耳背静脉放血治疗无先兆偏头痛止痛效应观察和对家兔模型PAG区c-fos表达、G蛋白含量的影响.pdfVIP

提 要 目的：观察耳背静脉放血对无先兆偏头痛患者的即刻止痛效应及疗效，并从偏头 痛家兔模型中脑导水管（PAG）c-fos基因表达、G蛋白含量变化的角度探讨其中枢作 用机制。 方法：临床试验：对 30 例符合纳入标准的发作期无先兆偏头痛患者，予以耳背 静脉放血治疗，观察首次治疗前后患者疼痛强度的变化，及1个疗程后的疗效。动物 实验：将 30只纯种新西兰家兔随机分成三组，即治疗组、模型组和空白组，每组10 只。治疗组采用皮下注射硝酸甘油造模后，予以耳缘静脉放血治疗；模型组只造模， 不治疗；空白组不做处理。然后观察家兔模型PAG区c-fos基因表达、G蛋白含量变 化情况。 结果：①耳背静脉放血对发作期无先兆偏头痛患者有良好的即刻止痛效果，首次 治疗后与治疗前比较VAS值有显著性差异（P＜0.01）；临床疗效显著，与治疗前比较 头痛发作频率、持续时间均有显著性差异（P＜0.01），总有效率达93.33%。 ②耳缘 静脉放血可抑制偏头痛家兔模型 PAG 区 c-fos 基因的异常表达（P＜0.01），降低 G 蛋白含量（P＜0.01）。 结论：耳背静脉放血对无先兆偏头痛患者有较好的即刻止痛效果，临床疗效显著， 其镇痛机制可能与抑制PAG区c-fos基因的异常表达、降低G蛋白含量有关。 关键词 耳背静脉放血；无先兆偏头痛；家兔模型；c-fos基因；G蛋白 Observation of the analgesic effect of the migraine without aura patients and effect in c-fos expression and content of G protein of the rabbit model in PAG by era vein’s bloodletting Specialty:Acupuncture and moxibustion Author:kan Junzhen Tutor:Yang Dianhui Abstract Objective:To observe the instant effect and clinical evaluation of the migraine without aura patients by bloodletting via era vein,and explore the mechanisms through the point of view of c-fos and G protein in PAG. Method:The clinical trials:the 30 patients who met the inclusion criteria was treated by giving bloodletting via era vein,and observed the changes in pain intensity before and after the first treatment,and clinical evaluation after a course of treatment.Animal experiments:By the way of random and control trial,30 New Zealan rabbits were randomly averaged into three groups,treatment group,model group and blank group,each group of 10 only.Bled the two ears of rabbits in treatment group after the model.The model group model only,not treatde.The blank group did not deal with.Then determined rabbit model c-fos expression and content of G protein in PA