Ratanasampil is more effective than flunarizine in relieving migraine

AbstractAims: Migraine is a common neurological disorder with high incidence in population. This study aimed to investigate the therapeutic efficacy of Tibetan medicine Ratanasampil (RNSP) and to identify the serum biomarkers for diagnosis and response assessment.Materials and methods: We prospectively recruited 108 migraine patients living at high altitude (2,260 m), including 40 patients for RNSP group, 40 patients for flunarizine (FLZ) group, and 28 patients for placebo group. Serum levels of 5-hydroxytryptamine (5-HT), brain-derived neurotrophic factor (BDNF), calcitonin gene related peptide (CGRP), nerve growth factor (NGF) and β-endorphin (β-EP) before and after therapy were measured.Results: In comparison with placebo, both FLZ and RNSP significantly reduced the migraine days, HIT-6 score and verbal rating scale, headache intensity, duration, accompanying symptoms and headache score in four and eight weeks treatment. RNSP showed no significant difference to FLZ in the above parameters after four weeks treatment, but showed significantly better relief after eight weeks treatment. The overall effective rate of RNSP (92.5%) was also significantly higher than FLZ (74.4%, p < 0.05), mainly due to significantly higher ratio of patients with full recovery. The serum levels of biomarkers, including 5-HT, BDNF, NGF and β-EP, significantly elevated after eight weeks of treatment with RNSP, whereas the level of CGRP significantly decreased. The serum level of 5-HT exhibited significantly bigger percentage changes than other markers.Conclusion: In conclusion, RNSP was more effective than FLZ in relieving migraine after eight weeks continuous treatment. Serum 5-HT, BDNF, CGRP, NGF and β-EP were effective markers reflecting the response to RNSP and FLZ therapy.Keywords: MigraineheadacheRannasangpeiRNSPflunarizineFLZ5-HTCGRP Disclosure statementThe authors declare that they have no conflict of interest in this study.Author contributionsDr. Lele Song and Dr. Aiqin Zhu designed the study and organized the study. Dr. Xing Zhong, Dr. Yi Zhu, Dr. Peng Li, Dr. Junxia Zhang and Dr. Yonglan Hou performed the clinical study, including patient recruitment, sample collection, sample test, data collection and data analysis. Dr. Lele Song wrote the manuscript and Dr. Aiqin Zhu proofread the manuscript.Availability of data and materialsThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.Additional informationFundingThis study was supported by the Scientific and Technological Activity Program for Overseas Students supported by the Ministry of Human Resources and Social Security of the People’s Republic of China (Project No. (2016)384)