偏头痛发病机制与药物干预研究进展
Research Progress on the Pathogenesis and Pharmacological Intervention of Migraine
DOI: 10.12677/acm.2026.1652070, PDF,   
作者: 杭爱民:内蒙古民族大学临床医学院五疗脑病科,内蒙古 通辽;敖其尔*:内蒙古自治区国际蒙医医院五疗脑病科,内蒙古 呼和浩特
关键词: 偏头痛发病机制西药中药蒙药Migraine Pathogenesis Western Medicine Traditional Chinese Medicine Mongolian Medicine
摘要: 偏头痛是一种临床常见的原发性头痛,具有患病率高、致残性强、易反复发作的特点,严重影响患者的生活质量。现代医学、中医学与蒙医学对偏头痛的发病机制各有不同的理论阐释,在药物治疗方面也积累了丰富的临床经验。本文系统梳理三类医学体系中偏头痛的发病机制认识,分别总结其在急性期治疗和预防性用药方面的药物应用现状,重点介绍近年来以CGRP为靶点的新药进展以及蒙医药的特色理论与实践,以期为偏头痛的临床治疗和新药研发提供参考。
Abstract: Migraine is a common primary headache disorder characterized by high prevalence, strong disability, and recurrent episodes, which seriously affects patients’ quality of life. Modern medicine, traditional Chinese medicine, and Mongolian medicine have different theoretical explanations for the pathogenesis of migraine, and have accumulated rich clinical experience in pharmacological treatment. This article systematically reviews the understanding of migraine pathogenesis in the three medical systems, summarizes their current application of drugs in acute treatment and preventive medication, and focuses on the recent advances in new drugs targeting CGRP as well as the characteristic theories and practices of Mongolian medicine, aiming to provide reference for clinical treatment and new drug development of migraine.
文章引用:杭爱民, 敖其尔. 偏头痛发病机制与药物干预研究进展[J]. 临床医学进展, 2026, 16(5): 2597-2603. https://doi.org/10.12677/acm.2026.1652070

参考文献

[1] Sacco, S., Lampl, C., Maassen van den Brink, A., et al. (2021) Burden and Attitude to Resistant and Refractory Migraine: A Survey from the European Headache Federation with the Endorsement of the European Migraine & Headache Alliance. The Journal of Headache and Pain, 22, Article No. 39. [Google Scholar] [CrossRef] [PubMed]
[2] Yu, S., Liu, R., Zhao, G., Yang, X., Qiao, X., Feng, J., et al. (2011) The Prevalence and Burden of Primary Headaches in China: A Population‐Based Door‐to‐Door Survey. Headache: The Journal of Head and Face Pain, 52, 582-591. [Google Scholar] [CrossRef] [PubMed]
[3] Feigin, V.L., Stark, B.A., Johnson, C.O., et al. (2021) Global, Regional, and National Burden of Stroke and Its Risk Factors, 1990-2019: A Systematic Analysis for the Global Burden of Disease Study 2019. The Lancet Neurology, 20, 795-820. [Google Scholar] [CrossRef] [PubMed]
[4] Khan, J., Asoom, L.I.A., Sunni, A.A., Rafique, N., Latif, R., Saif, S.A., et al. (2021) Genetics, Pathophysiology, Diagnosis, Treatment, Management, and Prevention of Migraine. Biomedicine & Pharmacotherapy, 139, Article 111557. [Google Scholar] [CrossRef] [PubMed]
[5] Braganza, D.L., Fitzpatrick, L.E., Nguyen, M.L. and Crowe, S.F. (2022) Interictal Cognitive Deficits in Migraine Sufferers: A Meta-Analysis. Neuropsychology Review, 32, 736-757. [Google Scholar] [CrossRef] [PubMed]
[6] 杨浩军, 程强强, 范姣, 等. 神经血管活性物质在偏头痛发病机制中的作用研究[J]. 中国疗养医学, 2025, 34(12): 69-73.
[7] 蒋仙国. 偏头痛发病机制及治疗新进展[J]. 神经病学与神经康复学杂志, 2019, 15(2): 80-88.
[8] Tuka, B. and Juhasz, G. (2020) Genetics of Migraine: A Complex Disorder with Heterogeneous Clinical Manifestations. The FEBS Journal, 287, 236-254.
[9] 张亚男, 刘璐, 张雅杰, 等. 无先兆偏头痛患者针刺治疗后双侧楔叶的镜像同伦功能连接改变[J]. 磁共振成像, 2022, 13(6): 50-55.
[10] 李欣宇, 孟紫嫣, 朱美杰, 等. 中医治疗偏头痛研究进展[J]. 中华养生保健, 2023, 41(22): 75-78.
[11] 张璐. 本经逢原[M]. 北京: 中国中医药出版社, 1996.
[12] 孙琦. 无先兆偏头痛患者头痛严重程度与中医证候学特征分布的相关性研究[D]: [硕士学位论文]. 长春: 长春中医药大学, 2024.
[13] 敖其尔, 特木其乐. 偏头痛蒙西医病机研究进展[J]. 中国民族医药杂志, 2018, 24(7): 64-67.
[14] 白清云. 中国医学百科全书·蒙医学[M]. 赤峰: 内蒙古科学技术出版社, 1987: 187-189.
[15] 白宝玉. 蒙医病理学[M]. 呼和浩特: 内蒙古人民出版社, 2004: 554.
[16] 四部医典[M]. 特·特木热, 校注. 赤峰: 内蒙古科学技术出版社, 1987: 476-496.
[17] 策·苏荣扎布. 蒙医内科学(统编教材) [M]. 呼和浩特: 内蒙古人民出版社, 1986: 481.
[18] 其格其图. 现代蒙医学[M]. 沈阳: 辽宁民族出版社, 2002: 245-247.
[19] 胥小诺, 董亮, 周冀英. 偏头痛急性治疗药物新进展及优化策略[J]. 重庆医科大学学报, 2024, 49(5): 577-582.
[20] 中国医师协会神经内科医师分会, 中国研究型医院学会头痛与感觉障碍专业委员会. 中国偏头痛诊治指南(2022版) [J]. 中国疼痛医学杂志, 2022, 28(12): 881-898.
[21] Eadie, M.J. (2004) Ergot of Rye—The First Specific for Migraine. Journal of Clinical Neuroscience, 11, 4-7. [Google Scholar] [CrossRef] [PubMed]
[22] Tajti, J., Majláth, Z., Szok, D., Csáti, A. and Vécsei, L. (2015) Drug Safety in Acute Migraine Treatment. Expert Opinion on Drug Safety, 14, 891-909. [Google Scholar] [CrossRef] [PubMed]
[23] de Vries, T., Villalón, C.M. and MaassenVanDenBrink, A. (2020) Pharmacological Treatment of Migraine: CGRP and 5-HT Beyond the Triptans. Pharmacology & Therapeutics, 211, Article 107528. [Google Scholar] [CrossRef] [PubMed]
[24] Yu, S., Kim, B., Guo, A., Kim, M., Zhang, M., Wang, Z., et al. (2023) Safety and Efficacy of Rimegepant Orally Disintegrating Tablet for the Acute Treatment of Migraine in China and South Korea: A Phase 3, Double-Blind, Randomised, Placebo-Controlled Trial. The Lancet Neurology, 22, 476-484. [Google Scholar] [CrossRef] [PubMed]
[25] Ailani, J., Burch, R.C. and Robbins, M.S. (2021) The American Headache Society Consensus Statement: Update on Integrating New Migraine Treatments into Clinical Practice. Headache: The Journal of Head and Face Pain, 61, 1021-1039. [Google Scholar] [CrossRef] [PubMed]
[26] Charles, A. and Pozo-Rosich, P. (2019) Targeting Calcitonin Gene-Related Peptide: A New Era in Migraine Therapy. The Lancet, 394, 1765-1774. [Google Scholar] [CrossRef] [PubMed]
[27] Lipton, R.B., Goadsby, P.J., Smith, J., Schaeffler, B.A., Biondi, D.M., Hirman, J., et al. (2020) Efficacy and Safety of Eptinezumab in Patients with Chronic Migraine. Neurology, 94, e1365-e1377. [Google Scholar] [CrossRef] [PubMed]
[28] Chiang, C.C. and Schwedt, T.J. (2020) Calcitonin Gene-Related Peptide (CGRP)-Targeted Therapies as Preventive and Acute Treatments for Migraine: The Monoclonal Antibodies and Gepants. Progress in Brain Research, 255, 143-170.
[29] Giamberardino, M.A., Affaitati, G., Curto, M., Negro, A., Costantini, R. and Martelletti, P. (2016) Anti-CGRP Monoclonal Antibodies in Migraine: Current Perspectives. Internal and Emergency Medicine, 11, 1045-1057. [Google Scholar] [CrossRef] [PubMed]
[30] Silberstein, S.D. (2017) Current Management: Migraine Headache. CNS Spectrums, 22, 1-13. [Google Scholar] [CrossRef] [PubMed]
[31] 沈燕, 樊小农, 王舒. 从“神”论针刺预防性治疗偏头痛的思路探讨[J]. 中华中医药杂志, 2015, 30(4): 1160-1163.
[32] 张凤. 疏肝健脾止痛法针药并用治疗肝郁脾虚型偏头痛的临床研究[D]: [硕士学位论文]. 济南: 山东中医药大学, 2022.
[33] 吴帅. 养肾活血汤治疗无先兆偏头痛(肾虚血瘀证)的临床研究[D]: [硕士学位论文]. 郑州: 河南中医药大学, 2022.
[34] 金肖, 金斌, 赵薇. 散偏汤联合盐酸氟桂利嗪胶囊治疗偏头痛临床研究[J]. 新中医, 2020, 52(19): 36-38.
[35] 师虹艳, 杨少坤, 荀军锋, 等. 血府逐瘀汤加减联合盐酸赛庚啶片治疗血瘀型偏头痛的临床观察[J]. 中国医院用药评价与分析, 2023, 23(12): 1450-1453.
[36] 乌兰. 蒙医常见病诊疗指南[M]. 呼和浩特: 内蒙古人民出版社, 2018: 54.
[37] 王秀艳. 蒙医药治疗偏头痛的临床疗效[J]. 中国民族医药杂志, 2022, 28(3): 5-6.
[38] 苏布德, 高敬贤. 蒙医辨证治疗偏头痛临床疗效[J]. 中国民族医药杂志, 2020, 26(10): 1-2.
[39] 萨秋拉. 土木香十味散治疗无先兆偏头痛(热型)的临床研究[D]: [硕士学位论文]. 通辽: 内蒙古民族大学, 2022.
[40] 额尔德尼高娃, 巴格那. 蒙医治疗血管性偏头痛73例疗效观察[J]. 中国民族医药杂志, 2009(3): 12-13.