目的 探討?zhàn)B血清腦顆粒聯(lián)合苯噻啶治療偏頭痛的臨床療效。方法 選取2021年11月—2023年2月河北北方學(xué)院附屬第一醫(yī)院收治的122例偏頭痛患者，按隨機數(shù)字表法將所有患者分為對照組和治療組，每組各61例。對照組口服苯噻啶片，第1～3天，0.5 mg/次，1次/d，晚間服用；第4～6天，0.5 mg/次，2次/d，中午和晚間服用；第7天起，0.5 mg/次，3次/d；若病情基本控制，則酌情遞減0.5 mg/周至適當(dāng)劑量維持，若遞減后病情有加重趨勢再酌情增量。治療組在對照組治療基礎(chǔ)上口服養(yǎng)血清腦顆粒，1袋/次，3次/d。兩組療程均為8周。觀察兩組臨床療效，比較治療前后兩組頭痛發(fā)作情況、癥狀積分、顱內(nèi)動脈血流動力學(xué)指標(biāo)及血清高敏C反應(yīng)蛋白（hs-CRP）、5-羥色胺（5-HT）、降鈣素基因相關(guān)肽（CGRP）、內(nèi)皮素-1（ET-1）水平。結(jié)果 治療后，治療組總有效率是95.08%，較對照組的83.61%顯著提高（P＜0.05）。治療后，兩組發(fā)作次數(shù)、頭痛視覺模擬量表（VAS）評分、持續(xù)時間均較治療前顯著降低（P＜0.05）；且治療后，治療組發(fā)作次數(shù)、頭痛VAS評分、持續(xù)時間均低于對照組（P＜0.05）。治療后，兩組發(fā)作次數(shù)積分、頭痛程度積分、持續(xù)時間積分、伴隨癥狀積分及其總積分均顯著降低（P＜0.05）；且治療后，治療組癥狀積分顯著低于對照組（P＜0.05）。治療后，兩組大腦中動脈平均血流速度（V_m）均顯著降低，而動脈搏動指數(shù)（PI）均顯著增加（P＜0.05）；且治療后，治療組大腦中動脈V_m低于對照組，PI高于對照組（P＜0.05）。治療后，兩組血清hs-CRP、CGRP、ET-1水平均顯著下降，而血清5-HT水平均顯著上升（P＜0.05）；且治療后，治療組hs-CRP、CGRP、ET-1水平均顯著低于對照組，5-HT水平均顯著高于對照組（P＜0.05）。結(jié)論 養(yǎng)血清腦顆粒聯(lián)合苯噻啶治療偏頭痛有較好的臨床療效，能有效促進頭痛發(fā)作的緩解和癥狀減輕，使機體炎癥反應(yīng)、血管舒縮及疼痛感知異常得到控制，具有良好的療效及安全性，值得臨床推廣應(yīng)用。

Objective To explore the clinical efficacy of Yangxue Qingnao Granules combined with pizotifen in treatment of migraine. Method A total of 122 migraine patients admitted to the First Affiliated Hospital of Hebei North University from November 2021 to February 2023 were selected and divided into control group and treatment group according to random number table method, with 61 patients in each group. Patients in the control group were po administered with Pizotifen Tablets, 0.5 mg/time, once daily, at night on the 1st to 3rd day, on the 4th to 6th day, 0.5 mg/time, twice daily, from the 7th day at noon and evening, 0.5 mg/time, 3 times daily. If the disease was basically controlled, decreasing by 0.5 mg/week as appropriate to maintain the appropriate dosage. If the disease had a worsening trend after the decrease, then increase as appropriate. Patients in the treatment group were po administered with Yangxue Qingnao Granules on the basis of the control group, 1 bag/time, 3 times daily. The treatment course of both groups was 8 weeks. The clinical effects of the two groups were observed, and the headache onset, symptom score, intracranial arterial hemodynamics indexes and serum levels of high sensitive C-reactive protein (hs-CRP), 5-hydroxytrypsin (5-HT), calcitonin gene-related peptide (CGRP) andendothelin-1 (ET-1) were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 95.08%, which was significantly higher than that of the control group (83.61%, P < 0.05). After treatment, the frequency of attacks, visual analogue scale (VAS) score and duration of headache in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the frequency of attack, VAS score and duration of headache in the treatment group were lower than those in the control group (P < 0.05). After treatment, the score of the number of attacks, the score of headache degree, the score of duration, the score of accompanying symptoms and the total score of the two groups were significantly decreased (P < 0.05). After treatment, the symptom score of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the mean blood flow velocity (V_m) of middle cerebral artery was significantly decreased, while the arterial pulsation index (PI) was significantly increased in both groups (P < 0.05). After treatment, the V_m of middle cerebral artery in treatment group was lower than that in control group, and PI was higher than that in control group (P < 0.05). After treatment, serum hs-CRP, CGRP and ET-1 levels were significantly decreased, but serum 5-HT levels were significantly increased in two groups (P < 0.05). After treatment, serum hs-CRP, CGRP and ET-1 levels in treatment group were significantly lower than those in control group, but 5-HT levels were significantly higher than those in control group (P < 0.05). Conclusion Yangxue Qingnao Granules combined with pizotifen has good clinical efficacy in treatment of migraine, and can effectively promote the relief of headache and symptoms, and control the inflammatory response, vasomotor and pain perception with good efficacy and safety, which is worthy of clinical application.

R971

張家口市重點研發(fā)計劃項目（2121173D）