| Objective:By means of plasma calcitonin gene related peptide(CGRP),β-endorphin(β-EP),5-hydroxytryptamine(5-HT)and proto-oncogenes c-fos in chronic migraineur(CM)and cortical spreading depression(CSD)migraine rats expression level measurement,combined with headache symptom score,to explore the effect of acupuncture and drug in the treatment of migraine,at the same time,analysis the relevant mechanism of CGRP,β-EP,5-HT and c-fos role in migraine endogenous analgesia system.Methods:1.Patients: Ninety CM patients were randomly and equally divided into two groups: Acupuncture treatment group and Flunarizine treatment group,The patients who had fell off the follow-up and mid-term termination were eliminated.Finally,forty-one patients were assigned to the acupuncture group and 43 patients to the Flunarizine group.A normal control group was screened for 10 healthy subjects.The acupuncture treatment group: the patients were selected with shaoyang gallbladder meridian or shoushaoyang triple energizer and the efficacy was determined after acupuncture treatment for 12 weeks,and more than 3 times per week.The drug treatment group: the efficacy was determined after 12 weeks of oral administration of Flunarizine by 5 mg from Monday to Friday per week.Healthy control group: without any treatment.ELISA was used to detect the contents of plasma CGRP,β-EP and 5-HT in the patients before and after treatment in each group,then analyze their changes in each group.2.Animals: Fifty SD rats were randomly divided into five groups: Normal control group: without any treatment.Model control group: kalium chloratum was used to stimulate rats’ cortex and induce CSD migraine model.Behavioral experiment was used to verify whether the model is successfully established.Acupuncture treatment group: rats were treated with acupuncture at Taichong and Yanglingquan after being modeled,20 min each time,lasted 12 weeks,and theacupuncture was more than 3 times per week.Acupuncture prevention group: rats were received acupuncture treatment 10 d before being modeled,20 min each time,continuous 10 d,no acupuncture after molding.Acupuncture prevention and acupuncture treatment group: rats were received acupuncture treatment before being modeled 10 d,then treated with acupuncture at Taichong and Yanglingquan after being modeled,continued for 12 weeks,and the acupuncture was more than 3times per week.ELISA was used to detect the contents of plasma CGRP,β-EP and5-HT after acupuncture.The method of strept avidin-biotin complex(SABC)was used to detect the contents of CGRP,β-EP,5-HT and c-fos in periaqueductalgray(PAG)after acupuncture treatment.Results:1.In migraine patients,compared with normal control group,the scores of pain degree,frequency,duration and accompanying symptom in chronic migraineur were significantly increased(P<0.05),in chronic migraine groups the contents of CGRP were increase,the contents of β-EP and 5-HT were decreased(P<0.05).2.In migraine patients,compared with before treatment,the scores of pain degree,frequency,duration and accompanying symptom after treatment in both patients groups were obviously decreased(P < 0.05),while the changes in acupuncture group were more significant than those in drug group(P<0.05);the contents of CGRP were decreased(P<0.05),whereas the contents of β-EP and5-HT in both patients groups after treatment were obviously higher(P < 0.05).However,compared with drug group,the contents of CGRP,β-EP and 5-HT changed in acupuncture group were significant improvement(P<0.05).3.The safety,cure rate and total effeciency in acupuncture group were significantly higher than drug group(P<0.05).4.The CSD migraine rats model were successfully established by stimulation of kalium chloratum on occipital cortex of rats.5.Compared with normal control group,in model control group there arebehavioral changes of rats,the contents of CGRP in plasma was increased,and the contents of β-EP and 5-HT were decreased(all P < 0.05),the positive cells of CGRP in PAG was increased,and the positive cells of β-EP and 5-HT were decreased(all P<0.01).6.There were behavioral changes after model were successfully established,compared with model control group,the behavioral change duration acupuncture prevention group,acupuncture treatment group and acupuncture treatment group were shorter,the contents of CGRP in plasma was decreased,and the contents ofβ-EP and 5-HT were increased(all P<0.01),the positive cells of CGRP in PAG was decreased,and the positive cells of β-EP and 5-HT were increased(all P<0.05).7.Compared with acupuncture prevention group and acupuncture treatment group,the duration of rats behavioral changes in acupuncture prevention and treatment group shown more shorter,the contents of CGRP in plasma was more lower,and the contents of β-EP and 5-HT were more higher(all P<0.05),the positive cells of CGRP and c-fos in PAG was more lower,and the positive cells ofβ-EP and 5-HT were more higher(all P<0.05).Conclusions:1.Acupuncture can reduce the pain symptoms in patients with CM by affecting the content of neurotransmitters associated with the endogenous analgesic system of CSD migraine.2.Acupuncture treatment for CM is superior to drug therapy and has fewer side effects. |
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