ABSTRACT
ObjectiveTaking Chuanxiong Chatiaosan prescription as the carrier， by comparing the differences of volatile components in Chuanxiong Rhizoma with single decoction pieces and compatible prescription of different decoction pieces， the differences of material basic connotation of different formulations of Chuanxiong Chatiaosan were revealed from the aspects of processing （raw and wine-processed products）， compound compatibility and dosage form （powder and decoction）. MethodThe volatile oil was extracted from different decoction pieces of Chuanxiong Rhizoma， Chuanxiong Chatiaosan and its decoction with different decoction pieces of Chuanxiong Rhizoma by steam distillation， the main components and their relative contents were identified by gas chromatography-mass spectrometry （GC-MS）. ResultA total of 25 volatile components were identified from different processed products of Chuanxiong Rhizoma， including 11 monoterpenoids， 4 phenols， 3 sesquiterpenoids， 3 phthalides， 2 ketones and 2 olefins， the contents of α-pinene， β-pinene， 3-butylphthalide and others increased after the raw products was processed with wine. A total of 85 constituents were identified from Chuanxiong Chatiaosan with different decoction pieces， including 31 monoterpenoids， 23 sesquiterpenoids， 5 alcohols， 5 aldehydes， 4 phenols， 4 phthalides， 3 ethers， 3 ketones， 1 olefin， 1 organic acid， 2 esters and 3 other compounds. A total of 22 components， including 9 sesquiterpenoids， 3 phthalides， 2 phenols， 6 monoterpenoids， 1 aldehyde and 1 alkane， were identified from the decoction of Chuanxiong Chatiaosan with different processed products. ConclusionThere was no significant difference in the composition between raw products and wine-processed products of Chuanxiong Rhizoma either in single decoction pieces or in compatibility prescription， but the relative content changed to some extent， and the wine-processed products was the most obvious. There was a great difference in the composition of volatile components between the Chuanxiong Chatiaosan and its decoction. The volatile components， such as isopulegol， isocalamendiol and safrole， were not found in the decoction. Components in Chuanxiong Rhizoma processed with wine will change with the addition of yellow rice wine， and volatile components can reflect the difference between decoction pieces and prescriptions of the wine-processed products.
ABSTRACT
Chuanxiong Chatiaosan was first recorded in Taiping Huimin Heji Jufang, which was made up of 8 herbs, including Chuanxiong Rhizoma, Menthae Haplocalycis Herba, Asari Radix et Rhizoma, Schizonepetae Herba, Saposhnikoviae Radix, Angelicae Dahuricae Radix, Notopterygii Rhizoma et Radix and Glycyrrhizae Radix et Rhizoma. This prescription mainly contains a variety of alkaloids, flavonoids, phenylpropanoids, volatile oils and other compounds, which play the biological activity of promoting blood circulation and relieving pain. Modern pharmacological studies have confirmed that Chuanxiong Chatiaosan can reduce blood viscosity, improve cerebral circulation, and has central analgesic effect to treat migraine effectively. However, the mechanism for treating migraine of this prescription is still unclear. The author elaborated the research status of Chuanxiong Chatiaosan from four aspects, including quality control method, chemical composition, preparation technology and pharmacological research, hoping to provide references for rational clinical application and explanation of pharmacological mechanism of this prescription.
ABSTRACT
Objective:To observe the efficacy of addition and subtraction therapy of Chuanxiong Chatiaosan combined with acupuncture for acute migraine attack with syndrome of wind phlegm blocking collaterals and to investigate its effect on neurovascular active medium. Method:One hundred and thirty-four patients were randomly divided into control group（67 cases） and observation group （67 cases）by random number table. During the treatment， 63 patients completed the study in control group （loss to follow-up in 2 cases， and elimination in 2 cases）. 64 patients completed the study in observation group （loss to follow-up in 3 cases）. Patients in both groups got ibuprofen sustained release tablets， 1 tablet/time， 2 times/day， Zolmitriptan tablets， 2.5 mg/time， 1 time/day， which were stopped when symptoms got relieved. Patients in control group got acupuncture treatment， 1 time/day， and Zhengtian pills by oral administration， 6 g/time， 2 times/day. Based on the treatment of acupuncture in control group， patients in observation group additionally received addition and subtraction therapy of Chuanxiong Chatiaosan， 1 dose/day， with a treatment course of 10 days in both groups. Before treatment， at the first day （2， 4 ， 12 ， 24 h） and second to tenth day after the treatment， scores of pain visual analoguescale （VAS） were graded； before and after treatment， scores of duration and degree of headache， concomitant symptoms， number of headache attacks， syndrome of wind phlegm blocking collaterals， migraine specific quality of life scale （MSQ） were graded. Levels of nitric oxide （NO）， endothelin-1 （ET-1）， calcitonin gene-related peptide （CGRP）， 5-hydroxytryptamine （5-HT）， and β endorphin （β -EP） were detected before and after treatment. Result:The clinical efficacy in observation group was better than that in control group （Z=2.115， P<0.05）. At the second and fourth hour after treatment， VAS scores were decreased in both groups， but there was no statistically significant difference between two groups. At the 12th and 24th hour after treatment， VAS scores were increased as compared with those at the previous time point （P<0.01）， and VAS scores in observation group at the 12th and 24th hour were lower than those in control group （P<0.01）， but there was no statistically significant difference in onset time for pain， effective rate for pain at second hour after treatment and the disappearance rate of pain at the third day after treatment. Time to pain relief in observation group was shorter than that in control group （P<0.01）. Degree of headache， duration of headache， number of headache attacks and accompanying symptoms were all lower than those in control group， while scores of MSQ and the total score of MSQ were all higher than those in control group （P<0.01）. Recurrence rate of pain in observation group was 18.75% （12/64）， lower than 36.51% （23/63） in control group at the 24th hour （P<0.05）. Disappearance rate of pain in observation group was 70.31% （45/64） and 90.63% （58/64） at the fifth day and tenth day after treatment， higher than 52.38% （33/63） and 76.19% （48/63） in control group （P<0.05）. Levels of NO， β-EP and 5-HT were higher than those in control group （P<0.01）， while levels of CGRP and ET-1 were lower than those in control group （P<0.01）. Conclusion:Chuanxiong Chatiaosan combined with acupuncture in the treatment of acute migraine attack in patients， has equivalent effect in terms of rapid pain relief， but with advantages of long-lasting analgesic effect， low recurrence rate， high pain relief rate and disappearance rate. In addition， it can also regulate neurovascular active mediators， more effectively control acute migraine attack， and improve the quality of life of patients， with a better clinical efficacy.