Objectives: To observe the curative efficacy of auricular comprehensive therapy on menstrual migraine(MM) and its effect on serum prostaglandin F2α(PGF2α), prostaglandin E2(PGE2) contents and ratio, so as to explore its possible mechanism.
Methods: A total of 66 patients with MM of liver-fire syndrome were randomly divided into observation group (33 cases, 2 cases dropped off) and control group (33 cases, 2 cases dropped off), and 20 healthy women were included in the normal group. Patients in the control group were given flunarizine hydrochloride capsules orally, twice a day, for 3 consecutive weeks. Patients in the observation group were treated with auricular comprehensive therapy, starting 2-5 days before menstrual cramps, once a week, for a total of 3 weeks. The visual analogue scale (VAS) and migraine score were evaluated before and after treatment, and follow-up for 1 and 2 menstrual cycles. Serum PGF2α and PGE2 contents were measured before and after treatment, and the PGF2α/PGE2 ratio was calculated. The clinical effective rates in the two groups were calculated.
Results: After treatment and follow-up for 1 and 2 menstrual cycles, the VAS scores, headache degree, the frequency and duration of headache attacks, as well as accompanying symptoms of the observation and control groups were lower than those before treatment(P<0.05), and those of the observation group was lower than those of the control group(P<0.05). Before treatment, the PGF2α contents in the observation and control group were significantly higher(P<0.05), while the PGE2 contents lower(P<0.05) and PGF2α/PGE2 ratio higher(P<0.05) than those in the normal group. After treatment, the serum PGF2α contents in the observation and control group were significantly reduced compared with which before treatment(P<0.05), and were lower in the observation group than that in the control group (P<0.05). The serum PGE2 contents in the observation and control groups were significantly increased after treatment compared with which before treatment(P<0.05), with the contents in the observation group higher than that in the control group(P<0.05). The serum PGF2α/PGE2 ratio in the observation and control group was significantly reduced after treatment compared with which before treatment(P<0.05), with the control group higher than the normal group(P<0.05), and the observation group lower than the control group(P<0.05). The clinical effective rate of the observation group was 93.5% (29/31), and that of the control group was 77.4% (24/31). The effective rate of the observation group was significantly higher than that of the control group(P<0.05).
Conclusions: The curative efficacy of auricular comprehensive therapy on MM with liver-fire syndrome is significantly better than that of oral flunarizine hydrochloride capsules, especially in relieving hea-daches, reducing the frequency and duration of headache attacks, as well as accompanying symptoms. Its mechanism may be related to regulating the abnormal PGF2α and PGE2 contents of patients and reducing the ratio of PGF2α/PGE2.
目的: 观察耳穴综合疗法治疗月经性偏头痛（MM）的临床疗效及对血清前列腺素F2α（PGF2α）、前列腺素E2（PGE2）含量、比值的影响，探讨其可能的作用机制。方法: 将66例肝火旺盛型MM患者随机分为观察组（33例，脱落2例）和对照组（33例，脱落2例），并纳入20例健康女性作为正常组。对照组口服盐酸氟桂利嗪胶囊，每天2次，连续治疗3周；观察组予以耳穴综合疗法治疗，从月经来潮前2~5 d开始，1周治疗1次，共治疗3次。观察组与对照组分别于治疗前后及治疗后随访2个月经周期时以视觉模拟量尺（VAS）和偏头痛积分评价患者头痛程度，观察组、对照组和正常组分别于治疗前后测定月经期血清PGF2α、PGE2含量并计算PGF2α/PGE2比值，评定两组MM患者的临床疗效。结果: 与治疗前比较，观察组与对照组患者治疗后及随访时VAS评分均明显降低（P<0.05），且观察组低于对照组（P<0.05）。与治疗前比较，观察组与对照组患者治疗后及随访时偏头痛积分中头痛发作次数、每次发作持续时间、头痛程度及伴随症状评分均降低（P<0.05），且观察组低于对照组（P<0.05）。治疗前观察组与对照组患者PGF2α含量高于正常组（P<0.05），PGE2含量低于正常组（P<0.05），PGF2α/PGE2比值高于正常组（P<0.05）；与治疗前比较，观察组与对照组患者治疗后血清PGF2α含量明显降低（P<0.05），且观察组低于对照组（P<0.05）；与治疗前比较，观察组与对照组患者治疗后血清PGE2含量明显升高（P<0.05），且观察组高于对照组（P<0.05）；与治疗前比较，观察组与对照组患者治疗后血清PGF2α/PGE2比值均明显降低（P<0.05），且对照组较正常组明显升高（P<0.05），观察组较对照组明显降低（P<0.05）。观察组的临床有效率为93.5%（29/31），对照组的临床有效率为77.4%（24/31），观察组高于对照组（P<0.05）。结论: 耳穴综合疗法治疗肝火旺盛型MM疗效明显优于口服盐酸氟桂利嗪胶囊，在缓解头痛程度、减少头痛发作次数、发作时间以及伴随症状等方面疗效更好，其作用机制可能与调节患者异常PGF2α和PGE2含量，降低PGF2α/PGE2比值有关。.
Keywords: Auricular point comprehensive therapy; Menstrual migraine; Prostaglandin E2; Prostaglandin F2α.