天宁饮类方对不同证型偏头痛血流动力学及血清TNF-α含量的影响
Impact of Tianning Yin Categorized Formula on Hemodynamics and TNF-α Content of Migraine Patients of Different Syndromes
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摘要: 目的 通过观察天宁饮类方对4种证型偏头痛患者头痛、测定-6（HIT-6）评分、颅内平均血流速度（Vm）及血清肿瘤坏死因子（TNF-α）水平的影响，了解其疗效及作用机制。方法 随机将200例偏头痛患者分为中药组与西比灵组各100例。根据四诊分为风痰瘀阻证、风痰瘀阻兼肝阳上亢证、风痰瘀阻兼气血亏虚证、风痰瘀阻兼肝肾阴虚证4型，中药组予相应的天宁饮类方，西比灵组予西比灵口服。均连续治疗2个疗程，每疗程15 d。观察同一证型患者头痛的缓解状况、Vm及血清TNF-α含量的变化。结果 ①治疗后2组患者HIT-6评分较前均明显下降（P<0.05~0.01），中药组更优（P<0.05~0.01）；②治疗后2组患者大脑前、中、后动脉及基底动脉的Vm较前均下降（P<0.05~0.01），中药组更优(P<0.05~0.01)；③治疗后2组患者血清TNF-α较前均下降（P<0.05~0.01），中药组更优（P<0.05~0.01）。结论 天宁饮类方改善不同证型偏头痛患者的症状，其作用机制与调节患者的颅内血流速度及血清TNF-α水平有关。Abstract: OBJECTIVE To explore the curative effects and action mechanism of Tianning Yin categorized formula by observing its impact on headache influence test-6 (HIT-6) score， Intracranial mean blood flow velocity (Vm) and tumor necrosis factor (TNF-α) level of migraine patients of four kinds of syndromes. METHODS 200 migraine patients were randomly divided into the Chinese medicine group and the flunarizine group， and 100 cases in each group. According to the four diagnosis， the migraines were divided into four syndromes including the syndrome of wind phlegm and blood stasis， syndrome of wind phlegm and blood stasis combined with hyperactivity of liver yang， syndrome of wind phlegm and blood stasis combined with deficiency of qi and blood， syndrome of wind phlegm and blood stasis combined with yin deficiency of liver and kidney. The Chinese medicine group was treated with Tianning Yin categorized formula， and the flunarizine group was intervened by orally taking flunarizine (flunarizine hydrochloride capsules). Both groups were continuously treated for two courses， 15 d for each course. Relief of headache， changes of Vm and TNF-α content of the same syndrome were observed. RESULTS ①After the treatment， HIT-6 scores of patients in both groups were significantly decreased than those of the pre-treatment， and the Chinese medicine group was better (P<0.05， P<0.01). ②After the treatment， Vm of the anterior， middle， posterior， and basilar arteries of the brain in both group were decreased compared with those of the pre-treatment， and the Chinese medicine group was better (P<0.05， P<0.01). ③After the treatment， TNF-α levels of patients in both group were decreased compared with those of the pre-treatment， and the Chinese medicine group was better (P<0.05， P<0.01). CONCLUSION Tianning Yin categorized formula can improve the symptoms of patients with migraine of different syndromes， and its action mechanism is correlating with the regulation of patients' intracranial blood flow velocity and TNF-α level.
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Key words:
- Tianning Yin categorized formula /
- migraine /
- different syndromes /
- HIT-6 score /
- Vm /
- TNF-α
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