天麻钩藤饮基于HPO轴治疗肝阳上亢型经行头痛的机制探讨

Study on the Mechanism of Tianma Gouteng Decoction in the Treatment of Transvaginal Headache With Hyperactivity of Liver

目的通过观察经行头痛患者下丘脑-垂体-卵巢轴(hypothalamic-pituitary-ovarian axis,HPO)相关激素水平的变化,探讨天麻钩藤饮治疗经行头痛的作用机制。方法选取2021年1月—2022年6月60例在厦门市中医院妇科门诊确诊的肝阳上亢型经行头痛患者,随机分为对照组与治疗组各30例,对照组予氟桂利嗪胶囊口服,治疗组予中药天麻钩藤饮口服,两组均于经前1周开始治疗,连续治疗14 d为1个疗程,共治疗2个疗程。观察两组治疗前后促性腺激素释放激素(gonadotrophic releasing hormone,GnRH)、雌二醇(estradiol,E2)、睾酮(testosterone,T)、孕激素(progesterone,P)、卵泡刺激素(follicle-stimulating hormone,FSH)、催乳素(prolactin,PRL)、黄体生成素(luteinizing hormone,LH)水平的变化,并进行分析比较。结果两组治疗后P、T、PRL均较治疗前未见明显改变,差异无统计学意义(P>0.05);GnRH、LH、FSH、E2均较治疗前有所升高,差异有统计学意义(P<0.05),且治疗组E2较对照组升高明显(P<0.01)。结论口服氟桂利嗪胶囊、天麻钩藤饮均可干扰下丘脑-垂体-卵巢轴功能,提升Gn RH、LH、FSH、E2的水平,口服天麻钩藤饮E2的水平提升更明显。

Objective To observe the changes of hypothalamicpituitary-ovarian axis(HPO)related hormones in patients with transitory headache,and to explore the mechanism of Tianma gouteng decoction in the treatment of transitory headache.Methods A total of 60 patients diagnosed with meridian headache due to hyperactivity of liver yang in the gynecological clinic of Xiamen Hospital of Traditional Chinese Medicine from January 2021 to June 2022 were randomly divided into a control group and a treatment group,30 cases in each group.The control group was orally administered with flunarizine capsule and the treatment group was orally administered with Tianma gouteng decoction.The two groups started their treatment one week before the meridian passage and received one course of continuous treatment of 14d,with two courses of treatment in total.The levels of gonadotropin releasing hormone(GnRH),estradiol(E2),testosterone(T),progesterone(P),follicle stimulating hormone(FSH),prolactin(PRL)and luteinizing hormone(LH)in the two groups before and after treatment were observed and compared.Results After treatment,P,T and PRL of the two groups were not significantly changed,there were no statistical significances(P>0.05).GnRH,LH,FSH and E2were increased compared with those before treatment,and the difference was statistically significant(P<0.05).E2of the treatment group was significantly higher than that of the control group(P<0.01).Conclusion Oral administration of flunarizine capsule and Tianma gouteng decoction could interfere with the hypothalamic–pituitary–ovarian axis function and increase the levels of GnRH,LH,FSH and E2.The E2level of orally administrated with Tianma gouteng decoction was improved more significantly.