摘要
目的 观察针刺激痛点联合盐酸氟桂利嗪治疗偏头痛患者的疗效及对炎症相关指标、血管活性物质的影响.方法 选择2017 年1 月—2022 年1 月首都医科大学附属北京中医医院诊治的80 例偏头痛患者为研究对象,根据随机数字表法按1:1 比例将患者分为观察组、对照组,每组40 例.对照组予以假针刺+口服盐酸氟桂利嗪治疗,观察组予以激痛点针刺+口服盐酸氟桂利嗪治疗,针刺隔天治疗1 次,2 组均治疗4 周.比较2 组治疗后头痛情况,临床疗效,血清炎症相关指标[环氧化酶-2(COX-2)、降钙素基因相关肽(CGRP)、前列腺素E2(PGE2)]及血管活性物质[血管性血友病因子(vWF)、内皮素-1(ET-1)、一氧化氮(NO)]水平、脑血流速度及不良反应发生情况.结果 治疗后,观察组偏头痛发生次数、头痛发作总时间、疼痛程度VAS评分均明显低于对照组(P均<0.05);观察组总有效率明显高于对照组[92.5%(37/40)比 75.0%(30/40),P<0.05];观察组血清COX-2、CGRP、PGE2、vWF、ET-1 水平均明显低于治疗前及对照组(P 均<0.05),NO水平均明显高于治疗前及对照组(P均<0.05);观察组大脑前动脉、大脑中动脉、大脑后动脉、椎动脉、基底动脉的血流速度均明显慢于治疗前及对照组(P均<0.05).治疗期间2 组不良反应发生率比较差异无统计学意义(P>0.05).结论 针刺激痛点联合盐酸氟桂利嗪治疗偏头痛疗效显著,可有效缓解患者的疼痛症状,降低炎症相关指标水平,改善血管内皮功能和脑血流动力学,且治疗安全.
Abstract
Objective It is to observe the efficacy of acupuncture at myofascial trigger points combined with flunarizine hydrochloride in the treatment of patients with migraine and its effects on inflammation-related indicators and vasoactive sub-stance.Methods Eighty migraine patients treated in Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from January 2017 to January 2022 were selected for the study,and the patients were divided into obser-vation group and control group according to the randomized numerical table method in the ratio of 1∶1,with 40 cases in each group.The control group was treated with sham acupuncture+oral administration of flunarizine hydrochloride,and the observation group was treated with acupuncture at myofascial trigger points combined with oral administration of flunarizine hydrochloride,the acupuncture was performed once every other day,and both groups were treated for 4 weeks.The head-ache,clinical efficacy,serum levels of inflammation-related indexes[cyclooxygenase-2(COX-2),calcitonin gene-related peptide(CGRP),prostaglandin E2(PGE2)],and vasoactive substances[vascular hemophilic factor(vWF),endothelin-1(ET-1),nitric oxide(NO)],cerebral blood flow velocity after treatment,and the incidence of adverse effects were com-pared between the two groups.Results After treatment,the times of migraine occurrences,the total duration of headache attacks,and the VAS score of pain in the observation group were significantly lower than those in the control group(all P<0.05);the total effective rate of the observation group was significantly higher than that of the control group[92.5%(37/40)VS.75.0%(30/40),P<0.05];the serum levels of COX-2,CGRP,PGE2,vWF,ET-1 in the observation group were significantly lower(all P<0.05),while the level of NO was significantly higher than those before treatment and in the control groups(all P<0.05);the blood flow velocities of the anterior cerebral artery,middle cerebral artery,posterior cerebral artery,vertebral artery,and basilar artery in the observation group were significantly slower than those before treat-ment and in the control groups(all P<0.05).There was no statistically significant difference in the incidence of adverse reactions during treatment between the two groups(P>0.05).Conclusion Acupuncture at myofascial trigger points com-bined with flunarizine hydrochloride is significantly effective in the treatment of migraine,which can effectively alleviate the pain symptoms of patients,reduce the level of inflammation-related indexes,improve vascular endothelial function and cer-ebral hemodynamics,and the treatment is safe.
基金项目
国家自然科学基金资助项目(82004452)
北京市科学技术学会青年人才托举工程(BYESS2023337)
北京市医院管理局"扬帆"计划重点医学专业(重点扶持专业)(ZYLX202140)
维普
万方数据