目的 探討丹珍頭痛膠囊聯(lián)合倍他司汀治療血管痙攣性頭痛的臨床療效。方法 選取2021年3月—2022年3月在北京中醫(yī)醫(yī)院懷柔醫(yī)院接受治療的102例血管痙攣性頭痛患者為研究對(duì)象，根據(jù)用藥差別分為對(duì)照組和治療組，每組各51例。對(duì)照組口服鹽酸倍他司汀片，10 mg/次，3次/d；治療組在對(duì)照組治療基礎(chǔ)上口服丹珍頭痛膠囊，2 g/次，3次/d。兩組均連續(xù)治療2周。觀(guān)察兩組的臨床療效，比較兩組相關(guān)評(píng)分、癥狀改善情況、血清細(xì)胞因子和血流動(dòng)力學(xué)的變化情況。結(jié)果 治療組總有效率是98.04%，顯著高于對(duì)照組的80.39%（P<0.05）。治療后，兩組視覺(jué)模擬（VAS）評(píng)分較治療前顯著降低，而格拉斯哥預(yù)后（GOS）評(píng)分、明尼蘇達(dá)滿(mǎn)意度量表（MSQ）評(píng)分、匹茲堡睡眠質(zhì)量指數(shù)（PSQI）評(píng)分、生活質(zhì)量綜合評(píng)定問(wèn)卷（GQOLI-74）評(píng)分均顯著升高（P<0.05）；治療后，治療組相關(guān)評(píng)分改善優(yōu)于對(duì)照組（P<0.05）。治療后，兩組頭痛發(fā)作次數(shù)、頭痛持續(xù)時(shí)間均較治療前顯著降低（P<0.05），并以治療組改善的更為明顯（P<0.05）。治療后，兩組血清降鈣素基因相關(guān)肽（CGRP）、蛋白激酶C（PKC）、基質(zhì)金屬蛋白酶（MMP-9）、垂體腺苷酸環(huán)化酶激活肽（PACAP）、細(xì)胞間黏附分子-1（ICAM-1）水平均顯著降低（P<0.05），并以治療組下降的更明顯（P<0.05）。治療后，左側(cè)腦中動(dòng)脈（LMCA）、左側(cè)大腦后動(dòng)脈（LPCA）、左側(cè)大腦前動(dòng)脈（LACA）、右側(cè)大腦中動(dòng)脈（RMCA）、右側(cè)大腦前動(dòng)脈（RACA）、右側(cè)大腦后動(dòng)脈（RPCA）平均血流流速度均較治療前顯著升高（P<0.05），并以治療組升高的更明顯（P<0.05）。結(jié)論 丹珍頭痛膠囊聯(lián)合倍他司汀治療血管痙攣性頭痛可有效改善患者頭痛癥狀，改善機(jī)體細(xì)胞因子及血流動(dòng)力學(xué)情況，促進(jìn)睡眠和生活質(zhì)量改善，具有良好臨床應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of Danzhen Toutou Capsules combined with betahistine in treatment of vasospasm headache. Methods A total of 102 patients with vasospastic headache who were treated in Beijing Hospital of Traditional Chinese Medicine Huairou Hospital from March 2021 to March 2022 were selected as the research objects, and they were divided into control group and treatment group according to medication difference, with 51 cases in each group. Patients in the control group were po administered with Betahistine Hydrochloride Tablets, 10 mg/time, three times daily. Patients in the treatment group were po administered with Danzhen Toutou Capsules on the basis of the control group, 2 g/time, three times daily. Both groups were treated for 2 weeks. The clinical efficacy of the two groups were observed, and the correlation scores, symptom improvement, serum cytokines and hemodynamics were compared between the two groups. Results After treatment, the total effective rate of treatment group was 98.04%, significantly higher than that of control group 80.39% (P < 0.05). After treatment, visual analog scale (VAS) was significantly decreased in both groups compared with before treatment, while GOS, MSQ, PSQI and GQOLI-74 scores were significantly increased (P < 0.05). After treatment, the improvement of correlation score in the treatment group was better than that in the control group (P< 0.05). After treatment, the frequency and duration of headache in both groups were significantly decreased compared with before treatment (P< 0.05), and the improvement was more obvious in the treatment group (P< 0.05). After treatment, the levels of serum calcitonin gene-related peptide (CGRP), protein kinase C (PKC), matrix metalloproteinase (MMP-9), pituitary adenylate cyclase activating peptide (PACAP) and intercellular adhesion molecule-1 (ICAM-1) in two groups were significantly decreased (P< 0.05). The decrease was more obvious in the treatment group (P < 0.05). After treatment, the average blood flow velocity of left cerebral artery (LMCA), left posterior cerebral artery (LPCA), left anterior cerebral artery (LACA), right middle cerebral artery (RMCA), right anterior cerebral artery (RACA) and right posterior cerebral artery (RPCA) was significantly increased compared with that before treatment (P < 0.05). The increase was more obvious in the treatment group (P < 0.05). Conclusion Danzhen Toutou Capsules combined with betahistine can effectively improve vasospasm headache symptoms, and can improve cytokines, hemodynamics, and sleep and life quality, which has good clinical application value.

R971

國(guó)家中醫(yī)藥管理局國(guó)家中醫(yī)臨床基地業(yè)務(wù)建設(shè)科研專(zhuān)項(xiàng)（JDZX2015043）