清肝解郁优化方治疗偏头痛的临床疗效及对免疫炎症指标的影响  

Clinical Efficacy of Optimized Qinggan Jieyu Formula in the Treatment of Migraine and Its Influence on Immune Inflammation Indicators

作　　者：郝同 周波 刘娴 程正果 曹克刚[1,4] HAO Tong;ZHOU Bo;LIU Xian;CHENG Zhengguo;CAO Kegang(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Beijing Xiaotangshan Hospital,Beijing 102211,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Institute for Brain Disorders,Beijing University of Chinese Medicine,Beijing 100027,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京小汤山医院,北京102211 [3]中国中医科学院西苑医院,北京100091 [4]北京中医药大学中医脑病研究院,北京100027

出　　处：《世界中医药》2024年第16期2473-2478,共6页World Chinese Medicine

基　　金：2022年青年岐黄学者培养项目(国中医药人教函〔2022〕256号);第四批全国优秀中医临床人才项目(国中医药人教发〔2017〕24号)。

摘　　要：目的:观察清肝解郁优化方治疗偏头痛患者的临床疗效及对免疫炎症相关指标的影响。方法:观察应用清肝解郁优化方干预肝郁化热证偏头痛患者前后的头痛变化情况;对肝郁化热证偏头痛患者用药前后、非肝郁化热证偏头痛患者及健康人血清免疫炎症相关指标白细胞介素-1β(IL-1β)、白细胞介素细胞-6(IL-6)、肿瘤坏死因子-α(TNF-α)进行分析,探究3组免疫炎症相关指标的差异。结果:与用药前比较,应用清肝解郁优化方治疗后的肝郁化热证偏头痛患者头痛发作次数、天数及总持续时间下降,差异均有统计学意义(均P<0.05);患者报告结局评价(PRO)量表中的头痛情况、躯体症状、精神心理状态、功能状态及PRO总分均有所下降,差异均有统计学意义(均P<0.05);肝郁化热证诊断量表评分下降,差异有统计学意义(P<0.05)。与健康组比较,肝郁化热证偏头痛患者血清IL-1β、IL-6、TNF-α含量较高,差异均有统计学意义(均P<0.05);非肝郁化热证偏头痛患者血清IL-1β含量升高,差异有统计学意义(P<0.05)。与非肝郁化热证偏头痛患者比较,肝郁化热证偏头痛患者血清IL-6、TNF-α含量较高,差异均有统计学意义(均P<0.05)。结论:清肝解郁方能够有效缓解偏头痛患者的头痛病情,改善肝郁化热证患者的相关症状;肝郁化热证偏头痛患者可能存在免疫炎症相关指标的异常。Objective:To study the clinical efficacy of optimized Qinggan Jieyu Formula in the treatment of migraine and its effect on immune inflammation indicators.Methods:Optimized Qinggan Jieyu Formula was used to treat migraine patients with the syndrome of liver depression transforming into heat,and the changes of headache were observed.The serum immune inflammation indicators,including interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α),were analyzed for migraine patients with the syndrome of liver depression transforming into heat before and after medication,migraine patients without the syndrome,and healthy people to explore the differences in the immune inflammation indicators in the three groups.Results:After the treatment with optimized Qinggan Jieyu Formula,the frequency,days,and total duration of headache in migraine patients with the syndrome of liver depression transforming into heat were decreased(P<0.05).In the patient-reported outcome(PRO)scale,the results of headache,physical symptoms,mental and psychological status,functional status,and the PRO total score decreased(P<0.05).The score of the diagnostic scale for syndrome of liver depression transforming into heat decreased(P<0.05).Compared with the healthy group,the migraine patients with the syndrome had higher serum levels of IL-1β,IL-6,and TNF-α(P<0.05).The serum level of IL-1βin migraine patients without the syndrome was increased(P<0.05).Compared with migraine patients without the syndrome,those with the syndrome had higher serum levels of IL-6 and TNF-α(P<0.05).Conclusion:Qinggan Jieyu Formula can effectively relieve the headache of migraine patients and improve the related symptoms of patients with the syndrome of liver depression transforming into heat.Migraine patients with the syndrome may have abnormal immune inflammation indicators.

关 键 词：清肝解郁优化方 肝郁化热证 偏头痛 临床疗效 白细胞介素-1Β 白细胞介素细胞-6 肿瘤坏死因子-α 

分 类 号：R255.9[医药卫生—中医内科学]