针刺对慢性偏头痛患者血浆CGRP、β-EP和5-HT的影响

Effects of acupuncture on calcitonin gene-related peptide,beta endorphin and 5-hydroxytryptamine in patients with chronic migraine

目的探讨针刺对慢性偏头痛患者血浆降钙素基因相关肽(CGRP)、β-内啡肽(β-EP)和5-羟色胺(5-HT)的影响。方法慢性偏头痛患者84例随机分为两组:针刺组41例,取足少阳胆经、手少阳三焦经,随症加穴取位;药物组43例,给予盐酸氟桂利嗪胶囊口服。两组均治疗12周。评估治疗前后头痛症状学积分,检测血浆CGRP、β-EP和5-HT水平。结果与治疗前比较,两组治疗后CGRP水平降低,β-EP和5-HT水平增高(P<0.01)。治疗后,针刺组CGRP低于药物组[(65.55±15.37)pg/ml vs.(71.23±8.65)pg/ml](P<0.05),针刺组β-EP高于药物组[(243.27±32.15)ng/ml vs.(229.01±29.87)ng/ml](P<0.05),针刺组5-HT高于药物组[(198.60±30.09)ng/ml vs.(182.06±25.40)ng/ml](P<0.05)。针刺组总有效率高于药物组(95.12%vs.88.37%)(P<0.05)。针灸组不良反应发生率低于药物组(2.43%vs.11.63%)(P<0.05)。结论针刺治疗较药物治疗更能降低慢性偏头痛患者血浆CGRP、增高5-HT及β-EP水平,减轻慢性偏头痛患者的疼痛症状。

Objective To investigate the effects of acupuncture on calcitonin gene-related peptide（CGRP） ,beta endorphin（β-EP） and 5-hydroxytryptamine（5-HT） in the patients with chronic migraine. Methods Eighty-four patients with chronic migraine were randomly assigned into two groups of A（treated with acupuncture for 12 weeks,41 cases） and B（treated with flunarizine for 12 weeks,43 cases）. Before and after treatment, plasma CGRP, β-EP and 5-HT were detected and the score of headache symptoms were evaluated. Results Compared to before, plasma levels of β-EP and 5-HT were increased, and CGRP were decreased after treatment in both groups （P〈0. 01）, which were more in group A than those in group B E（243.27± 32.15） ng/m[ vs. （229.01±29.87） ng/ml and （198. 60±30.09） ng/ml vs. （182.06±25.40） ng/ml, and （65.55 ±15.37） pg/ml vs. （71.23 ± 8. 65） pg/ml]（P〈0. 05）. The overall effectiveness rate was higher in group A than that in group B （95. 12% vs. 88. 37%）（P〈0. 05）. the incidence rate of adverse effects was lower in group A than that in group B （ 2.43% vs. 11.63 %） （ P〈0. 05 ）. Conclusion Acupuncture is better than flunarizine treatment in increasing plasma levels of β-EP and 5-HT, decreasing plasma CGRP and attenuating the pain symptoms in the patients with chronic migraine.