头痛宁和西比灵治疗偏头痛的效果及血浆溶血磷脂酸(LPA)和酸性磷脂(AP)水平的变化

Comparative analysis on the clinical effects of Toutongning versus flunarizine in the treatment of migraine and on the changes of plasma lysophosphatidic acid(LPA)and acidic phospholipids(AP)levels

目的比较偏头痛患者应用头痛宁和西比灵治疗的效果及其血浆溶血磷脂酸(LPA)和酸性磷脂(AP)水平的变化情况。方法选择2012-02—2015-02我院收治的82例偏头痛患者,按照随机数表法分为观察组和对照组,每组41例。观察组采用头痛宁胶囊治疗,对照组采取西比灵治疗。观察2组治疗前后头痛持续时间和发作次数、LPA与AP水平及血液流变学指标变化。比较2组临床疗效、头痛改善情况及不良反应。结果治疗后,观察组总有效率为87.80%(36/41)明显较对照组的68.29%(28/41)高,差异有统计学意义(P<0.05);观察组偏头痛持续时间(7.56±2.11)h/次和发作次数(2.05±0.35)次/月低于对照组(P<0.05);观察组偏头痛改善程度明显优于对照组(P<0.05);观察组LAP(2.31±0.43)μmol/L与AP(3.51±0.65)μmol/L明显低于对照组(P<0.05);观察组全血比黏度高切(3.36±0.25)80s-1、全血比黏度低切(4.36±0.45)20s-1及血浆比黏度(1.08±0.14)明显低于对照组(P<0.05)。结论头痛宁可明显减少偏头痛持续时间和发作次数,降低LPA与AP及血液流变学水平,明显改善偏头痛程度,疗效良好。

Objective To analyze the effects of Toutongning versus flunarizine in the treatment of migraine and on the changes of plasma lysophosphatidic acid（LPA）and acidic phospholipids（AP）levels.Methods Totally 82 patients with migraine in our hospital from February 2012 to February 2015 were recruited and randomly divided into observation group and control group according to random number table method,41 cases in each group.Patients in the observation group were treated with Toutongning capsules and others in the control group received flunarizine.Then the lasting time and attack times of migraine,the levels of LAP and AP as wellas the changes of hemorheological indexes in the two groups were recorded.And we comparedthe clinical effects,the improvements in headache and adverse events between the two groups.Results After treatment,the total effective rate was 87.80%（36/41）in the observation group,significantly higher 68.29%（28/41）in the control group,and the difference was statistically significant（P〈0.05）.Compared with control group,the observation group showed shorter lasting time（7.56±2.11h/time）,less attack times（2.05±0.35times/month）and also better degree of improvement（P〈0.05）.Furthermore,the observation group presented lower levels of LAP（2.31±0.43μmol/L）and AP（3.51±0.65umol/L）relative to the control group（P〈0.05）.Similarly,the lower levels of whole blood viscosity at both high（3.36±0.25）80s-1 and low shear rates（4.36±0.45）20s-1as well as plasma viscosity（1.08±0.14）existed in the observation group（P〈0.05）.Conclusion The application of toutongning can significantly decrease the lasting time and attack time of migraine duration,reduce the levels of LAP,AP and hemorheological indexes and effectively improve the degree of headache with better efficacy.