目的 研究天麻頭痛片聯(lián)合佐米曲普坦治療偏頭痛的臨床效果。方法 選取2021年6月—2022年6月鄭州市第三人民醫(yī)院收治的偏頭痛患者共80例為研究對(duì)象，按照隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各40例。對(duì)照組患者口服佐米曲普坦片，2.5 mg/次，1次/d。如首次服藥后頭痛癥狀持續(xù)，可于2 h后再服2.5 mg，每日最大劑量不超過15 mg。治療組在對(duì)照組基礎(chǔ)上口服天麻頭痛片，4片/次，3次/d。如癥狀改善不佳，可增1片/次，每次口服劑量不超過6片，每日不超過18片。兩組均連續(xù)服藥3個(gè)月。觀察兩組的臨床療效，比較兩組癥狀改善情況和血清因子變化情況。結(jié)果 治療后，治療組總有效率是95.00%，顯著高于對(duì)照組的77.50%（P＜0.05）。治療后，兩組偏頭痛發(fā)作次數(shù)、持續(xù)時(shí)間及視覺模擬（VAS）評(píng)分均較治療前顯著降低（P＜0.05）；且治療后，治療組偏頭痛發(fā)作次數(shù)、持續(xù)時(shí)間及VAS評(píng)分均低于對(duì)照組（P＜0.05）。治療后，兩組血清載脂蛋白（LPA）、腫瘤壞死因子-α（TNF-α）、血清內(nèi)皮素-1（ET-1）及一氧化氮（NO）水平均較治療前顯著降低，而5-羥色胺（5-HT）水平顯著升高（P＜0.05）；治療后，治療組患者LPA、TNF-α、ET-1、NO水平低于對(duì)照組，5-HT高于對(duì)照組（P＜0.05）。結(jié)論 天麻頭痛片聯(lián)合佐米曲普坦能夠顯著改善偏頭痛患者的臨床癥狀，調(diào)節(jié)血清因子水平，且不增加不良反應(yīng)發(fā)生率，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To study the clinical effect of Tianma Toutong Tablets combined with zolmitriptan in treatment of migraine. Methods A total of 80 migraine patients admitted to the Third People’s Hospital of Zhengzhou from June 2021 to June 2022 were selected as the study objects. According to the random number table method, all patients were divided into control group and treatment group, with 40 cases in each group. Patients in the control group were po administered with Zolmitriptan Tablets, 2.5 mg/time, once daily. If headache symptoms persist after the first dosage, take another 2.5 mg 2 h later and the maximum daily dosage should not exceed 15 mg. Patients in the treatment group were po administered with Tianma Toutong Tablets on the basis of the control group, 4 tablets/time, 3 times daily. If symptoms do not improve well, add 1 tablet/time, each oral dosage is not more than 6 tablets, not more than 18 tablets a day. Both groups took the drug continuously for 3 months. The clinical efficacy of the two groups was observed, and the improvement of symptoms and changes of serum factors were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 95.00%, which was significantly higher than that of the control group (77.50%) (P < 0.05). After treatment, the number of migraine attacks, duration, and visual analog scale (VAS) scores in both groups were significantly decreased compared with those before treatment (P < 0.05). After treatment, the frequency, duration and VAS score of migraine in the treatment group were lower than those in the control group (P < 0.05). After treatment, serum apolipoprotein (LPA), tumor necrosis factor-α (TNF-α), serum endothelin-1 (ET-1), and nitric oxide (NO) levels in two groups were significantly decreased compared with before treatment, but 5-hydroxytryptamine (5-HT) levels were significantly increased (P < 0.05). After treatment, the levels of LPA, TNF-α, ET-1 and NO in the treatment group were lower than those in the control group, but the levels of 5-HT was higher than that in the control group (P < 0.05). Conclusion Tianma Toutong Tablets combined with zolmitriptan can significantly improve the clinical symptoms of migraine patients, and can regulate the level of serum factors, and does not increase the incidence of adverse reactions, which has a certain clinical application value.

R971

河南省科技攻關(guān)項(xiàng)目（182102310172）