针灸治疗偏头痛患者的效果及其对血清基质金属蛋白酶-2活性的影响

Effect of Acupuncture in Migraine Patients and Its Influence on Serum MMP-2 Activity

目的:探讨针灸治疗偏头痛患者的效果及其对血清基质金属蛋白酶-2(MMP-2)活性的影响。方法:选取2010年1月—2013年1月本院收治的急性期偏头痛患者68例志愿者例按数字随机法分为观察组和对照组,每组34例。对观察组患者双边头维,内庭,合谷,曲池,LIV3,三阴交,瞳子髎,阳白,风池,大椎,百会,印堂,太阳,耳神门穴进行针灸,对照组采用盐酸氟桂利嗪治疗,5 mg/次,1次/d,7 d为1个疗程,共治疗3个疗程。比较两组治疗前后头痛发作次数、持续时间、视觉疼痛模拟评分(VAS)、健康调查简表(SF-36)及血清MMP-2活性变化并分析患者VAS与血清MMP-2活性的关系。结果:观察组和对照组治疗前1周内头痛发作次数、头痛持续时间、VAS、SF-36及血清MMP-2活性比较差异均无统计学意义(P>0.05)。观察组治疗7 d、14 d和21 d的1周内头痛发作次数较治疗前减少,头痛持续时间较治疗前缩短,VAS较治疗前降低,各维度生活质量得分和MMP-2活性较治疗前降低;对照组治疗14 d和21 d的1周内头痛发作次数较治疗前减少,头痛持续时间较治疗前缩短,VAS较治疗前降低,各维度生活质量得分和MMP-2活性较治疗前降低;且与对照组比较,观察组治疗14 d和21 d的1周内头痛发作次数减少,头痛持续时间缩短,VAS降低,各维度生活质量得分和MMP-2活性降低,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,偏头痛患者VAS与血清MMP-2水平呈正相关(r=0.733,P<0.05)。结论:针灸治疗活性偏头痛可有效缓解患者的疼痛症状并提高患者的生存质量,且针灸治疗活性偏头痛的效果与MMP-2活性的降低相关,可通过降低MMP-2活性缓解患者的疼痛症状。

Objective： To investigate the effect of acupuncture in migraine patients and its influence on serum matrix metalloproteinase- 2（ MMP- 2） activity. Methods： 68 patients and volunteers with acute migraine in our hospital from January 2010 to January 2013 were randomly divided into observation group and control group according to digital ransom method,34 cases in each group. Observation group adopted acupuncture in bilateral Touwei（ ST8）,Neiting（ ST44）,Hegu（ LI4）,Quchi（ LI11）,LIV3,Sanyinjiao（ SP6）,Tongziliao（ GB1）,Yangbai（ GB14）,Fengchi（ GB20）,Dazhui（ GV14）,Baihui（ GV20）,Yintang（ EX- HN3）,Taiyang（ EX- HN5）,Shenmen（ HT7）,while control group adopted Flunarizine Hydrochloride Capsules 5 mg/times,once a day,7 d for a course,and total treatment including 3 course. Headache frequency,duration,visual analogue scale（ VAS） pain,health survey profiles（ SF- 36） and serum activity of MMP- 2 changes of two groups before and after treatment were compared and relationship between VAS and the activity of serum MMP – 2 was analyzed. Results： Headache frequency,duration,VAS,SF- 36 serum activity of MMP- 2 of observation group and control group had no statistical significant differences after treated for 1 week（ P〈0. 05）. After treated for 7 d,14 d and 21 d,1- week headache frequency and activity of MMP- 2 of observation group was decreased and headache duration was shortened and the VAS was reduced. All dimensions of life quality score increased. After treated for 14 d and 21 d,1- week headache frequency and activity of MMP- 2 of control group was decreased and headache duration was shortened and the VAS was reduced. All dimensions of life quality score increased. Compared with the control group,1-week headache frequency and activity of MMP- 2 of observation group was decreased and the headache duration was shortened and the VAS was reduced. All dimensions of life quality score increased and the difference was statistically significant（ P〈0.05）. Spearman correlation analysis results showed activity of MMP- 2 and VAS of migraine patients was positively correlated（ r= 0. 733,P〈0. 05）. Conclusion： Acupuncture can effectively alleviate the pain symptoms of patients with migraine and improve life quality. The effect of acupuncture may be associated with reducing of activity of MMP- 2,and thus migraine patients＇ pain symptoms can be alleviated through reducing activity of MMP- 2.