Venous plasma levels of endothelin-1 are not altered immediately after nitroglycerin infusion in healthy subjects

Endothelin-1 and nitric oxide play an important regulatory role in the control of vascular smooth muscle tone. Nitroglycerin (NTG), a nitric oxide donating drug, may inhibit endothelin production. In this double-blind placebo-controlled crossover study, plasma levels of endothelin-1 were measured before and immediately (5–30 s) after 80 min infusion of NTG (glyceryl trinitrate) or saline in 12 healthy subjects. On two different days separated by at least 1 week, NTG in four different doses, 0.015, 0.25, 1.0, and 2.0 g·kg^–1·min^–1, or placebo (isotonic saline) was infused successively for 20 min each dose. During the infusion blood pressure and heart rate were measured. NTG infusion significantly decreased systolic blood pressure from 112.4 to 103.4 mmHg and pulse pressure from 39.3 to 29.5 mmHg. Heart rate increased from 62.7 to 73.1 beats·min^–1. No changes in endothelin-1 plasma levels were induced by NTG infusion (2.4 pg·ml^–1 before NTG vs. 2.7 pg·ml^–1 after NTG) and placebo infusion also did not affect plasma endothelin-1. It is concluded that venous plasma levels of endothelin-1 are not altered immediately after NTG infusion.     

Arterial spasm as a finding intimately associated with the onset of vascular headache

Summary A patient with migraine headaches of the cluster variant type is presented in whom vasospasm of the middle cerebral artery, the anterior cerebral artery and the internal carotid artery triggered a pain episode identical in character and severity to the headaches which had led to her investigation. Vasospasm associated with the painful phase of headache in this case conflicts with the more accepted theory that the pain phase of a vascular headache is related to vasodilatation of cerebral or extracerebral vessels. The literature is reviewed.     

Headache and family history

In two headache questionnaire surveys we inquired about the occurrence of headache in the mothers, fathers, siblings and children of the respondents. In total, 633 people completed valid questionnaires, 260 in the first survey and 373 in the second. The hypothesis was that familial headache occurrence would be positively associated with headache frequency. In each survey, the regression of headache frequency on the number of parents having headache was highly significant. Neither sex nor the sibling and children variables were significant predictors. In the cross-tabulations of the parental occurrence of headache with headache frequency we saw a clear "break-point" between the "no headache" and the headache frequency categories studied. For the final analyses the dichotomy "headache/no headache" was related in fourfold tables to headache occurrence in the father and the mother separately, and to the number of headache parents. The positive associations were not simply due to the large number of migraine cases since they remained after removing the migraineurs.     

Tension-type headache in children: A clinical evaluation

BACKGROUND: Headache Society (IHS) criteria for episodic tension-type headache were included in the present study. Pain characteristics, associated symptoms, and stress-triggering factors were evaluated. Psychiatric and psychosocial evaluations were performed according to DSM-IV criteria. RESULTS: Pain was bilateral in 93.7% of patients and bitemporal in 50% of children. The intensity of pain increased with motion and stress in more than half of the patients, while pain decreased with rest and massage in 43.7% of patients. Ten of the 16 (62.5%) patients were diagnosed as having a psychiatric disorder. The most common stress-triggering factors were difficulty in adaptation at school and relationship problems with family members. All of the children reported 26 stress factors. Of these stress factors, 20 (76.9%) were reported by children diagnosed with psychiatric disorder. CONCLUSION: These results suggest that in children with tension-type headache a thorough psychiatric evaluation should be performed to rule out underlying psychiatric disorders.     

通天口服液治疗不同类型紧张型头痛的疗效比较

目的 :观察通天口服液治疗不同类型紧张型头痛的临床疗效。方法 :紧张型头痛病人 1 2 1例 ,分为发作性紧张型头痛组 44例和慢性紧张型头痛组 77例 ,口服通天口服液 1mo,治疗后 2mo内动态观察头痛程度、发作频率、持续时间的变化。结果 :治疗 1mo后 1 2 1例病人临床总有效率为90 .9% ,发作性紧张型头痛组临床有效率为 98% ,慢性紧张型头痛组为 87% (P <0 .0 1 )。停药 1mo后全组临床总有效率为 83 .5 % ,发作性紧张型头痛组临床有效率为 93 % ,慢性紧张型头痛组为 78%(P <0 .0 1 )。无效的 2 0例多为慢性紧张型头痛组病人。 2组病人未见不良反应发生。结论 :通天口服液治疗紧张型头痛安全、有效 ,对发作性紧张型头痛的疗效优于慢性紧张型头痛     

中药结合中医经络诊断仪诊治神经性头痛157例

目的 探讨中医经络诊断仪与中医学的辨证施治相结合治疗神经性头痛。方法 用中医经络诊断仪对157例神经性头痛患者进行检测，区分虚实，然后结合中医辨证分型进行中药治疗，1个疗程后再用中医经络诊断仪复查，比较两次检查结果，再结合临床观察疗效。结果 实证平均总有效率达88．5％，虚证平均总有效率达90．8％。结论 中医经络诊断仪为中医学的辨证施治提供了一种量化的手段。     

头痛宝口服液治疗儿童血管性头痛48例的疗效

目的: 观察自制头痛宝口服液治疗儿童血管性头痛临床效果.方法: 94例血管性头痛患儿随机分为两组,对照组46人采用对症治疗;治疗组48人在对照组治疗的基础上加用自制头痛宝口服液10 ml tid,3周为一疗程.结果: 对照组总有效率43.5%,治疗组总有效率达72.9%,两组间有非常显著性差异(P＜0.01).结论: 该制剂是治疗儿童血管性头痛的有效药物.     

中药治疗头痛的临床试验设计

为了探讨治疗头痛的中药新药临床试验方法,本文根据从事头痛中药新药临床试验的体会,结合国际头痛协会近年来发表的紧张型头痛和偏头痛临床试验指南,提出了紧张性头痛和偏头痛中药新药临床试验设计中需要注意的问题和处理方法.认为国际头痛协会的头痛临床试验指南所确定的原则同样适用于中药新药临床试验.头痛中药新药临床试验应采用国际头痛协会诊断标准,在明确药物的治疗定位的基础上,根据国际头痛协会推荐的临床试验原则确定纳入标准、疗程、疗效指标和选择对照药.中医特色项目设计也应当符合相同的原则.     

正天丸对小白鼠心脏等基因的影响及治疗各种头痛可能的机理

目的观察方剂“正天丸”，调节正常小白鼠心、甲状腺、肾和胰腺等基因活力的增减与其功能相联系，对比多瘀、多风、多湿“证”头痛患者，有助于了解正天丸能治疗各种头痛患者的奥秘。方法用3H-dTR掺人已连续服正天丸药水五天的正常小白鼠各器官组织DNA(基因)，并测其放射性。结果促进小白鼠心、甲状腺、淋巴结、肾、胸腺、肾上腺和肺基因活力分别提高176．0％、149．8％、108．2％、81.3％、58．0％、36．9％、21．7％，并使胰腺、骨髓、小肠和脾基因分别受到62.3％、43．7％、38．4％、31．3％的抑制。结论正天丸方剂的有效成分，如阿魏酸、川芎嗪、芍药甙、β谷甾醇、红花甙、苦杏仁甙、钩藤碱、伪麻黄碱等调节特定基因-心肌(“心激素”、心NOS等)基因、甲状腺基因、肾基因和胰腺基因等及其调理其它所有基因的结果，使心脑血管内的血液成分、血管舒缩物质、神经体液、ROS、电解质等逐渐恢复平衡。所谓“正天”，即正天丸多成分、多靶点、多途径、多层次、多环节调理与清除由风湿瘀所引起的，中枢神经系统可感受疼痛的神经星形胶质细胞兴奋因子(致炎因子、NO与其它因子等)，使各种头痛患者疼痛感缓解或消失。