GB43）,xingjian（LR2）. Course of treatment of both groups were 4 weeks. Scores of traditional Chinese medicine symptoms in both groups were compared. Scores of times of headache,lasting time of headache and visual analogous scale（VAS）were detected per week for two groups. Serum of 5-HT and CGRP in both groups of patients were detected. Results：The total effective rate for treatment group was 93. 18% ,the control group was 70. 45% ,and the difference was statistically significant（χ2 = 6. 188,P ﹤ 0. 05）. After treatment,scores of traditional Chinese medicine symptoms in treatment group was evidently lower than that of control group（P ﹤ 0. 01）. Times of headache,lasting time of headache and VAS in treatment group were obviously less than that of control one after treatment（P ﹤ 0. 01）. After treatment,serum 5-HT was obviously higher,while CGRP was evidently lower than that of control group with a statistically significant difference（P ﹤ 0. 01）. Conclusion：Combination of acupuncture and medicine on acute episode of migraine with liver-Yang excess syndrome can effectively improve the clinical symptoms and the clini-cal efficacy. The serum of high 5-HT and low CGRP might play a role in the study.