舒天宁冲剂治疗偏头痛的临床与实验研究

Clinical and Experimental Study on Treatment of Migraine with Shutianning Granule

目的 :运用中医学理论结合现代研究 ,对偏头痛的病因病机和治疗进行探讨 ,以寻求治疗偏头痛的新思路及有效药物。方法 :90例偏头痛患者分为 3组 ,舒天宁组给以舒天宁冲剂 9g ,每天 3次。复方羊角组给予复方羊角胶囊 5粒 ,口服 ,每天 3次。西比灵组给予西比灵胶囊 5mg ,口服 ,每天 1次。共治疗 2 8天。观察疼痛程度、持续时间、发作频度 ,计算其头痛指数。并分别于治疗前和观察结束时进行经颅多普勒(TCD)检测和血清 β内啡肽 (β EP)和血清神经肽Y(NPY)检测。慢性疼痛SD大鼠实验中 ,测定生理盐水组及各用药组对脑NPY、下丘脑 β EP的影响。 结果 :舒天宁组显效率 5 6 6 7% ,总有效率 90 0 0 %。与西比灵组比较差异有显著性 (P <0 0 5 ) ,与复方羊角组比较 ,差异无显著性 (P >0 0 5 )。各用药组均能升高大鼠下丘脑β EP含量 ,降低NPY含量 ,与生理盐水组比较 ,差异有显著性 (P <0 0 5或P <0 0 1)。结论 :舒天宁冲剂可有效改善颅内血管的机能状态 ,能升高血浆β EP水平 ,降低血浆NPY含量 ,缓解血管的紧张状态。

Objective: To explore the cause and pathogenesis of migraine based on TCM theory and modern researches to seek for new thinking and effective drugs in treating migraine. Methods: Ninety patients with migraine were divided into three groups, the treated group treated with Shutianing Granule (STNG) 9 g, three times a day, the control A group treated with composite Yangjiao capsule, 5 capsules each time, three times a day and the control B group treated with flunarizine hydrochloride capsule, 5 mg, once a day. The treatment lasted for 28 days to observe the degree, lasting time and frequency of pain attack, and the headache index was calculated. Transcranial Doppler examination, serum β evoked potential (β EP) and neuropeptide (NPY) determination were also performed before and after treatment. In the experimental study, effect of treatment of cerebral NPY and β EP were tested in SD rats with chronic pain in the treated or the control groups. Results: In the treated group, the markedly effective rate was 56.67% and the total effective rate was 90.00%, significant difference was shown in comparison with those in the control B group (P<0 05), but with no difference in comparison with those in the control A group. Cerebral β EP level was raised and plasma NPY level was lowered in all the three treated groups. Compared with the normal saline group, there was significant difference (P<0 05 or P<0 01). Conclusion: STNG could improve the cerebrovascular function effectively, raise plasma β EP level, lower plasma NPY level and alleviate vascular tension in patients with migraine.