偏头痛患者血浆一氧化氮和降钙素基因相关肽含量测定及发病机制探讨

目的探讨一氧化氮（ＮＯ）和降钙素基因相关肽（ＣＧＲＰ）在偏头痛发病机制中的作用。方法采用分光光度法和放免法,对偏头痛发作期２６例、间歇期２３例,其他头痛患者２７例及正常人２０例颈静脉（ＥＪＶ）和肘静脉（ＣＦ）血中ＮＯ和ＣＧＲＰ进行了测定。结果偏头痛发作组ＥＪＶ和ＣＦ血中ＮＯ含量均较正常人显著升高（Ｐ均＜０．０１）;偏头痛发作组ＥＪＶ血中ＣＧＲＰ含量明显升高（Ｐ＜０．０１）,而ＣＦ血中两组间无显著差异（Ｐ＞０．０５）。结论ＮＯ和ＣＧＲＰ在偏头痛的发病机制中起重要作用。     

偏头痛患者血浆一氧化氮和降钙基因相关肽含量测定及发病机制 …

目的 探讨一氧化氮（ＮＯ）和降钙素基因相关肽（ＣＧＲＰ）在偏头痛发病机制中的作用。方法 采用分光光度法和放免法,对偏头痛发作期２６例、间歇期２３例,其他头痛患者２７例及正常人２０例颈静脉（ＥＩＶ）和肘静脉（ＣＦ）血中ＮＯ和ＣＧＲＰ进行了测定。结果 偏头痛发作组ＥＪＶ和ＣＦ血中ＮＯ含量均较正常人显著升高（Ｐ均〈０．０１）;偏头痛发作组ＥＪＶ血中ＣＧＲＰ含量明显升高（Ｐ〈０．０１）,而ＣＦ血中两组间无     

降钙素基因相关肽与偏头痛关系的研究

目的:研究降钙素基因相关肽与偏头疼的关系。方法:选择28例偏头痛发作期患者及20例正常对照组,抽取肘静脉血2ml,随后行腰椎穿刺,留取CSF1ml,检测CGRP,CGRP测定采用放免法。结果:偏头痛组肘静脉血中CGRP明显高于正常对照(P<0.001),偏头痛组CSF中CGRP含量明显高于正常对照组(P<0.001)。结论:偏头痛发作与CGRP的异常释放密切相关。     

降钙素基因相关肽与偏头痛

降钙素基因相关肽(CGRP)是一种广泛存在于中枢及周围神经系统的神经肽。多项试验证实其在偏头痛发作中发挥着舒张血管、介导神经源性炎症、调节痛觉感受等作用。近年来大量Ⅱ、Ⅲ期临床试验结果显示,针对降钙素基因相关肽的药物在偏头痛的急性期治疗和预防治疗中均可产生良好疗效,这或许可以彻底改变偏头痛的药物治疗选择。本文即通过总结国内外相关文献,讨论降钙素基因相关肽的结构分布,其在偏头痛发作过程中的作用及其相关药物的研发。     

偏头痛患者血浆内皮素和降钙素基因相关肽含量的变化与临床意义

目的：观察偏头痛患血装饰品中内皮素（ET）和降钙素基因相关肽（CGRP）含量的变化，并探讨其临床意义。方法：采用放射免疫的方法，测38例无先兆型偏头痛患及25例正常人血浆ET，CGRP含量。结果：均高于对照组偏头痛组的ET，CGRP含量，差异有显性意义（P＜0．01），ET和CGRP的比值升高（ET／CGRP）与偏头痛的严重程度有关，重度显高于轻中度。结论：偏头痛的发病可能与ET，CGRP水平失衡有关。     

天舒胶囊治疗偏头痛50例疗效分析

近年来,偏头痛在人群中发病率有逐年增高趋势,严重影响患者的工作和生活。我科自2010年来应用天舒胶囊治疗偏头痛取得较好疗效,现报告如下。1资料与方法1.1一般资料入选的100例偏头痛患者均来自我院2010年门诊和住院患者,均符合国际头痛协会偏头痛诊断标准,并经多项检查排除脑血管疾病、癫、颅内占位性病变、颅内感染、眼科疾病及全身性疾病引起的头痛。随机分为2组各50例,治疗组(天舒胶囊组)中男21例,女29例,年     

降钙素基因相关肽在偏头痛中的作用

偏头痛的具体发病机制至今尚未明确,但它严重影响患者的日常生活,因此寻找其特异性治疗成为重中之重。越来越多的研究表明,降钙素基因相关肽(CGRP)在偏头痛中发挥重要作用,本文将从CGRP结构、分布及其在偏头痛发作过程中的作用和相关药物研发几方面来进行阐述。     

天舒胶囊治疗偏头痛疗效的Meta分析

目的评价天舒胶囊治疗偏头痛的疗效和安全性。方法检索公开发表关于天舒胶囊治疗偏头痛的随机对照试验的文献,通过Cochrane系统评价方法对所纳入文献进行质量评价,采用Revman 5.2软件进行统计分析。结果将对照组仅为氟桂利嗪、结局指标为总有效率的7篇文献进行Meta分析显示,天舒胶囊组疗效显著优于氟桂利嗪组(OR=2.92,95%CI:1.89~4.49,Z=4.87,P0.00001);选取其中3个剂量及疗程相同的研究做亚组分析发现,治疗组与对照组疗效差异有统计学意义(OR=4.21,95%CI:2.21~8.02,Z=4.37,P0.0001),与整体分析结果一致。对另4篇因对照组药物不同及结局指标无法合并的文献进行描述性分析发现,天舒胶囊治疗偏头痛的疗效优于奥卡西平(P=0.007),且奥卡西平更易发生肝功能异常;治疗前后头痛发作频率、头痛持续时间差异均有统计学意义(均P0.05)。8篇文献以胃部不适、女性月经过多为主要不良反应,未见严重不良反应。结论天舒胶囊治疗偏头痛的疗效优于氟桂利嗪、奥卡西平、传统中成药元胡止痛胶囊、丹参胶囊,且不良反应少。     

天舒胶囊对偏头痛大鼠血浆β内啡肽、五羟色胺含量及其脑组织c-fos表达的影响

目的研究天舒胶囊对偏头痛大鼠血浆β内啡肽(β-EP)、五羟色胺(5-HT)含量及其脑组织c-fos表达的影响。方法皮下注射硝酸甘油建立偏头痛大鼠模型,给予天舒胶囊高、中、低剂量灌胃(剂量为7.5g/kg、3.75g/kg和1.88g/kg),按治疗和预防两种方式给药。空白对照组和模型组予以相应剂量的生理盐水灌胃。采用放免法和高效液相色谱法分别测定大鼠静脉血中β-EP、5-HT含量;免疫组化染色观察中脑导水管周围灰质β-EP、5-HT和c-fos阳性表达。结果与模型组比较,天舒胶囊高剂量治疗和预防组、中剂量预防组血浆β-EP水平明显升高(均P<0.05),天舒胶囊高、中、低剂量治疗和预防组血浆5-HT水平明显降低(均P<0.05);天舒胶囊中剂量治疗和预防组中脑导水管周围灰质c-fos表达明显降低(均P<0.05),而β-EP、5-HT表达增高(均P<0.05)。结论天舒胶囊可改善偏头痛发作时血管活性物质和神经递质水平失常,从而改善偏头痛症状。     

降钙素基因相关肽对中枢神经系统的影响

降钙素基因相关肽(CGRP)是一种新型的内源性生物活性神经多肽,它广泛分布于中枢神经系统(CNS),并对其产生多种影响。研究表明,CGRP能扩张脑血管、对损伤的神经元具有保护和功能恢复、参与伤害性信息感受、介导神经-免疫系统相互调节等。此外,CGRP也能对癫痫疾病产生影响。深入研究CGRP对CNS的影响,对揭示脑部某些疾病的发生、发展规律,进而提出新的诊断措施和开发新的治疗思路,可能提供有益的帮助。     

妙纳与天舒胶囊合用治疗紧张性头痛疗效观察

目的探讨妙纳与天舒胶囊合用时对紧张性头痛的治疗效果。方法100例患者随机分成治疗组(50例)和对照组(50例),治疗组联合服用妙纳及天舒胶囊,对照组单用天舒胶囊,治疗2周,观察疼痛程度改变。结果联合服用妙纳及天舒胶囊治疗紧张性头痛疗效优于单用天舒胶囊。结论两者合用治疗紧张性头痛效果更好。     

β-淀粉样肽对AD大鼠脑NO、NOS和氧自由基的影响研究

目的　探讨一氧化氮 ( NO)、一氧化氮合酶 ( NOS)和氧自由基在阿尔茨海默病 ( AD)发病中的作用。方法参照 Nabeshima方法 ,将 1 μLβ-淀粉样肽 ( beta-amyloid peptide,Aβ) 1 -4 0 ( 1 0 μg/μL)在立体定仪下注入大鼠侧脑室建立大鼠 AD模型 ,分别于 1、2、3周时测定血液和脑组织中 NO、NOS、过氧化氢酶 ( CAT)、总抗氧化能力( T-AOC)、胆碱酯酶 ( Ch E)的含量及其学习记忆能力 ,并进行相关分析。结果　 Aβ注射 1周后 ,Ch E、CAT、T-AOC明显下降 ( P <0 .0 5 ) ,而 NO和 NOS的含量较对照组显著升高 ( P<0 .0 5 )。随时间延长 ,在 2周、3周时Ch E仍呈下降趋势 ,而 NO、NOS较第 1周时无显著变化 ,CAT和 T-AOC下降越显著 ,动物的学习记忆能力亦明显降低 ,且两者间呈正相关。结论　Aβ能诱发机体的氧化应激反应 ,致机体抗氧化能力降低 ,NO和 NOS的增高与学习记忆的减退密切相关 ,提示 Aβ诱导的氧化应激损伤和 NO/NOS途径在 AD的形成过程中有一定作用 ,可能是 Aβ对 AD脑神经毒性作用的机制之一。     

Calcitonin gene-related peptide antagonism for acute treatment of migraine: a meta-analysis

Purpose: Calcitonin gene-related peptide (CGRP) is an effector of acute migraine attack. And the CGRP antagonisms have shown some early promise in the treatment of migraine. Here, we performed a meta-analysis to evaluate the efficacy of CGRP antagonisms in treating acute migraine attack. Methods: Pubmed, Cochrane Library, Web of Science and OvidSP were systematically searched up to 9 April 2015 for randomized controlled trials (RCTs) which is dealing with the efficacy of CGRP antagonisms in treating acute migraine attack. The bias and quality of RCTs were assessed with Cochrane collaboration's tool for assessing risk of bias. Reviewer manager 5.2 was utilized for data analysis. Results: Totally 13 publications matched the inclusion criteria, including 10 independent RCTs and 6803 patients. Pooled analysis indicated that CGRP antagonisms had better outcomes in number of patients with pain free at 2h, 2-24h sustained pain free, phonophobia free at 2h, patients with photophobia free at 2h and nausea free at 2h post-dose, as compared with placebo. But CGRP antagonisms were no superior than 5-HT agonists in the indices above mentioned. Conclusions: CGRP antagonisms may be an effective and promising treatment for acute migraine attack.     

大鼠大脑缺血再灌注中PMNLs对脑组织cGRP表达及损伤程度的影响

目的:探讨多形核白细胞(ＰＭＮＬｓ)在大鼠大脑缺血再灌注中对大脑神经元降钙素基因相关肽(ｃＧＲＰ)表达及脑损伤程度的影响。方法:大鼠大脑中动脉(ＭＣＡ)缺血再灌注模型中,观察神经元的ｃＧＲＰ表达,对比各组大脑神经元超微结构变化。结果:未加注Ｍａｃ－１抗体组脑组织ＰＭＮＬｓ聚集较明显,相应区域的神经元呈ｃＧＲＰ弱阳性反应,电镜观察神经元、神经纤维及突触肿胀明显,神经毡结构间隙增大并常有变性或坏死。结论:大鼠大脑中动脉缺血再灌注期间,脑神经元的ｃＧＲＰ表达可反应性增加,而浸润到脑组织中的大量ＰＭＮＬｓ可干扰神经元的ｃＧＲＰ表达,并同时伴有脑组织超微结构的破坏性改变。     

Cerebral arterial innervation by nerve fibers containing calcitonin gene-related peptide (CGRP): I. Distribution and origin of CGRP perivascular innervation in the rat

The origin, density and distribution of calcitonin gene-related peptide (CGRP) immunoreactivity in cerebral perivascular nerves and the trigeminal ganglion of rats were examined in this study. CGRP immunoreactive axons were abundant on the walls of the rostral circulation of the major cerebral arteries in the circle of Willis. The fibers form a grid- or meshwork of longitudinal and circumferential axons studded with numerous varicose swellings. The density of CGRP fibers was particularly high at the bifurcation of major arteries. A few CGRP fibers cross the midline to innervate arteries on the contralateral side of the arterial tree. The arteries of the caudal circulation were sparsely innervated by CGRP fibers. In the trigeminal ganglion, about 30% of the ganglion cells had CGRP immunoreactivity. The cell size of most (75%) of CGRP neurons was less than 30 micron in diameter. There was no significant difference in staining density between small and large CGRP neurons. Unilateral transection of the maxillary and mandibular divisions of the trigeminal nerve caused a substantial decrease of CGRP immunoreactivity in the ipsilateral dorsal two-thirds of the trigeminal nucleus and cervical spinal cord but did not noticeably change the diameter of the vascular lumen or the densities of CGRP fibers in the walls of the cerebral arteries. In contrast, unilateral transection that included the ophthalmic division eliminated CGRP fibers on the ipsilateral cerebral arteries and eliminated CGRP immunoreactivity throughout the trigeminal nucleus in the brainstem and rostral cervical cord. In addition, these lesions caused a significant reduction in the diameter of the denervated arteries. The present study demonstrates that CGRP, a putative neurotransmitter/neuromodulator, is especially abundant in the rostral cerebral circulation and is derived from the ipsilateral ophthalmic division of the trigeminal nerve. In addition, the loss of CGRP perivascular nerves is associated with a reduction of the arterial lumen. This suggests that CGRP is a strong candidate as a nerve-derived trophic factor at trigeminal terminals and provides additional evidence that CGRP is a component in the trigeminovascular system influencing vascular diameter.     

温针灸对腰神经根受压大鼠模型一氧化氮合酶和降钙素相关基因肽的影响

BACKGROUND： Varying degrees of inflammatory responses occur during lumbar nerve root compression. Studies have shown that nitric oxide synthase （NOS） and calcitonin gene-related peptide （CGRP） are involved in secondary disc inflammation. OBJECTIVE： To observe the effects of warm acupuncture on the ultrastructure of inflammatory mediators in a rat model of lumbar nerve root compression, including NOS and CGRP contents. DESIGN, TIME AND SETTING： Randomized, controlled study, with molecular biological analysis, was performed at the Experimental Center, Sixth People＇s Hospital Affiliated to Shanghai Jiao Tong University, between September 2006 and April 2007. MATERIALS： Acupuncture needles and refined Moxa grains were purchased from Shanghai Taicheng Technology Development Co., Ltd., China; Mobic tablets were purchased from Shanghai Boehringer Ingelheim Pharmaceuticals Co., Ltd., China; enzyme linked immunosorbent assay （ELISA） kits for NOS and CGRP were purchased from ADL Biotechnology, Inc., USA. METHODS： A total of 50, healthy, adult Sprague-Dawley rats, were randomly divided into five groups normal, model, warm acupuncture, acupuncture, and drug, with 10 rats in each group. Rats in the four groups, excluding the normal group, were used to establish models of lumbar nerve root compression. After 3 days, Jiaji points were set using reinforcing-reducing manipulation in the warm acupuncture group. Moxa grains were burned on each needle, with 2 grains each daily. The acupuncture group was the same as the warm acupuncture group, with the exception of non-moxibustion. Mobic suspension （3.75 mg/kg） was used in the oral drug group, once a day. Treatment of each group lasted for 14 consecutive days. Modeling and medication were not performed in the normal group. MAIN OUTCOME MEASURES： The ultrastructure of damaged nerve roots was observed with transmission electron microscopy; NOS and CGRP contents were measured using ELISA. RESULTS： The changes of the radicular ultramicrostructure were characterized by Wallerian degeneration; nerve fibers were clearly demyelinated; axons collapsed or degenerated; outer Schwann cell cytoplasm was swollen and its nucleus was compacted. Compared with the normal group, NOS and CGRP contents in the nerve root compression zone in the model group were significantly increased （P 〈 0.01）. Nerve root edema was improved in the drug, acupuncture and the warm acupuncture groups over the model group. NOS and CGRP expressions were also decreased with the warm acupuncture group having the lowest concentration （P 〈 0.01）. CONCLUSION： In comparison to the known effects of Mobic drug and acupuncture treatments, the warm acupuncture significantly decreased NOS and CGRP expression which helped improve the ultrastructure of the compressed nerve root.     

亚低温治疗对蛛网膜下腔出血继发性血管痉挛及脑脊液和血浆内皮素、降钙素基因相关肽的影响

目的 探讨亚低温治疗对蛛网膜下腔出血(SAH)继发性血管痉挛及脑脊液和血浆内皮素(ET)、降钙素基因相关肽(CGRP)水平的影响.方法 56例SAH患者随机分成亚低温组和对照组,两组在常规治疗的基础上,亚低温组增加局部亚低温治疗;检测两组入院时及治疗7 d、14 d脑脊液和血浆ET、CGRP水平,并比较两组脑血管痉挛的发病情况.结果 (1)脑脊液、血浆ET水平治疗7 d时亚低温组较对照组显著降低(均P＜0.05);14 d时差异更显著(均P＜0.01);两组CGRP水平治疗第7 d时降至最低,后渐升高,亚低温组较对照组变化幅度小,差异有统计学意义(P＜0.05～0.01).(2)亚低温组脑血管痉挛发病率为6.67%,较对照组的30.77%明显减少(P＜0.05).结论 亚低温治疗减少了SAH患者脑脊液和血浆中ET水平上升幅度及CGRP水平下降幅度,从而降低脑血管痉挛的发生率.     

Gabapentin inhibits central sensitization during migraine

Peripheral and central sensitizations are phenomena that occur during migraine. The role of gabapentin, a migraine preventive drug, on central sensitization remains unclear. In this study, a rat model of migraine was established by electrical stimulation of the trigeminal ganglion, and the animals were given intragastric gabapentin. Changes in amino acid content in the cerebrospinal fluid and protein kinase C membrane translocation in the spinal trigeminal nucleus were examined to clarify the mechanisms underlying the efficacy of gabapentin in the treatment of central sensiti- zation during migraine. Electrophysiology, liquid chromatography-mass spectrometry and western blot analysis results revealed that gabapentin reduces neuronal excitability in the spinal nucleus in the trigeminal nerve, decreases excitatory amino acid content and inhibits the activation of protein kinase C. This provides evidence that excitatory amino acids and protein kinase C are involved in the formation and maintenance of central sensitization during migraine. Gabapentin inhibits mi- graine by reducing excitatory amino acid content in the cerebrospinal fluid and inhibiting protein kinase C activation.