本文關鍵詞： 脈血康膠囊 偏頭痛 血瘀型 溶血磷脂酸 內皮素-1　出處：《福建中醫(yī)藥大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：本課題通過臨床研究血瘀型偏頭痛患者血漿溶血磷脂酸(LPA)及內皮素(ET-1)水平,從而對偏頭痛的機制進行進一步的探討。通過急性發(fā)作期給予中藥脈血康膠囊干預治療觀察LPA及ET-1水平變化,試圖尋找另一種適用于偏頭痛急性期的中成用藥。 研究方法：本研究采用隨機平行對照方法,入組80例急性發(fā)作血瘀型偏頭痛(中度程度頭痛)患者。按照隨機數字表法分為常規(guī)治療組(38例)和脈血康治療組(42例)。常規(guī)治療組方案：氟桂利嗪5mg qn；脈血康治療組方案：氟桂利嗪5mg qn+脈血康膠囊(2粒／次、3次／日),兩組患者均連續(xù)服藥28天。兩組患者分別在就診次日、服藥14天、28天進行頭痛量表評分、頭痛程度VAS評分、抽血檢測血漿LPA和ET-1水平。測定同期健康人群LPA和ET-120例作為正常對照組。 結果：1.血瘀型偏頭痛急性期患者血漿LPA及ET-1水平較正常對照組升高,差異有統(tǒng)計學意義(P0.05)。2.血瘀型偏頭痛急性發(fā)作3天內LPA及ET-1水平較發(fā)作14天、28天后明顯升高,差異有統(tǒng)計學意義(P0.05)。.3.急性發(fā)作期脈血康治療組較常規(guī)治療組臨床療效更好,頭痛量表評分及頭痛程度VAS評分下降更顯著,差異有統(tǒng)計學意義(P0.05)。4.兩組患者14天、28天時血漿LPA及ET-1,與治療前比較均有下降,脈血康治療組與常規(guī)治療組比較降低更明顯,差異均有統(tǒng)計學意義(P0.05),14天時兩組患者血漿LPA仍高于正常對照組,與正常對照組比較差異有統(tǒng)計學意義(P0.05)；14天時脈血康治療組血漿ET-1與正常對照組比較差異無統(tǒng)計學意義(p0.05),常規(guī)治療組ET-1仍高于正常對照組,與正常對照組比較差異有統(tǒng)計學意義(P0.05)。兩組患者服藥28天后血漿LPA及ET-1水平均接近正常對照組,與正常對照組比較差異均無統(tǒng)計學意義(P0.05)。 結論：1.血瘀型偏頭痛急性期患者血漿溶血磷脂酸及內皮素-1水平較正常人群高。2.脈血康膠囊能降低血瘀型偏頭痛急性發(fā)作期患者頭痛量表評分及頭痛程度評分。3.脈血康膠囊能降低血瘀型偏頭痛急性發(fā)作期患者血漿LPA及ET-1水平。4.血瘀型偏頭痛急性發(fā)作期患者LPA與ET-1水平同時升高,提示偏頭痛急性發(fā)作期患者可能同時存在血小板活化、內皮損傷及血管舒縮障礙。
[Abstract]:Objective: to study the levels of plasma lysophosphatidic acid (LPA) and endothelin (et 1) in patients with migraine with blood stasis type. Therefore, the mechanism of migraine was further discussed. The changes of LPA and ET-1 levels were observed by the intervention therapy of Mai Xue Kang capsule during acute attack, in order to find another medium medicine suitable for migraine acute phase. Methods: a randomized parallel control method was used in this study. 80 patients with acute attack of blood stasis type migraine (moderate degree headache) were divided into routine treatment group (n = 38) and mai xuekang treatment group (n = 42). Routine treatment group: flunarizine 5 mg QN; mai xue Kang. The treatment group was treated with flunarizine 5 mg QN Mai Xue Kang capsule 2 capsules / time 3 times a day. The patients in both groups were treated continuously for 28 days. The scores of headache scale, VAS score of headache degree, plasma LPA and ET-1 levels were measured in 14 days and 28 days after taking medicine, and LPA and ET-120 were measured as normal control group in the same period. Results 1. The levels of plasma LPA and ET-1 in patients with acute migraine of blood stasis type were significantly higher than those in the control group (P 0.05). The levels of LPA and ET-1 in acute migraine of blood stasis type were significantly higher than those in 14 days and 28 days after onset of migraine with blood stasis. The difference was statistically significant (P 0.05) .3.The clinical efficacy of Mai Xue Kang group was better than that of routine treatment group, and the score of headache scale and the VAS score of headache degree decreased more significantly. There was a significant difference in plasma LPA and ET-1 between the two groups at 14 days and 28 days after treatment. The plasma LPA and ET-1 levels in the two groups were significantly lower than those before treatment, and those in the Maoxuekang group were significantly lower than those in the routine treatment group. There were significant differences in plasma LPA between the two groups on the 14th day of P0.05, and the plasma LPA in the two groups was still higher than that in the normal control group. There was no significant difference in plasma ET-1 between the control group and the normal control group at 14 days after treatment. The ET-1 of the routine treatment group was still higher than that of the normal control group. The plasma LPA and ET-1 levels in the two groups were similar to those in the normal control group after 28 days, but there was no significant difference between the two groups. Conclusion 1.The plasma levels of lysophosphatidic acid and endothelin-1 in patients with acute migraine of blood stasis type are higher than those in normal people. Meisuekang capsule can reduce the score of headache scale and headache degree in patients with acute migraine of blood stasis type. 3.Mai Xue Kang capsule can reduce the levels of plasma LPA and ET-1 in patients with migraine of blood stasis type. 4. The levels of LPA and ET-1 in patients with acute attack of migraine of blood stasis type increased at the same time. The results suggest that there may be platelet activation, endothelial injury and vasomotor dysfunction in patients with migraine during acute attack.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R747.2

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