丹珍头痛胶囊联合尼莫地平治疗偏头痛的临床研究

Clinical study of Danzhen Toutong Capsules combined with nimodipine in treatment of migraine

目的探讨丹珍头痛胶囊联合尼莫地平治疗偏头痛的临床疗效。方法选取2016年1月—2018年3月东营市东营区人民医院收治的122例偏头痛患者作为研究对象,采用随机数字表法将所有患者分为对照组和治疗组,每组各61例。对照组患者口服尼莫地平片,40 mg/次,3次/d。治疗组在对照组基础上口服丹珍头痛胶囊,3粒/次,3次/d。两组患者均连续治疗4周。观察两组的临床疗效,比较两组治疗前后头痛发作情况积分、相关理化指标、颅内各动脉平均血流速度(MFV)。结果治疗后,对照组和治疗组的总有效率分别为80.3%、93.4%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者头痛发作次数、持续时间、疼痛程度、伴随症状积分及总分均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组患者的头痛发作次数、持续时间、疼痛程度、伴随症状积分及总分均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血浆黏度(PV)、血小板聚集率(PAR)、血小板α颗粒膜蛋白(GMP-140)、D-二聚体(D-D)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组PV、PAR、GMP-140、D-D水平均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者大脑前动脉、大脑中动脉、大脑后动脉的MFV均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组大脑前动脉、大脑中动脉、大脑后动脉的MFV均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论丹珍头痛胶囊联合尼莫地平治疗偏头痛具有较好的临床疗效,能明显改善患者头痛发作情况,纠正血流变学异常,改善血栓前状态,调节脑血流量,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Danzhen Toutong Capsules combined with nimodipine in treatment of migraine. Methods Patients（122 cases） with migraine in the People’s Hospital of Dongying District in Dongying City from January 2016 to March 2018 were randomly divided into control and treatment groups, and each group had 61 cases. Patients in the control group were po administered with Nimodipine Tablets, 40 mg/time, three times daily. Patients in the treatment group were po administered with Danzhen Tongtong Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the scores of headache attack, related physical and chemical indicators, and MFV values of various intracranial arteries in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.3% and 93.4%, respectively, and there was difference between two groups（P 〈 0.05）. After treatment, the scores of headache incidence, duration, degree of pain, associated symptom and the total scores in two groups were significantly decreased, and there were differences in the same group（P 〈 0.05）. After treatment, the scores of headache incidence, duration, degree of pain, associated symptom and the total scores in the treatment group were significantly lower than those in the control group, and there were differences between two groups（P 〈 0.05）. After treatment, the PV, PAR, GMP-140 and D-D levels in two groups were significantly decreased, and there were differences in the same group（P 〈 0.05）. And the PV, PAR, GMP-140 and D-D levels in the treatment group were significantly lower than those in the control group, and there were differences between two groups（P 〈 0.05）. After treatment, the MFV of anterior cerebral artery, middle cerebral artery, and posterior cerebral artery in two groups were significantly decreased, and there were differences in the same group（P 〈 0.05）. And the MFV of anterior cerebral artery, middle cerebral artery, and posterior cerebral artery in the treatment group were significantly lower than those in the control group, and there were differences between two groups（P 〈 0.05）. Conclusion Danzhen Toutong Capsules combined with nimodipine has significant clinical effect in treatment of migraine, can significantly improve the headache frequency, correct the abnormal hemorheology, improve the pre-thrombus state, and regulate the cerebral blood flow, which has a certain clinical application value.