Addition And Subtraction Of Chuanxiong Tea To Regulate The Effects Of CGRP And ET-1 On Patients With Frequent Episodes Of Migraine (wind And Cold Disturbance)

ObjectiveThrough the modified Chuanxiong Chatiao decoction for frequent attacks of migraineur's(syndrome of wind-cold disturbance)clinical research on the effects of CGRP and ET-1,for the clinical effect of the modified Chuanxiong Chatiao decoction in the treatment and prevention of migraine,providing objective evaluation index.MethodsCases were selected from June 2015 to January 2016,who were treated in neurology department of the Affiliated Hospital of Chengdu University of TCM,the differentiation was the syndrome of wind-cold disturbance in frequent attacks of migraineur.Using random, control method,40 cases were divided into the experimental group and the control group for clinical research.According to the proportion of one to one,each group had 20 cases.The control group was given flunarizine hydrochloride (Xi'an Janssen Pharmaceutical Ltd production, specification: each tablet of 5mg) preventive medicine,5 to 10 mg every time,once per night. Diclofenac sodium double release Intestine-sol Capsule can be used when migraine attacked(Temmler Werke GmbH specification:each tablet of 75mg)ease of therapeutic drugs,75 mg every time,once or twice a day.The experimental group:flunarizine hydrochloride and the modified Chuanxiong Chatiao decoction.The modified Chuanxiong Chatiao decoction,the decoction method is detailed in appendix one. Course of treatment for four weeks.The content of ET-1 and CGRP were tested,the evaluation of TCM syndrome, the efficacy score of migraine,the frequency, duration, and the level of pain score of migraine attacks were evaluated, blood routine,urine routine,stool routine, hepatic parameters, renal function and the examination of ECG were performed each time before and after the treatment.The vital signs were observed during the medication,which to be used as safety evaluation. Follow up for three months after treatment,the evaluation of TCM syndrome,the efficacy score of migraine,the frequency,duration and the level of pains core of migraine attacks were evaluated,to determine the clinical effect and recurrence.Results(1)Comparison of the content of CGRP and ET-1:?Within group comparison:The content of CGRP and ET-1 in the experimental group and the control group reduced than before treatment,there was statistically significant difference within group(P<0.05),after the treatment of four weeks.?Comparison between the experimental group and the control group:There was no statistically significant difference in the content of CGRP between the experimental group and the control group(P> 0.05),but the experimental group downward trend is more obvious.There was statistically significant difference in the content of ET-1 between the experimental group and the control group after the treatment of four weeks(P<0.05),the experimental group reduced more significantly.(2)Comparison of the changes between CGRP and ET-1:?Within group comparison:The changes of CGRP and ET-1 in the experimental group were statistically significant difference than before treatment(P< 0.05),we found that the content of CGRP and ET-1 in the experimental group significantly reduced compared with before treatment.The changes of CGRP and ET-1 in the control group were no statistically significant difference(P>0.05),after the treatment of four weeks. We found that the content of CGRP and ET-1 in the control group were not significantly reduced compared with before treatment.?Comparison between the experimental group and the control group:There were statistically significant differences in the change of CGRP and ET-1 between the experimental group and the control group,after the treatment of four weeks(P< 0.05),we found that compared with the control group, the experimental group reduced more significantly.(3)Therapeutic evaluation:?Within group comparison:The evaluation of TCM syndrome,the efficacy score of migraine,the frequency,the duration and the level of pain score of migraine attacks in the experimental group and the control group were reduced than before treatment, there was statistically significant difference within group(P<0.05),after the treatment of four weeks,we found that the two groups had significant effect.?Comparison between the experimental group and the control group:The evaluation of TCM syndrome,the efficacy score of migraine,the frequency and duration score of migraine attacks between the experimental group and the control group were all decreased,but the experimental group decreased more significantly, there were statistically significant difference between the experimental group and the control group(P<0.05),comparison of the leyel of pain scores between groups, there was no statistically significant difference(P> 0.05),the average score of level of pain in the experimental group was lower than that in the control group,after the treatment of four weeks.we found that the experimental group curative effect was better than the control group.?The analysis of effectiveness of the evaluation of TCM syndrome,the total effective rate of the experimental group was 90%, and the control group was 60%. There was statistically significant difference(P< 0.05),after the treatment of four weeks,we found that the experimental group curative effect was better than the control group.?The analysis of effectiveness of the efficacy score of migraine, the total effective rate of the experimental group was 85%, the control group was 55%,there was statistically significant difference between two groups(P< 0.05),after the treatment of four weeks,we found that the experimental group curative effect was better than the control group.(4)Safety evaluation:?Before and after the treatment,blood routine,urine routine,stool routine, hepatic parameters,renal function,ECG examination showed no obvious abnormality (P>0.05).?There was no statistically significant difference in vital signs between the two groups (P>0.05).?There was no statistically significant difference in adverse reactions between two groups(P>0.05).(5)Follow-up situation:?Within group comparison:There was statistically significant difference in the evaluation of TCM syndrome,the efficacy score of migraine within two groups, between the treatment of four weeks ago and after three months follow-up(P< 0.05),there was a long-term effect in the experimental group,there was no statistically significant difference within the control group(P> 0.05),the long-term effect of the control group was not significant. There was statistically significant difference in the frequency,the duration and the level of pain score of migraine attacks within two groups, between the treatment of four weeks ago and after three months follow-up(P <0.05),there were long-term effect in two groups.?Comparison between the experimental group and the control group:There was statistically significant difference in the evaluation of TCM syndrome,the efficacy score of migraine,the frequency and duration score of migraine attacks between the two groups,after three months follow-up(P< 0.05), comparison of the level of pain scores between groups, there was no statistically significant difference(P>0.05),the average score of level of pain in the experimental group was lower than that in the control group.In the experimental group, the average score of the evaluation of TCM syndrome,efficacy score of migraine,the frequency, the duration, and the level of pain score of migraine attacks was lower than the control group,after three months follow-up, the long-term effect of the experimental group was better than that of the control group.Above all,we found that two groups have preventive effect, compared with the control group, the experimental group can effectively prevent the recurrence and reduce the recurrence rate of migraine.Conclusion(1)The modified Chuanxiong Chatiao decoction can effectively improve the frequent attacks of migraineur's(syndrome of wind-cold disturbance)symptom.(2)We speculate that compatibility component of the modified Chuanxiong Chatiao decoction may affect the expression of CGRP and ET-l's gene, so as to it can achieve the prevention and treatment of migraine.(3)The modified Chuanxiong Chatiao decoction in the treatment of migraineur (syndrome of wind-cold disturbance)at the same time, it can effectively prevent the recurrence of migraine,combined with the modern medicine of migraine, preventive effect can be enhanced.