目的 探讨丹珍头痛胶囊联合倍他司汀治疗血管痉挛性头痛的临床疗效。方法 选取2021年3月—2022年3月在北京中医医院怀柔医院接受治疗的102例血管痉挛性头痛患者为研究对象，根据用药差别分为对照组和治疗组，每组各51例。对照组口服盐酸倍他司汀片，10 mg/次，3次/d；治疗组在对照组治疗基础上口服丹珍头痛胶囊，2 g/次，3次/d。两组均连续治疗2周。观察两组的临床疗效，比较两组相关评分、症状改善情况、血清细胞因子和血流动力学的变化情况。结果 治疗组总有效率是98.04%，显著高于对照组的80.39%（P<0.05）。治疗后，两组视觉模拟（VAS）评分较治疗前显著降低，而格拉斯哥预后（GOS）评分、明尼苏达满意度量表（MSQ）评分、匹兹堡睡眠质量指数（PSQI）评分、生活质量综合评定问卷（GQOLI-74）评分均显著升高（P<0.05）；治疗后，治疗组相关评分改善优于对照组（P<0.05）。治疗后，两组头痛发作次数、头痛持续时间均较治疗前显著降低（P<0.05），并以治疗组改善的更为明显（P<0.05）。治疗后，两组血清降钙素基因相关肽（CGRP）、蛋白激酶C（PKC）、基质金属蛋白酶（MMP-9）、垂体腺苷酸环化酶激活肽（PACAP）、细胞间黏附分子-1（ICAM-1）水平均显著降低（P<0.05），并以治疗组下降的更明显（P<0.05）。治疗后，左侧脑中动脉（LMCA）、左侧大脑后动脉（LPCA）、左侧大脑前动脉（LACA）、右侧大脑中动脉（RMCA）、右侧大脑前动脉（RACA）、右侧大脑后动脉（RPCA）平均血流流速度均较治疗前显著升高（P<0.05），并以治疗组升高的更明显（P<0.05）。结论 丹珍头痛胶囊联合倍他司汀治疗血管痉挛性头痛可有效改善患者头痛症状，改善机体细胞因子及血流动力学情况，促进睡眠和生活质量改善，具有良好临床应用价值。

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

国家中医药管理局国家中医临床基地业务建设科研专项（JDZX2015043）