天麻素胶囊联合洛美利嗪治疗血管神经性偏头痛的临床研究
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摘要
目的探讨天麻素胶囊联合洛美利嗪胶囊治疗血管神经性偏头痛的临床疗效。方法选取2016年3月—2018年3月在中国人民解放军联勤保障部队第九八三医院治疗的血管神经性偏头痛患者82例,随机分为对照组(41例)和治疗组(41例)。对照组口服盐酸洛美利嗪胶囊,5mg/次,根据病情适量增减,每日剂量不可超过20mg,2次/d;治疗组在对照组基础上口服天麻素胶囊,100 mg/次,3次/d。两组均治疗8周。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状改善、SF-36和VAS评分及血清学指标和脑血流情况。结果治疗后,对照组和治疗组临床有效率分别为78.05%和95.12%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组头痛发作次数、头痛持续时间均显著降低(P<0.05),且治疗组头痛发作次数和头痛持续时间明显低于对照组(P<0.05)。治疗后,两组SF-36评分显著升高(P<0.05),VAS评分显著降低(P<0.05),且治疗组SF-36和VAS评分明显好于对照组(P<0.05)。治疗后,两组血清超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、高脂蛋白a(LPA)、血管内皮生长因子(VEGF)、P物质(SP)水平及椎动脉(VA)、基底动脉(BA)、大脑前动脉(ACA)、中动脉(MCA)、后动脉(PCA)的平均血流速度均显著降低(P<0.05),且治疗组上述指标明显低于对照组(P<0.05)。结论天麻素胶囊联合盐酸洛美利嗪胶囊治疗血管神经性偏头痛可有效改善患者临床症状,改善脑血流速度,提高患者生活质量,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Gastrodin Capsules combined with lomeflozine in treatment of vasculoneurous migraine. Methods Patients(82 cases) with vasculoneurous migraine in 983 Hospital of the Joint Logistics Support Force of PLA from March 2016 to March 2018 were randomly divided into control(41 cases) and treatment(41 cases) groups. Patients in the control group were po administered with Lomerizine Hydrochloride Capsules, 5 mg/time, changed the dosage according to condition, the maximum dose was less than 20 mg/d, twice daily. Patients in the treatment group were po administered with Gastrodin Capsules on the basis of the control group, 100 mg/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the improvement of clinical symptoms, SF-36 and VAS scores, serological indexes and cerebral blood flow in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control and treatment groups was 78.05% and 95.12%, respectively, and there were differences between two groups(P < 0.05). After treatment, the frequency of headache attacks and headache duration in two groups was significantly decreased(P < 0.05), and which in the treatment group was significantly lower than that in the control group(P < 0.05). After treatment, the SF-36 scores in two groups were significantly increased(P < 0.05), but VAS scores were significantly decreased(P < 0.05), and these scores in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the serum hs-CRP, Hcy, LPA, VEGF, SP levels, and the average blood flow velocity of ACA, MCA, PCA, BA, VA in two groups were significantly decreased(P < 0.05), and these indexes in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Gastrodin Capsules combined with lomeflozine in treatment of vasculoneurous migraine can effectively improve the clinical symptoms, the cerebral blood flow speed and the quality of life, which has a certain clinical application value.
Objective To investigate the clinical efficacy of Gastrodin Capsules combined with lomeflozine in treatment of vasculoneurous migraine. Methods Patients(82 cases) with vasculoneurous migraine in 983 Hospital of the Joint Logistics Support Force of PLA from March 2016 to March 2018 were randomly divided into control(41 cases) and treatment(41 cases) groups. Patients in the control group were po administered with Lomerizine Hydrochloride Capsules, 5 mg/time, changed the dosage according to condition, the maximum dose was less than 20 mg/d, twice daily. Patients in the treatment group were po administered with Gastrodin Capsules on the basis of the control group, 100 mg/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the improvement of clinical symptoms, SF-36 and VAS scores, serological indexes and cerebral blood flow in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control and treatment groups was 78.05% and 95.12%, respectively, and there were differences between two groups(P < 0.05). After treatment, the frequency of headache attacks and headache duration in two groups was significantly decreased(P < 0.05), and which in the treatment group was significantly lower than that in the control group(P < 0.05). After treatment, the SF-36 scores in two groups were significantly increased(P < 0.05), but VAS scores were significantly decreased(P < 0.05), and these scores in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the serum hs-CRP, Hcy, LPA, VEGF, SP levels, and the average blood flow velocity of ACA, MCA, PCA, BA, VA in two groups were significantly decreased(P < 0.05), and these indexes in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Gastrodin Capsules combined with lomeflozine in treatment of vasculoneurous migraine can effectively improve the clinical symptoms, the cerebral blood flow speed and the quality of life, which has a certain clinical application value.
引文
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[9]郭丰,任占秀,何秋,等.偏头痛发作期患者血浆HCY和CRP含量及其相关性研究[J].中风与神经疾病杂志, 2015, 32(3):225-227.
[10]张志坚,吴秀丽,慕容慎行,等.偏头痛患者头痛缓解初期血中CGRP与SP含量观察[J].中国疼痛医学杂志, 2000, 6(3):133-135.
[11]宋叶华,牛建平,李妙端,等.偏头痛患者与血浆溶血磷脂酸及内皮素-1的相关性研究进展[J].海峡药学,2014, 26(3):96-98.
[12]杨小艳,汤建平,王静芬,等.偏头痛患者血清VEGF及5-HT表达及意义[J].中国实用神经疾病杂志,2018, 21(7):787-789.
[2]温慧丽.盐酸洛美利嗪治疗偏头痛的临床有效性评析[J].中西医结合心血管病电子杂志, 2016, 4(25):71.
[3]何晶.天麻素的药理作用及临床应用[J].津药学,2006, 18(5):62-63.
[4]刘春梅.偏头痛的国际分类、诊断标准、发病机制与防治研究进展[J].疑难病杂志, 2010, 9(12):953-955.
[5]孙增华,杨玉金.偏头痛诊断、疗效评定标准意见[J].中风与神经疾病杂志, 1995, 12(2):110-111.
[6]张磊,徐德忠,黄久仪,等. SF-36量表中文版的应用及分级截断点选择的研究[J].中华流行病学杂志,2004, 25(1):69-73.
[7]高万露,汪小海.视觉模拟疼痛评分研究的进展[J].医学研究杂志, 2013, 42(12):144-146.
[8]张惠光,商玉洁.偏头痛患者超敏C-反应蛋白与降钙素基因相关肽测定意义的研究[J].中国基层医药,2010, 17(11):1504-1505.
[9]郭丰,任占秀,何秋,等.偏头痛发作期患者血浆HCY和CRP含量及其相关性研究[J].中风与神经疾病杂志, 2015, 32(3):225-227.
[10]张志坚,吴秀丽,慕容慎行,等.偏头痛患者头痛缓解初期血中CGRP与SP含量观察[J].中国疼痛医学杂志, 2000, 6(3):133-135.
[11]宋叶华,牛建平,李妙端,等.偏头痛患者与血浆溶血磷脂酸及内皮素-1的相关性研究进展[J].海峡药学,2014, 26(3):96-98.
[12]杨小艳,汤建平,王静芬,等.偏头痛患者血清VEGF及5-HT表达及意义[J].中国实用神经疾病杂志,2018, 21(7):787-789.