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天麻素联合尼莫地平治疗偏头痛急性发作期临床效果【摘要】：目的分析探讨天麻素联合尼莫地平治疗偏头痛急性发作期的临床效果。
方法选取我院2018年8月~2019年8月收治的60例急性期偏头痛患者作为研究对象，随机分为对照组和实验组，每组各30例。
对照组采用尼莫地平进行治疗，实验组在对照组基础上联合天麻素进行治疗，将两组患者的临床治疗效果进行对比分析。
结果经治疗，实验组治疗有效率高于对照组，不良反应率明显低于对照组，差异有统计学意义(P<0.05)；实验组患者头痛发作频率、持续时间及头痛程度均明显低于对照组，差异有统计学意义(P<0.05)。
结论对偏头痛急性发作期患者采用天麻素联合尼莫地平治疗，能够有效缓解病痛，提高治疗有效率，降低不良反应率，值得临床推广应用。
【关键词】：偏头痛；天麻素；尼莫地平；急性期疗效Clinical effect of gastrodin combined with nimodipine in the treatment of acute migraine【abstract 】: objective to analyze and discuss the clinical effect of gastrodin combined with nimodipine in the treatment of acute migraine.Methods 60 cases of acute stage migraine patients admitted to our hospital from August 2018 to August 2019 were randomly pided into control group and experimental group, with 30 cases in each group.The control group was treated with nimodipine, and the experimental group was treated with gastrodin on the basis of the control group.Results after treatment, the effective rate of treatment in the experimental group was higher than that in the control group, and the adverse reaction rate was significantly lower than that in the control group, the difference was statistically significant (P<0.05).The frequency,duration and degree of headache in the experimental group were significantly lower than those in the control group (P<0.05).Conclusion gastrodin combined with nimodipine can effectively relieve pain, improve the effective rate of treatment and reduce the rate of adverse reactions in patients with acute migraine, which is worthy of clinical application.【 key words 】 : migraine;Gastrodia elata;Nimodipine;Acute stage effect偏头痛是一种常见的神经科慢性疾病，且女性发病率高于男性，给患者的日常生活带来负面影响。
天麻素治疗老年人偏头痛的临床疗效观察摘要】目的: 通过观察天麻素治疗老年人偏头痛的临床疗效，了解其临床应用的前景。
方法: 选择2011.10～2013.10我科收治的老年人偏头痛患者70例,按随机分配原则分为对照组和治疗组各35例,其中治疗组男15例,女20例，年龄60～89岁,平均76.1岁, 对照组男13例,女22例，年龄61～88岁,平均75.3岁。
两组均给予相同的静脉滴注活血化瘀药物等常规治疗及扩张脑血管、止痛治疗,治疗组在此基础上给予天麻素注射液0.6g加人0.9%氯化钠溶液 250 ml静脉滴注。
结果: 经过治疗后临床疗效比较,治疗组总有效率明显高于对照组（P<0.01）。
结论: 天麻素注射液治疗老年人偏头痛疗效显著，无明显不良反应，临床中值得推广。
【关键词】天麻素老年人偏头痛临床疗效【中图分类号】R453 【文献标识码】A 【文章编号】2095-1752（2014）03-0066-02The clinical curative effect in treatment of the elderly migraineZHANG Yan-xia,SU Yu-wen,WANG Li-qun,SONG Yu-min ,Department of Cadre,the 88th Hospital of PLA,Tai’an,271000,China【Abstract】Objective To observe the clinical efficacy of Gastrodin in treatmentof elderly patients with migraine, to understand the feasibility of clinical application. Methods Choose 2011.10 to 2013.10 in our hospital from 70 cases of elderly patients with migraine, randomly divided into control group and treatment group with 35 cases in each group, the treatment group male 15 cases, female 20 cases, age 60 ~ 89 years old, average age 76.1, contrast group male 13 cases, female22 cases, age 61 ~ 88 years old, average 75.3 years old. The two groups were given intravenous drip of Huoxue Huayu drugs and other conventional treatment and dilate cerebral vessels, analgesic therapy, the treatment group was given based on Gastrodin Injection 0.6g plus 0.9% Sodium Chloride Solution intravenous infusion of 250ml. Results Through the comparison of clinical efficacy after treatment, the total effective rate of treatment group was significantly higher than the control group(P<0.01). Conclusion Gastrodin Injection significant efficacy in the treatment of migraine elderly, no obvious adverse reaction, worthy of promotion in clinical therapy.【Key words】Gastrodin elderly migraine clinical effect偏头痛是一种常见的慢性神经血管性疾病，以发作性头痛反复出现、程度剧烈、或左或右等症状为特征，发病前部分患者可出现视物模糊、闪光、幻视、盲点、眼胀、情绪不稳、怕光等先兆，数分钟后即出现一侧性头痛 [1]。
尼莫地平联合天麻素治疗血管性眩晕的疗效评价和不良反应观察目的剖析尼莫地平联合天麻素治疗血管性眩晕的疗效评价和不良反应观察。
方法随机选取90例椎基底动脉供血不足所致眩晕患者，并随机分为三组（每组30例）：联合组，尼莫地平组和天麻素足，联合组给予尼莫地平联合天麻素治疗，尼莫地平组给予尼莫地平治疗，天麻素组给予天麻素治疗，并对三组的临床效果进行统计比较分析。
结果联合组的总有效率为96.43%，尼莫地平组的总有效率为85.71%，天麻素组的总有效率为86.25%，联合组的疗效高于其他两组，且具有组间统计学差异（P＜0.05）；联合组和天麻素组的均无不良反应报告，仅尼莫地平组存在1例不良反应，不良反应发生率为3.57%，各组组间不存在统计学差异（P>0.05）。
结论尼莫地平联合天麻素治疗椎基底动脈供血不足性眩晕病症疗效优于单独给药，临床用药建议两者联合使用。
标签：尼莫地平；天麻素；血管性眩晕；疗效评价；不良反应观察椎基底动脉供血不足（Vertebrobasiliar Insufficiency，VBI）的发病机制主要源于椎基底动脉形态和功能差异所致颅内不同区域血液流量存在差异和不足[1-2]；该病症是临床常见病症，频发于中老年患者，临床主要症状为突发性眩晕[1-2]；由于发患者群的集中在中老年，该病的病后恢复期往往较长且易反复发作，严重影响患者的生活质量，增加医疗负担[1-2]。
目前，国内椎基底动脉供血不足患者的数量呈现逐步稳定增长的趋势，而目前临床常用给予某一药物却常常不能达到理想的效果[2]。
因此，本文拟采用尼莫地平联合天麻素给药的方式治疗椎基底动脉供血不足性眩晕，进行两者联合给药的疗效评价和不良反应观察，现报告如下。
1资料与方法1.1一般资料研究对象随机入选我院所2012年12月～2013年12月的90例由椎基底动脉供血不足所致眩晕患者，男女不限，年龄为59～72岁。
其中26 例合并高血压，11 例合并糖尿病，2 例并发共济失调。
天麻素联合尼莫地平治疗偏头痛急性发作期临床研究【摘要】：目的观察分析天麻素联合尼莫地平治疗偏头痛急性发作期的临床效果和安全性。
方法选择我院2018年4月-2019年10月收治的偏头痛急性发作患者88例作为本次的研究对象，随机将其分为例数相同的两组，治疗组和对照组，每组患者44例。
对照组常规口服尼莫地平片，治疗组在口服尼莫地平片的基础上加用天麻素注射液。
比较两组患者的临床疗效及治疗前后头痛发作频率、头痛持续时间。
结果治疗组患者的总有效率为93.18%，明显低于对照组的77.27%，差异有统计学意义（P<0.05）。
两组患者治疗后的头痛发作频率、头痛持续时间均明显降低，差异有统计学意义（P<0.05）。
治疗组治疗后头痛发作频率、头痛持续时间较对照组降低更加显著，差异有统计学意义（P<0.05）。
结论天麻素注射液联合尼莫地平片可明显提高偏头痛急性发作期的临床疗效，患者的临床症状明显改善，值得进行大力的推广及应用。
【关键词】：偏头痛；尼莫地平；阿司匹林；临床疗效；不良反应Clinical study of gastrodin combined with nimodipine in the treatment of acute migraine[abstract] : objective to observe and analyze the clinical effect and safety of gastrodin combined with nimodipine in the treatment of acute migraine.Methods a total of 88 patients with acute migraine attack admitted to our hospital from April 2018 to October 2019 were selected as the study subjects and randomly pided into two groups with the same number of cases, the treatment group and the control group, with 44 cases in each group.The control group received nimodipine tablets orally and the treatment group received gastrodin injection on the basis of nimodipine tablets orally.The clinical efficacy,frequency and duration of headache before and after treatment were compared between the two groups.Results the total effective rate of the patients in the treatment group was 93.18%, significantly lower than that of the control group (77.27%), and the difference was statistically significant (P<0.05).After treatment, the frequency and duration of headache in the two groups were significantly reduced, and the difference was statistically significant (P<0.05).After treatment, the frequency and duration of headache in the treatment group were more significantly reduced than those in the control group, with statistically significant differences (P<0.05).Conclusion gastrodin injection combined with nimodipine tablets can significantly improve the clinical efficacy of migraine during the acute attack period, and the clinical symptoms of the patients are significantly improved.【key words 】: migraine;Nimodipine;Aspirin;Clinical efficacy;Adverse reactions偏头痛是常见的神经血管性疾病，全球发病率为 5% ～10%，世界卫生组织将其列为致残严重的慢性疾病，危险性与四肢瘫痪、精神疾病、痴呆等疾病相同。
尼莫地平联合天麻素治疗偏头痛疗效观察摘要】目的：探讨分析应用天麻素结合尼莫地平对偏头痛患者进行治疗的临床效果。
方法：选择2012年12月—2014年11月来我院接受治疗的116例偏头痛患者作为研究对象，采用随机数字法把其分成对照组和治疗组，其中治疗组患者采用天麻素结合尼莫地平实施治疗，而对照组患者采用天麻素实施治疗。
结果：治疗组患者的临床治疗有效率为94.8％，而对照组患者的临床治疗有效率为72.4％，治疗组患者的临床治疗效果明显比对照组好（P＜0.05）。
结论：应用天麻素结合尼莫地平对偏头痛患者进行治疗，可以有效的对患者临床症状进行控制，其是一种可行性、安全性以及有效性较高的治疗方案。
【关键词】偏头痛；尼莫地平；天麻素【中图分类号】R453 【文献标识码】A 【文章编号】2095-1752（2015）03-0067-02Nim horizon joint gastrodia elata clinical observation on treatment ofmigraine Zhang Yibo. WeiChang hospitals in hebei province, Chengde, 068450, China 【Abstract】Objective To explore the gastrodine in combination with analysis of nim horizon the clinical effect of treatment in patients with migraine. Methods Choice in December 2012 to November 2014 to our hospital for treatment of 116 cases of migraine patients as the research object, by using the method the random Numbers were divided into control group and treatment group, the treatment group were treated by integrative gastrodine nim horizon implementation of treatment, treatment and control group were treated by gastrodine implemented. Results Treatment group of patients with the clinical effective rate was 94.8%, and the control group patients clinical effective rate was 72.4%, patients clinical therapeutic effect of treatment group was obviously better than the control group (P < 0.05). Conclusions Application of gastrodia elata in combination with nim horizon for treatment in patients with migraine, can be effective to control patients' clinical symptoms, is a kind of higher feasibility, safety and efficacy of treatment.【Key words】Migraine; Nim horizon; Gastrodia elata偏头痛是一种神经内科常见与多发的慢性原发性疾病，患者往往呈现着中重度搏动性、发作性与偏侧头痛，常常伴随着视觉障碍、恶心与呕吐等症状，此病还具备着较高的发病率，其患病人数在神经内科接诊患者中已经超过了50%[1]。
* 临床药物研究 *天麻素联合氟桂利嗪治疗偏头痛的临床价值研究刘仲秋刘仲秋，，吕淑珍巨野县人民医院神经内三科，山东菏泽274900摘要目的探究偏头痛行天麻素+氟桂利嗪治疗的价值。
方法选取2022年2月—2023年1月巨野县人民医院神经内三科收治的120例偏头痛患者为研究对象，采用双盲法分为单药组、联合组，各60例。
单药组行氟桂利嗪治疗，联合组在单药组基础上联合天麻素治疗，比较两组头痛恢复情况、神经指标、血管内皮功能、有效率。
结果治疗前，两组头痛频率、持续时间比较，差异无统计学意义（P>0.05）；治疗后，联合组头痛频率、持续时间低于单药组，差异有统计学意义（P<0.05）。
治疗前，两组5-HT、BDNF、CGRP等指标比较，差异无统计学意义（P>0.05）；治疗后，两组5-HT、BDNF、CGRP均降低，且联合组低于单药组，差异有统计学意义（P<0.05）。
治疗前，两组NO和ET-1指标，差异无统计学意义（P>0.05）；治疗后，两组NO和ET-1指标均降低，且联合组低于单药组，差异有统计学意义（P<0.05）。
联合组有效率为95.00%，高于单药组的80.00%，差异有统计学意义（χ2=6.171，P=0.013）。
结论天麻素+氟桂利嗪有效性高，能纠正患者神经代谢状态，减轻血管损伤，快速改善偏头痛问题。
关键词氟桂利嗪；神经功能；有效率；天麻素；血管内皮功能；偏头痛中图分类号R747747..2文献标志码A doi10.11966/j.issn.2095-994X.2023.09.05.48Clinical Value of Gastrodin Combined with Flunarizine in the Treatment of MigraineLIU Zhongqiu, LYU ShuzhenDepartment of Neurology III, Juye County People's Hospital, Heze, Shandong Province, 274900 ChinaAbstract Objective To explore the value of gastrodin and flunarizine in the treatment of migraine. Methods A total of 120 migraine patients ad⁃mitted to the third Department of Neurology in Juye County People's Hospital from February 2022 to January 2023 were selected as the study objects. They were divided into monotherapy group and combined group by double-blind method, with 60 cases in each group. The single drug group was treated with flunarizine, and the combined group was treated with gastrodin on the basis of the single drug group. The recovery of headache, nerve indexes, vascular endothelial function and effective rate were compared between the two groups. Results Before treatment, there was no statistically significant difference in the frequency and duration of headache between the two groups (P>0.05). After treatment, the frequency and duration of headache in combination group were lower than those in monotherapy group, and the difference was statistically significant (P<0.05). Before treatment, there was no statistically significant difference in 5-HT, BDNF and CGRP between the two groups (P> 0.05). After treatment, 5-HT, BDNF and CGRP were decreased in both groups, and the combination group was lower than the monotherapy group, the difference was statistically significant (P<0.05). Before treatment, there was no statistically significant difference in NO and ET-1 indexes between the two groups (P>0.05). After treatment, NO and ET-1 indexes were decreased in both groups, and the combined group was lower than the monotherapy group, the difference was statistically significant (P<0.05). The effective rate of combination group (95.00%) was higher than that of monotherapy group (80.00%), and the difference was statistically significant (χ2=6.171, P=0.013). Conclusion Gastrodin + flunarizine is highly effective, can correct patients' neurometabolic status, reduce vascular damage, and quickly improve migraine problems. Key words Flunarizine; Nerve function; Efficient; Gastrodin; Vascular endothelial function; Migraine收稿日期：2023-03-05；修回日期：2023-03-25作者简介：刘仲秋（1982-），男，本科，副主任医师，研究方向为神经内科常见病。
丙戊酸钠联合天麻素治疗偏头痛的临床疗效观察许秀兰;朱建建;邹丽【期刊名称】《实用心脑肺血管病杂志》【年(卷),期】2016(024)009【摘要】Objective To observe the clinical effect of sodium valproate combined with gastrodin on migraine. Methods From 2014 to 2015,a total of 100 patients with migraine were selected in the Department of Neurology,the People's Hospital of Rugao,and they were divided into control group and treatment group according to random number table,each of 50 cases. Patients of the two groups received routine examination and symptomatic treatment after treatment,meanwhile patients of control group were given extra sodium valproate,while patients of treatment group were given sodium valproate combined with gastrodin;both groups continuously treated for 2 weeks. Clinicaleffect,attack frequency and duration of headache,and headache seriousness score before and after treatment,quality of life score after treatment,and incidence of adverse reactions during the treatment were compared between the two groups. Results The clinical effect of treatment group was statistically significantly better than that of control group(P ﹤ 0.05). No statistically significant differences of attack frequency or duration of headache,or headache seriousness score was found between the two groups before treatment( P ﹥ 0. 05). After treatment, attack frequency ofheadache of treatment group was statistically significant lower than that of control group,duration of headache of treatment group was statistically significantly shorter than that of control group,headache seriousness score of treatment group was statistically significantly lower than that of control group(P ﹤ 0. 05);attack frequency of headache of the two groups was statistically significant lower than that beforetreatment,respectively,duration of headache of the two groups was statistically significantly shorter than that before treatment, respectively, headache seriousness score of the groups was statistically significantly lower than that before treatment,respectively( P ﹤ 0. 05). After treatment,pressure resistance score,social relations score,nutritional status score,movement condition score and self - actualization score of treatment group were statistically significantly higher than those of control group(P﹤ 0. 05). During the treatment,incidence of adverse reactions of treatment group was statistically significantly lower than that of control group( P ﹤ 0.05). Conclusion Sodium valproate combined with gastrodin has certain clinical effect in treating migraine,can effectively reduce the attack frequency of headache, shorten the duration of headache,relive the headache seriousness,improve the quality of life,with relatively high safety.%目的：观察丙戊酸钠联合天麻素治疗偏头痛的临床疗效。
尼可占替诺与天麻素联用治疗血管神经性头痛临床观察
发表时间：2009-06-23T12:53:53.467Z 来源：《中外健康文摘》2009年第7期供稿作者：王伟[导读] 观察尼可占替诺与天麻素联用对血管神经性头痛的治疗作用。
【摘要】目的观察尼可占替诺与天麻素联用对血管神经性头痛的治疗作用。
方法 17例患者均经省市级医院神经科确诊为神经性头痛，经其他方法治疗无效的9例，未经过其他治疗的8例，均给予尼可占替诺240mg加入5 %葡萄糖300ml中缓慢静脉滴注，联合天麻素800mg加入5%葡萄糖200ml中静脉滴注，每日一次，治疗21天，观察治疗前后患者症状体征的改变。
结果经尼可占替诺联合天麻素治疗后，神经性头痛患者症状和体征改变明显，副作用轻微。
结论尼可占替诺联用天麻素治疗神经性头痛疗效显著，副作用轻微，值得临床推广。
【关键词】尼可占替诺天麻素血管神经性头痛
侧有明显的压痛点。
产生这种神经性头痛的主要原因是由于患者长期的神经活动处于紧张与疲劳状态或者强烈的精神创伤之后引起的大脑功能活动紊乱所致。
患者极其痛苦，此时除为患者做个脑部CT检查排除脑瘤或其他器质性病变是必须的外，其余的检查没有更多临床意义，选择恰当的扩张血管、改善脑血流、稳定脑神经药物是当务之急，2007年10月至2007年12月我们对17例血管神经性头痛患者给予尼克占替诺联合天麻素治疗，报道如下：
1 资料与方法
1.1临床资料选择住院患者共17例，男6例，女11例，其他方法治疗无效9例，未经过治疗8例，年龄37岁至52岁之间，均经过省市级医院神经科确诊为血管神经性头痛。
血管神经性头痛主要是由精神紧张、生气引起，主要症状为持续性的头部闷痛、压迫感、沉重感，有的病人自诉为头部有“紧箍”感。
大部分病人为两侧头痛，多为两颞侧、后枕部及头顶部或全头部。
头痛性质为钝痛、胀痛、压迫感、麻木感和束带样紧箍感。
头痛的强度为轻度至中度，虽然患者很少因头痛而卧床不起或影响日常生活，但是有的病人可有长年累月的持续性头痛，有的病人的症状甚至可回溯10～20年。
病人可以整天头痛，头痛的时间要多于不痛的时间。
因为激动、生气、失眠、焦虑或忧郁等因素常使头痛加剧。
病人常主诉双颞侧搏动性头痛。
病人多伴有头晕、烦躁易怒、焦虑不安、心慌、气短、恐惧、耳鸣、失眠多梦、腰酸背痛、颈部僵硬等症状，部分病人在颈枕两侧或两颞
1.2治疗方法入院后进行出凝血时间、血小板测定、多普勒超声、头部CT、心电图、胸透等常规检查，排除其他易出血疾患后，对17例病人均给予尼可占替诺（意大利宝利化大药厂生产） 240mg加入5%葡萄糖300ml中缓慢静脉滴注结束后联用天麻素（江西钟山药业有限责任公司生产）800mg加入5%葡萄糖200ml 中续点，连续应用21天，用药期间未同时应有其他药品。
1.3疗效观察显效临床症状消失，患者近期无头痛发作可以正常工作学习。
有效临床症状减轻，患者偶有头痛发作，持续时间短于5分钟，发作次数少于每3天1次。
无效治疗前后临床症状无改变，患者头痛时间频率无减轻。
2 结果
应用尼可占替诺联用天麻素治疗血管神经性头痛17例，显效 12例，有效5例，无效0例。
3 讨论
神经性头痛又称紧张性头痛功能性头痛或血管神经性头痛，其原因是由于头顶部、颈部、颞部肌肉过分收缩或痉挛，或是工作过度疲劳，或是心情压抑所致。
该病多发生于35～55岁妇女或高压力人群，过去常常被诊断为神经衰弱。
患者主要症状为持续性的头部闷痛、压迫感、沉重感，有的病人自诉为头部有“紧箍” 感。
大部分病人为两侧头痛，多为两颞侧、后枕部及头顶部或全头部。
头痛性质为钝痛、胀痛、压迫感、麻木感和束带样紧箍感。
几乎每天都觉得头部发沉，像有东西压在上面或是头顶被东西箍着，疼痛大多不很严重，可是使人感到不舒服，昏昏沉沉，头脑不清醒。
通常不会引起恶心、呕吐。
一般疼痛症状总是在下午加重，到晚间又减轻些，可是精神却相对兴奋起来，病人往往有焦虑情绪，所以入睡困难十分常见。
尼可占替诺主要成份为烟酸占替诺，其化学名称为：7-[2-羟基-3-[（2-羟乙基）甲胺基]丙基] 茶碱的烟酸盐。
是一种血管扩张剂，直接作用于小动脉平滑肌及毛细血管，使血管扩张，改善血液流变学，减少周围血管的阻力。
本品能促进葡萄糖透过血脑屏障，增强脑细胞的葡萄糖和氧的利用，改善大脑的糖代谢和大脑功能。
还有促进脂肪代谢，降低高血脂、高胆固醇和高纤维蛋白原的作用。
天麻素（化学名为对羟甲基苯-β-D-吡喃葡萄糖苷，又称天麻苷）可透过血脑屏障，在脑组织中以较高速度降解为天麻苷元，天麻苷元为脑细胞膜Bz 受体的配基。
因此天麻苷元作用于γ氨基丁酸/Bz受体，从而显示镇静、抗惊厥的中枢抑制效应、镇痛作用；同时对脑细胞损伤
还有保护作用；抗氧化活性、清除自由基作用也极强，此外，天麻素对循环系统的影响也很大，它能降低外周血管阻力、降低血压和增加动脉血管顺应性、增加心脑血管血流量、保护心肌细胞、加强心肌收缩力，而且使心肌细胞内糖原、核糖核酸、脱氧核糖核酸、三磷酸腺苷酯、琥珀酸脱氢酶和乳酸脱氢酶显著增加，表明天麻素可能具有促进心肌细胞能量代谢的作用。
天麻素抑制炎症早期的渗出和阻止血栓形成的作用显示对微循环障碍有预防作用，可阻止血栓形成。
还可以增强免疫和抗遗忘抗衰老作用，对噪声性耳蜗损伤防护作用。
而大量试验证实天麻素对受孕繁殖均无影响，对心、肝、肾、脾、肺作组织切片镜检，未见组织细胞异常变性，说明长期用药无明显毒性。
可见天麻素不仅有很高的药效价值，而且无明显毒副作用，为临床适应症的治疗提供了依据。
综合以上各点，笔者认为应用尼可占替诺联用天麻素治疗血管紧张性头痛治疗费用低，疗效显著，副作用轻微，值得临床医生大力推广使用。
参考文献
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