平肝潜阳药物对偏头痛肝阳上亢证患者的临床疗效及其对血淋巴细胞蛋白质表达的影响  

Herbs for calming liver and suppressing liver-yang in treatment of migraine with hyperactive liver-yang sydrome and its effects on lymphocyte protein expression:a randomized controlled trial

作　　者：钟广伟[1] 李炜[1] 罗艳红[2] 陈国林[1] 易振佳[1] 胡建军[1] 张莺[1] 尹耀慧[1] 张乐[3] 

机构地区：[1]中南大学湘雅医院中西医结合研究所,湖南长沙410008 [2]中南大学湘雅医院急诊科,湖南长沙410008 [3]中南大学湘雅医院神经内科,湖南长沙410008

出　　处：《中西医结合学报》2009年第1期25-33,共9页Journal of Chinese Integrative Medicine

基　　金：国家自然科学基金资助项目(No.30500644;No.30472115)

摘　　要：目的:观察平肝潜阳药物对偏头痛肝阳上亢证患者的临床疗效和对血淋巴细胞蛋白质表达的影响,为深入研究偏头痛肝阳上亢证病理生理机制及平肝潜阳法治疗作用的分子机制奠定基础。方法:32例偏头痛肝阳上亢证患者随机分为治疗组和对照组。治疗组口服平肝潜阳方,对照组口服氟桂利嗪片剂。治疗2个疗程。观察患者治疗前后的中医症状积分、止痛疗效和不良反应;采用双向凝胶电泳、基质辅助激光解吸电离-飞行时间质谱法分离和鉴定偏头痛患者外周血淋巴细胞和正常人之间差异蛋白表达,并观察应用平肝潜阳方干预后,各组差异蛋白质表达水平的变化。结果:平肝潜阳方有明显止痛效果(87.5%),与氟桂利嗪片(75.0%)比较,差异有统计学意义(P<0.01);以改善眩晕、烦躁易怒和面部烘热症状更为明显(P<0.05)。两组中医症状积分均降低(P<0.01),其中以治疗组更为明显(P<0.01),治疗组未出现明显不良反应。正常人、平肝潜阳方治疗组偏头痛肝阳上亢证患者治疗前和治疗后血淋巴细胞凝胶蛋白质点数依次为534±42、552±54和529±55。平肝潜阳方治疗组偏头痛肝阳上亢证患者与正常人比较有6个蛋白质表达下调,14个蛋白质表达上调;平肝潜阳方治疗组偏头痛肝阳上亢证患者治疗前后比较发现表达下调的6个蛋白质中有4个表达增强,而表达上调的14个蛋白质中有11个表达降低。共得到12个肽质量指纹图谱,2个无质谱结果,搜索到10个具有统计学意义的蛋白质,主要有通道蛋白、抗氧化蛋白、细胞信号转导蛋白、代谢相关蛋白和免疫相关蛋白等。结论:平肝潜阳中药复方有良好的止痛作用,能改善中医症状;可能通过调节部分血淋巴细胞蛋白质的表达治疗偏头痛肝阳上亢证。Objective： To observe the efficacy of herbs for calming liver and suppressing liver-yang in treatment of migraine patients with hyperactivity of liver-yang syndrome and to investigate its effects on the lymphocyte protein expression. This approach may lay a foundation for the further investigation of pathogenic mechanisms in migraine with hyperactive liver-yang sydrome and the curative mechanisms of calming liver and suppressing liver-yang treatment. Methods： A total of 32 migraine patients with hyperactivity of liver-yang syndrome were randomly divided into treatment group （16 cases） and control group （16 cases）. The patients in the treatment group were treated with herbs for calming liver and suppressing liver-yang in accordance with traditional Chinese medicine （TCM） theory and the patients in the control group were treated with Flunarizine Capsules for two courses of treatment. The therapeutic effects, the score of TCM symptom and the changes of headache attack were observed in both groups before and after the treatment. The side effects were also observed in both groups. The level of differential protein expression was analyzed by two-dimensional electrophoresis and matrix- assisted laser desorption/ionization time-of-flight mass spectrometry （MALDt-TOF-MS）. Results： The herbs for calming liver and suppressing liver-yang had better effects on headache improvement than the FlunarizineCapsules （P〈O.O1）. The cure rates in the treatment and control groups were 87.5% and 75.0% respectively. Vertigo, restlessness and tantrum, and prosopo-heat in the treatment group were also improved as compared with those in the control group （P〈0.05）. After treatment, the score of TCM symptom in the two groups were all decreased （P〈O. 01）, and there was a significant difference between the treatment group and the control group （P〈O.O1）. The herbs for calming liver and suppressing liver-yang had no side effects. The average protein spots in the blood lymphocyte of normal people, migra

关 键 词：平肝 潜阳 肝阳上亢 蛋白质组学 偏头痛 随机对照试验 

分 类 号：R277.7[医药卫生—中医学]