| In recent years,the incidence of migraine has become higher.The advantages of traditional Chinese medicine in the prevention and treatment of migraine have been explored further.Chinese medicine has a history of thousands of years in the diagnosis and treatment of migraine,At present,it has been widely used and studied in clinic.Sanpian Decoction from Chen Shiduo in Qing Dynasty has been used for the treatment of migraine and achieved good effect.Therefore,the purpose of this paper is to study the medication rule of traditional Chinese medicine in the treatment of migraine and the sedation of Sanpian Decoction in the treatment of migraine.The pharmacological mechanism provides the basis for improving the diagnosis and treatment of migraine in TCM[Objective]To explore the rule of traditional Chinese medicine in the treatment of migraine and the evidence-based medical of Sanpian Decoction in the treatment of migraine through literature research.To explore the effects of Sanpian Decoction on calcitonin gene related peptide(CGRP),5-hydroxytryptamine(5-HT),interleukin-1 beta(IL-1 beta)in peripheral blood of migraine model rats and the protein and gene expression of CGRP,PENK(proenkephalin,PENK)in trigeminal ganglion and midbrain of migraine model rats.To further explore the pharmacological mechanism of Sanpian Decoction in the treatment of migraine.[Methods]Literature research:(1)By searching the databases of Chinese scientific and technological journals,CNKI full-text databases,Wanfang Medical Network databases electronic journals from January 1989 to March 2018,we collected Chinese herbal decoction for migraine,and observed the clinical efficacy of effective Chinese herbal compound prescriptions for its medication.Cluster analysis was carried out to explore the regularity of compatibility of traditional Chinese medicine in treating migraine.(2)Randomized controlled trials of Sanpian Decoction in the treatment of migraine were collected by searching the databases of Weipu Information Chinese Science and Technology Journal,CNKI Chinese Journal Full Text Database,Wanfang Medical Network Database,PubMed and Springer Electronic Journal from January 1989 to March 2018.Meta-analysis was carried out using Review Mananger 5.3software.Experiment research:24 healthy SD rats of SPF grade are randomly divided into 4 groups:saline control group,migraine model group and sumatriptan succinate group,Sanpian Decoction group.The experimental migraine animal model is established by subcutaneous injection of nitroglycerin on the back of the rats'neck for 3 weeks.After the second injection of nitroglycerin,drug intervention is given.One week later,the rats are sacrificed and the serum and tissues are drawn 2 hours after the third injection of nitroglycerin,and the contents of CGRP,5-HT and IL-1? in peripheral blood of rats in each group are measured by Elisa method;The expression of CGRP and PENK protein in the trigeminal ganglia was tested by Western-blot method;The expression of CGRP and PENK gene in the midbrain was tested Real-Time PCR.[Results]Literature research:(1)The most commonly used drugs for migraine are Rhizome of Chua nxiong,dahurica,liquorice,radices paeoniae alba,Radix Angelicae,Gastrodia elata,Asarum,Bupleurum Bupleurum,Scorpio,Silkworm,Rhynchophylla,Thons.Cluster analysis shows that the commonly used drugs for migraine can be divided into 4categories,including Smooth liver and latent Yang,Improving blood stasis and dredging collaterals,Strengthing qi and blood,Dispelling wind and relieving pain and other drugs.(2)A total of 10 articles were included.The results of Meta analysis showed that Sanpian Decoction could relieve the pain of migraine patients and reduce the pain scores,[RR=1.23,95%CI(1.14,1.31),and P<0.00001],without obvious adverse reactions.Experiment research:(1)The content of serum CGRP in migraine model group increases,which is different from that in saline control group,the difference is statistically significant(P<0.05);The serum CGRP level of migraine model group increases,which is compared with that of sumatriptan succinate group and Sanpian Decoction group(P<0.05);The serum CGRP of Sanpian Decoction group is compared to that of sumatriptan succinate group(P>0.05);The content of 5-HT in the serum of migraine model group decreases,but there is no statistically significant differences between the groups(P>0.05);The content of IL-1? in the serum of migraine model group increases,but there is no statistically significant differences between the groups(P>0.05).(2)the expression of CGRP protein in the trigeminal ganglia in the model group increases,which was compared with the normal saline group(P<0.05).The CGRP protein expression in the trigeminal ganglia in the model group increases,which was compared with the sumatriptan group(P<0.05),and the CGRP protein in the trigeminal ganglia of the model group increases,which was compared with that in the Sanpian Decoction group(P<0.05),and the expression of PENK protein in the trigeminal ganglia in the model group decrease,which was compared with that of the saline group(P>0.05).The expression of PENK protein in the group of sanpian decoction and the sumatriptan group was increased,compared with the model group(P>0.05).(3)The expression of CGRP gene in the midbrain of model group was increased,compared with that of the saline group(P<0.05);the expression of CGRP gene in the midbrain of the model group was increased,compared with the sumatriptan group(P<0.05),and the CGRP gene expression in the midbrain of the model group was increased,compared with that of the Sanpian decoction group(P<0.05),and the expression of PENK protein in the model group was lower than that of the saline group.(P>0.05),the expression of PENK gene in the midbrain of the Sanpian decoction group and the sumatriptan group was higher than that in the model group(P>0.05).[Conclusions](1)The position of migraine in the brain and that is related to the five zang organs,Which is most closely related to the liver.In the process of migraine,the main pathological factors are wind and blood stasis.the main pathogenesis is wind evil attacking collaterals,liver wind movement,phlegm stasis blocking collaterals,deficiency of Qi and blood.(2)Sanpian decoction can effectively treat migraine with no obvious side effects.Because the quality of the literature is not high,it is necessary to carry out more high quality and multicenter randomized controlled trials to support the conclusions.(3)Sanpian Decoction can decrease the expression of CGRP of migraine rats induced by nitroglycerin,increase the content of 5-HT,and decrease the content of IL-1? in peripheral blood,which may also inhibit the transmission of pain information by improving the inflammatory response induced by CGRP.(4)Sanpian decoction can inhibit the protein expression of CGRP in the nociceptive transmission pathway,increase the expression of PENK protein in the trigeminal ganglia,inhibit the expression of CGRP protein in the migraine rat,and inhibit the transmission of pain information,which may have some influence on the analgesic effect of endorphin system.(5)Sanpian decoction can inhibit the gene expression of CGRP in the nociceptive transmission pathway,then,inhibit the transmission of pain information,which may have some influence on the analgesic effect of endorphin system. |
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