目的 探讨养血清脑颗粒联合苯噻啶治疗偏头痛的临床疗效。方法 选取2021年11月—2023年2月河北北方学院附属第一医院收治的122例偏头痛患者，按随机数字表法将所有患者分为对照组和治疗组，每组各61例。对照组口服苯噻啶片，第1～3天，0.5 mg/次，1次/d，晚间服用；第4～6天，0.5 mg/次，2次/d，中午和晚间服用；第7天起，0.5 mg/次，3次/d；若病情基本控制，则酌情递减0.5 mg/周至适当剂量维持，若递减后病情有加重趋势再酌情增量。治疗组在对照组治疗基础上口服养血清脑颗粒，1袋/次，3次/d。两组疗程均为8周。观察两组临床疗效，比较治疗前后两组头痛发作情况、症状积分、颅内动脉血流动力学指标及血清高敏C反应蛋白（hs-CRP）、5-羟色胺（5-HT）、降钙素基因相关肽（CGRP）、内皮素-1（ET-1）水平。结果 治疗后，治疗组总有效率是95.08%，较对照组的83.61%显著提高（P＜0.05）。治疗后，两组发作次数、头痛视觉模拟量表（VAS）评分、持续时间均较治疗前显著降低（P＜0.05）；且治疗后，治疗组发作次数、头痛VAS评分、持续时间均低于对照组（P＜0.05）。治疗后，两组发作次数积分、头痛程度积分、持续时间积分、伴随症状积分及其总积分均显著降低（P＜0.05）；且治疗后，治疗组症状积分显著低于对照组（P＜0.05）。治疗后，两组大脑中动脉平均血流速度（V_m）均显著降低，而动脉搏动指数（PI）均显著增加（P＜0.05）；且治疗后，治疗组大脑中动脉V_m低于对照组，PI高于对照组（P＜0.05）。治疗后，两组血清hs-CRP、CGRP、ET-1水平均显著下降，而血清5-HT水平均显著上升（P＜0.05）；且治疗后，治疗组hs-CRP、CGRP、ET-1水平均显著低于对照组，5-HT水平均显著高于对照组（P＜0.05）。结论 养血清脑颗粒联合苯噻啶治疗偏头痛有较好的临床疗效，能有效促进头痛发作的缓解和症状减轻，使机体炎症反应、血管舒缩及疼痛感知异常得到控制，具有良好的疗效及安全性，值得临床推广应用。

Objective To explore the clinical efficacy of Yangxue Qingnao Granules combined with pizotifen in treatment of migraine. Method A total of 122 migraine patients admitted to the First Affiliated Hospital of Hebei North University from November 2021 to February 2023 were selected and divided into control group and treatment group according to random number table method, with 61 patients in each group. Patients in the control group were po administered with Pizotifen Tablets, 0.5 mg/time, once daily, at night on the 1st to 3rd day, on the 4th to 6th day, 0.5 mg/time, twice daily, from the 7th day at noon and evening, 0.5 mg/time, 3 times daily. If the disease was basically controlled, decreasing by 0.5 mg/week as appropriate to maintain the appropriate dosage. If the disease had a worsening trend after the decrease, then increase as appropriate. Patients in the treatment group were po administered with Yangxue Qingnao Granules on the basis of the control group, 1 bag/time, 3 times daily. The treatment course of both groups was 8 weeks. The clinical effects of the two groups were observed, and the headache onset, symptom score, intracranial arterial hemodynamics indexes and serum levels of high sensitive C-reactive protein (hs-CRP), 5-hydroxytrypsin (5-HT), calcitonin gene-related peptide (CGRP) andendothelin-1 (ET-1) were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 95.08%, which was significantly higher than that of the control group (83.61%, P < 0.05). After treatment, the frequency of attacks, visual analogue scale (VAS) score and duration of headache in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the frequency of attack, VAS score and duration of headache in the treatment group were lower than those in the control group (P < 0.05). After treatment, the score of the number of attacks, the score of headache degree, the score of duration, the score of accompanying symptoms and the total score of the two groups were significantly decreased (P < 0.05). After treatment, the symptom score of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the mean blood flow velocity (V_m) of middle cerebral artery was significantly decreased, while the arterial pulsation index (PI) was significantly increased in both groups (P < 0.05). After treatment, the V_m of middle cerebral artery in treatment group was lower than that in control group, and PI was higher than that in control group (P < 0.05). After treatment, serum hs-CRP, CGRP and ET-1 levels were significantly decreased, but serum 5-HT levels were significantly increased in two groups (P < 0.05). After treatment, serum hs-CRP, CGRP and ET-1 levels in treatment group were significantly lower than those in control group, but 5-HT levels were significantly higher than those in control group (P < 0.05). Conclusion Yangxue Qingnao Granules combined with pizotifen has good clinical efficacy in treatment of migraine, and can effectively promote the relief of headache and symptoms, and control the inflammatory response, vasomotor and pain perception with good efficacy and safety, which is worthy of clinical application.

R971

张家口市重点研发计划项目（2121173D）