目的 研究天麻头痛片联合佐米曲普坦治疗偏头痛的临床效果。方法 选取2021年6月—2022年6月郑州市第三人民医院收治的偏头痛患者共80例为研究对象，按照随机数字表法将所有患者分为对照组和治疗组，每组各40例。对照组患者口服佐米曲普坦片，2.5 mg/次，1次/d。如首次服药后头痛症状持续，可于2 h后再服2.5 mg，每日最大剂量不超过15 mg。治疗组在对照组基础上口服天麻头痛片，4片/次，3次/d。如症状改善不佳，可增1片/次，每次口服剂量不超过6片，每日不超过18片。两组均连续服药3个月。观察两组的临床疗效，比较两组症状改善情况和血清因子变化情况。结果 治疗后，治疗组总有效率是95.00%，显著高于对照组的77.50%（P＜0.05）。治疗后，两组偏头痛发作次数、持续时间及视觉模拟（VAS）评分均较治疗前显著降低（P＜0.05）；且治疗后，治疗组偏头痛发作次数、持续时间及VAS评分均低于对照组（P＜0.05）。治疗后，两组血清载脂蛋白（LPA）、肿瘤坏死因子-α（TNF-α）、血清内皮素-1（ET-1）及一氧化氮（NO）水平均较治疗前显著降低，而5-羟色胺（5-HT）水平显著升高（P＜0.05）；治疗后，治疗组患者LPA、TNF-α、ET-1、NO水平低于对照组，5-HT高于对照组（P＜0.05）。结论 天麻头痛片联合佐米曲普坦能够显著改善偏头痛患者的临床症状，调节血清因子水平，且不增加不良反应发生率，具有一定的临床推广应用价值。

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

河南省科技攻关项目（182102310172）