柴芩温胆汤治疗前庭性偏头痛  

Chaiqin Wendan Decoction Treating Vestibular Migraine

作　　者：徐进[1] 刘梦琳 张道培 张怀亮[1] XU Jin;LIU Menglin;ZHANG Daopei;ZHANG Huailiang(The First Affiliated Hospital of Henan University of Chinese Medicine/Center for Diagnosis and Treatment of Vertigo in Henan Province/Institute of Vertigo in Henan University of Chinese Medicine,Zhengzhou Henan China 450000;Tianjin University of Chinese Medicine,Tianjin China 300000)

机构地区：[1]河南中医药大学第一附属医院/河南省眩晕病诊疗中心/河南省中医药大学眩晕病研究所,河南郑州450000 [2]天津中医药大学,天津300000

出　　处：《中医学报》2023年第10期2123-2127,共5页Acta Chinese Medicine

基　　金：河南省中医管理局科学研究专项课题项目(2023ZY2024)。

摘　　要：目的:基于少阳三焦理论评价柴芩温胆汤治疗前庭性偏头痛的疗效,并初步探讨该方的潜在作用靶点。方法:采用随机对照的临床试验方法,共收集符合前庭性偏头痛(三焦郁阻证)选择标准的患者66例,按照随机数字表法分为治疗组34例,对照组32例。对照组给予盐酸氟桂利嗪胶囊,治疗组在对照组治疗基础上给予柴芩温胆汤颗粒,两组疗程均为4周。比较两组患者治疗前后中医证候积分、眩晕障碍量表(dizziness handicap inventory,DHI)评分、眩晕发作频次以及潜在作用靶点:血清白细胞介素-6(interleukin-6,IL-6)、降钙素基因相关肽(calcitonin gene-related peptide,CGRP)、内皮素-1(endothelin-1,ET-1)水平,记录治疗期间所有患者出现的不良反应。结果:治疗后,两组患者中医证候积分、DHI评分眩晕发作频率均明显下降(P<0.05);治疗组治疗后中医证候积分、DHI评分显著低于同期对照组(P<0.05)。治疗后,两组患者血清IL-6、CGRP水平均显著下降(P<0.05);治疗组治疗后血清CGRP水平显著低于同期对照组(P<0.05)。结论:以少阳三焦理论为指导,采用柴芩温胆汤治疗三焦郁阻型前庭性偏头痛患者临床疗效显著,能够减少患者眩晕复发次数及眩晕复发持续时间,明显改善患者生活质量,其作用机制可能与降低血清CGRP、ET-1水平有关。Objective:Based on Shaoyang Sanjiao theory,to evaluate the curative effect of modified Chaiqin Wendan Decoction on vestibular migraine,and to preliminarily explore its potential target.Methods:A total of 66 patients with vestibular migraine(triple energizer depression type)were collected by randomized controlled clinical trials,and were randomly divided into treatment group(34 cases)and control group(32 cases).The control group was given flunarizine hydrochloride capsules,and the treatment group was given Jiawei Chaiqin Wendan Decoction granules on the basis of the treatment of the control group.The course of treatment of both groups was 4 weeks.The TCM syndrome score,visual analogue scale(VAS)score,vertigo attack frequency,serum interleukin-6(IL-6)and calcitonin gene-related peptide(CGRP)levels of potential targets were compared between the two groups before and after treatment,and the adverse reactions of all patients during treatment were recorded.Results:After treatment,the scores of TCM syndromes and the frequency of vertigo attacks in the two groups decreased significantly,and the differences were statistically significant(P<0.05).After treatment,the TCM syndrome score of the treatment group was significantly lower than that of the control group(P<0.05).After treatment,the serum levels of IL-6 and CGRP in the two groups decreased significantly,which was statistically significant(P<0.05).The serum CGRP level in the treatment group was significantly lower than that in the control group(P<0.05).Conclusion:Guided by the theory of Shaoyang Sanjiao,modified Chaiqin Wendan Decoction has a significant clinical effect on patients with vestibular migraine with stagnation of Sanjiao,which can reduce the number and duration of vertigo recurrence and obviously improve the quality of life of patients.Its mechanism may be related to the reduction of serum CGRP and ET-1 levels.

关 键 词：前庭性偏头痛 柴芩温胆汤 盐酸氟桂利嗪胶囊 白细胞介素-6 降钙素基因相关肽 少阳三焦理论 

分 类 号：R277.774[医药卫生—中医学]