目的 观察红龙镇痛片联合尼莫地平片治疗瘀阻脑络型偏头痛的临床疗效。方法 选择广州市中西医结合医院2022年3月—2024年3月收治的82例瘀阻脑络型偏头痛患者，通过随机数字表法将受试者均衡分为对照组（41例）和治疗组（41例）。对照组口服尼莫地平片，20 mg/次，3次/d。治疗组在对照组的基础上口服红龙镇痛片，3片/次，2次/d。两组均连续治疗4周。对比两组的临床疗效、临床症状改善情况、脑血流动力学指标、血清炎性因子和神经递质。结果 治疗组的总有效率（97.56%）高于对照组（82.93%，P＜0.05）。两组治疗后数字分级评分法（NRS）评分降低，偏头痛急性发作次数减少，单次偏头痛持续时间缩短（P＜0.05）；治疗组治疗后NRS评分、偏头痛急性发作次数少于对照组，单次偏头痛持续时间短于对照组（P＜0.05）。两组治疗后大脑中动脉（MCA）、前动脉（ACA）、后动脉（PCA）的平均血流速度下降（P＜0.05），治疗组治疗后MCA、PCA、ACA的平均血流速度低于对照组（P＜0.05）。两组治疗后血清环氧化酶-2（COX-2）、白细胞介素-6（IL-6）、前列腺素E₂（PGE₂）、超敏C反应蛋白（hs-CRP）水平下降（P＜0.05），且治疗组的血清COX-2、IL-6、PGE₂、hs-CRP水平低于对照组（P＜0.05）。两组治疗后血清降钙素基因相关肽（CGRP）、神经肽Y（NPY）水平下降，血清5-羟色胺（5-HT）、β-内啡肽（β-EP）水平升高（P＜0.05）；治疗组治疗后血清CGRP、NPY水平低于对照组，血清5-HT、β-EP水平高于对照组（P＜0.05）。结论 红龙镇痛片联合尼莫地平片治疗瘀阻脑络型偏头痛具有较好的临床疗效，可有效调节大脑血流动力学，改善神经因子和炎症因子。

Objective To observe the clinical efficacy of Honglong Zhentong Tablets combine with Nimodipine Tablets in treatment of migraine with blood stasis blocking cerebral meridians. Methods 82 Patients with blood stasis blocking cerebral meridians admitted to Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2022 to March 2024 were selected. The subjects were evenly divided into control group (41 cases) and treatment group (41 cases) using a random number table method. The control group was orally administered Nimodipine Tablets at 20 mg per time, three times daily. The treatment group received Honglong Zhentong Tablets in addition to the control group's regimen, at 3 tablets per time, twice daily. Two groups underwent continuous treatment for 4 weeks. The clinical efficacy, improvement in clinical symptoms, cerebral hemodynamic indicators, serum inflammatory factors, and neurotransmitters were compared between two groups. Results The total effective rate in the treatment group (97.56%) was higher than that in the control group (82.93%, P < 0.05). After treatment, the NRS scores of two groups decreased, the number of acute migraine attacks decreased, and the duration of a single migraine was shortened (P < 0.05). After treatment, the NRS score and number of acute migraine attacks in the treatment group were lower than those in the control group, and the duration of a single migraine attack was shorter than that in the control group (P < 0.05). After treatment, the average blood flow velocity of the middle cerebral artery (MCA), anterior cerebral artery (ACA), and posterior cerebral artery (PCA) decreased in two groups (P < 0.05). After treatment, the average blood flow velocity of MCA, PCA, and ACA in the treatment group was lower than that in the control group (P < 0.05). After treatment, the serum levels of cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), prostaglandin E₂ (PGE₂), and high-sensitivity C-reactive protein (hs-CRP) decreased in two groups (P < 0.05), and the serum levels of COX-2, IL-6, PGE₂, and hs-CRP in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of calcitonin gene-related peptide (CGRP) and neuropeptide Y (NPY) decreased, while the serum levels of serotonin (5-HT) and β-endorphin (β-EP) increased (P < 0.05). After treatment, the serum levels of CGRP and NPY in the treatment group were lower than those in the control group, while the serum levels of 5-HT and β-EP were higher than those in the control group (P < 0.05). Conclusion The combination of Honglong Zhentong Tablets and Nimodipine Tablets has good clinical efficacy in treatment of migraine with blood stasis blocking cerebral meridians, which can effectively regulate cerebral hemodynamics, improve nerve, and inflammatory factor.

R971

广东省医学会临床科研专项基金项目（A202302010）