Antioxidant Effects of Coenzyme Q10 in Naturally Aging Rats

 Coenzyme Q10, also known as ubiquinone 10, is a quinone cyclohexane compound, named after the polymerization degree of the polyisopentenyl group on the six-position side chain of the parent nucleus, which is 10. Coenzyme Q10 is found in the heart, liver, kidney and pancreas, and its physiological role is to act as a coenzyme in the oxidative phosphorylation reaction in the mitochondria. Its physiological role is to act as a coenzyme in the oxidative phosphorylation reaction in the mitochondria. Recent studies have found that in addition to its physiological function in the cellular respiratory chain, coenzyme Q10 also has a powerful scavenging effect on free radicals, and that exogenous intake of coenzyme Q10 into the organism can play a role in antioxidizing and delaying aging in vivo. In the present study, the in vivo antioxidant effect of coenzyme Q10 was investigated in aged rats to provide an experimental basis for its development and utilization.

 

1 Materials and methods

1.1  test subject

 The coenzyme Q10 solution provided by a domestic biological company using wheat germ oil as solvent was identified by the Physical and Chemical Inspection Institute of Guangxi Zhuang Autonomous Region Disease Prevention and Control Center, and the content of coenzyme Q10 in the solution was 4.5g/100g. The recommended human dosage of this solution is 1g per day for adults (equivalent to 45mg of coenzyme Q10), and the weight of adults is 60kg, which is equivalent to 0.75 mg/kg. （The recommended human dose of this solution is 1g per day for adults (equivalent to 45mg of Coenzyme Q10), or 0.75 mg/kg.BW for 60kg.

 

1.2 Laboratory animals  

48 18-month-old SPF male SD rats, purchased from Guangdong Medical Laboratory Animal Center, Laboratory Animal Production License No. SCXK 粤 2008-0002, Laboratory Animal Use License No. SYXK 桂 2007-0003, Laboratory Animal Room Temperature:

22～25℃, relative humidity: 55%～70%.

 

1.3 Main reagents and instruments  

Malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) kits were purchased from Nanjing Jianjian Bioengineering Institute. Methanol, ethanol, trichloromethane, sulfuric acid, quinine sulfate, etc., were all analytically pure in China. Hitachi KY2000 semi-automatic biochemistry instrument, fluorescence spectrophotometer, electronic analytical balance, low-temperature centrifuge, constant-temperature water bath, etc.

 

1.4 Experimental Methods  

The serum MDA levels of all rats were determined by the method of blood sampling from the inner canthus of the eye, and the rats were stratified according to the MDA levels and then randomly divided into 4 groups of 12 rats each. According to the recommended human dose of coenzyme Q10, three dose groups of 15.00, 7.50, and 3.75 mg/kg BW (equivalent to 20, 10, and 5 times the recommended human dose, respectively) and one negative control group were set up, and wheat germ oil was used as the solvent to prepare solutions with concentrations of 1.50, 0.75, and 0.375 mg/mL (in terms of the concentration of coenzyme Q10) as the test material of the dose groups, and the negative control group consisted of wheat germ oil as the solvent, and the test material of the negative control group consisted of wheat germ oil as the solvent. The negative control group was wheat germ oil. Wheat germ oil was used in the negative control group. 1.0mL/100g BW was administered orally to rats once daily for 90 days. At the end of the test, MDA, SOD and GSH-Px activities were measured in serum, brain and liver tissues of all rats, and lipofuscin (Lip) content was measured in brain and liver tissues.

 

1.5 Statistics  

One-way ANOVA and two-way comparisons between groups were performed using SPSS 13.0 statistical software.

 

2 Results

2.1 Effect of Coenzyme Q10 on body weight of rats There was no significant difference in the body weights of rats in each group before the test, and the differences in the body weights and weight gain of rats in each dosage group during the test were not significant when compared with those of the negative control group (P>0.05), which indicated that the sample did not have any significant effect on the body weights of old rats.

 

2.2 Effect of Coenzyme Q10 on malondialdehyde (MDA) in rats

At the end of the experiment, the MDA levels in serum, brain and liver tissues of rats in all dose groups were lower than those in the negative control group, and the differences between at least two dose groups and the negative control group were statistically significant (P < 0.05 or P < 0.01), as shown in Table 1, indicating that coenzyme Q10 can reduce the production of MDA in aged rats.

 

Table 1 MDA levels in serum, brain and liver tissues of rats (n=12, ± s)

 

groups	Dose group (m gLkgBW )	Pre-test serum (nmoLLm L)	Final test serum (nmoLLm L)	Test end brain tissue (nmoLLg)	Test end liver tissue (nmoLLg)
high dose group	15.00	4.94±0.69	5.01±0.71**	287.00±29.80**	247.80±35.90**
middle-dose group	7.50	5.07±0.60	5.22±0.62*	284.00 ± 30.10**	272.40±36.90
low dose group	3.75	4.98±0.71	5.64±0.81	297.70±40.00*	263. 10±46.20*
negative control	0.00	4.97±0.72	5.97±0.65	334.40±40.20	302.50±41.20

Note : *P<0.05, **P<0.01 compared with the negative control group , below.

2.3 Effect of coenzyme Q10 on superoxide dismutase (SOD) activity in rats  

At the end of the experiment, the SOD activity in serum, liver and brain tissues of rats in each dose group was higher than that in the negative control group, and the differences between at least two dose groups and the negative control group were statistically significant (P<0.05 or P<0.01), as shown in Table 2, indicating that coenzyme Q10 could improve the activity of SOD in serum and tissues of aged rats.

 

Table 2 SOD activity in serum, brain and liver tissues of rats (n=12, ± s)

groups	dosages (m gLkgB W )	Serum SOD (kULm L)	brain tissue SOD (kULg)	Liver tissue SOD (kULg)
high dose group	N5.00	N74.30±OO.U0**	N 09U.00±N73.U0**	N SNS.50±O05.40**
middle-dose group	7.50	N4O.00±N3.40	n 0n9.90±n79.s0*	N 453.30±NUU.50**
low dose group	3.75	N5U.40±O5.40*	97O.40±N49.90	n 3n9.40±onn. n0
negative control	0.00	N37.00±N9.00	U4U.70±N47. N0	N O3N.O0±NUO. N0

 

2.4 Effect of coenzyme Q10 on glutathione peroxidase (GSH-Px) activity in rats  

At the end of the experiment, the GSH-Px activity in serum, liver and brain tissues of rats in all dose groups was higher than that in the negative control group, and the differences between at least one dose group and the negative control group were statistically significant (P<0.05 or P<0.01), as shown in Table 3, indicating that Coenzyme Q10 could increase the GSH-Px activity in serum and tissues of aged rats.

Table 3 GSH-Px activity in serum, brain and liver tissues of rats (n=12, ± s)

 

groups	dosages (m gLkgB W )	Serum G SH -mx (kULm L)	Brain tissue G SH-mx (kULg)	Liver tissue G SH -mx (kULg)
high dose group	N5.00	477.P0±P4.40GG	2 995.90±4S7. N0GG	2 9S2. N0±424.50GG
middle-dose group	7.50	472.00±2P.S0GG	2 702.70±PS9.50	2 94S.90±P74.90G
low dose group	P.75	4sp. n0±24. n0g	2 s7s.00±ppn. n0	2 759.P0±404.20
negative control	0.00	4P5.P0±P0.50	2 4N9.20±44P.U0	2 455.S0±50P.90

 

2.5 Effect of coenzyme Q10 on lipofuscin (Lip) content in rats  

At the end of the experiment, the lipofuscin content of liver and brain tissues of rats in all dose groups was lower than that of the negative control group, and the differences between at least one dose group and the control group were significant (P<0.05 or P<0.01), as shown in Table 4, indicating that CoQ10 could reduce the Lip content of tissues in aged rats.

Table 4 Lip content in rat brain and liver tissues (n=12, ±s)

 

groups	Dose group (m gLkgB W )	Brain tissue iip (μgLg )	Liver tissue iip (μgLg )
high dose group	15.00	21.66±6.01**	8.75±2.26*
middle-dose group	7.50	23.54±4.64*	9.32±2. 19
low dose group	3.75	22.77±5.30*	10.75±2.51
negative control	0.00	28. 18±4.28	11.35±2.84

 

3 Discussion

Since oxidative stress has become the classic theory of cellular aging, the search for safe, efficient and multi-functional antioxidants has been a hot topic in medical research. Many antioxidants are unable to enter the cell due to permeability or cellular rejection, and they can only scavenge extracellular free radicals and protect the cell membrane, but they are unable to deal with oxidative damage to the mitochondrial membrane, which is the key to cellular aging. In recent years, it has been found that coenzyme Q10, as a component of the mitochondrial respiratory chain, is embedded in the lipid bilayer of the inner mitochondrial membrane, which not only acts as a coenzyme in the cellular energy production process, but also protects the mitochondrial membrane from the attack of free radicals by the six unstable double bonds contained in its own structure[1] , which aroused a great deal of interest from the researchers, and caused a great deal of research on the antioxidant effects and mechanisms of coenzyme Q10. This has aroused great interest among researchers and triggered a wave of research on the antioxidant effects and mechanisms of coenzyme Q10.

 

In the present study, we used naturally aged rats, which can more accurately reflect the antioxidant effect of coenzyme Q10 than the galactose-constructed aging model. The results showed that coenzyme Q10 effectively reduced the contents of MDA and lipofuscin, the products of lipid peroxidation, and increased the activities of the two major antioxidant enzymes, SOD and GSH-Px, which indicate that coenzyme Q10 has an antioxidant effect on rats. Coenzyme Q10 has antioxidant effects in rats. Coenzyme Q10 reduces MDA by scavenging free radicals and indirectly increases the activities of SOD and GSH-Px, but whether it has a direct effect on these two antioxidant enzymes is not known.

 

Coenzyme Q10 has a significant advantage as an antioxidant in that it also reduces physical fatigue. With the increase of age, the content of coenzyme Q10 in the human body gradually decreases, and the cellular energy production is also affected. Supplementation of exogenous coenzyme Q10 not only ensures the smoothness of the cellular respiratory chain, but also increases the body's reserve of hepatic glycogen[2] , which shows that coenzyme Q10 can be used as an anti-aging agent through both antioxidant and physical strength improvement. "This is an unparalleled advantage of any other antioxidant. Another significant advantage of coenzyme Q10 is that it is an endogenous enzyme in the human body, so it has a very high safety profile.

 

No significant side effects have been reported with 200 mg daily for 6-12 months or 100 mg daily for 6 years [3]. Coenzyme Q10 has been included as one of the health food ingredients licensed by the Ministry of Health, and can be used as a health food for long-term use. The human body needs at least 30 mg of coenzyme Q10 per day, and the older the person is, the higher the need is. Inadequate intake of coenzyme Q10 increases the risk of cardiovascular diseases, infections, and tumors. The human body can only synthesize trace amounts of coenzyme Q10, and the source of coenzyme Q10 in food is very limited, so the human body is very vulnerable to deficiency of coenzyme Q10. Foreign studies have shown that supplementation of exogenous coenzyme Q10 has a good effect on the treatment of Alzheimer's disease, obesity, ulcerative diseases, psoriasis, cystic fibrosis, acoustic trauma, and other diseases, and it can alleviate fatigue, anxiety, and improve the immunity of the human body and sexual function, etc. [4]. From the results of this study and other research literature, we believe that the use of coenzyme Q10 as an antioxidant for middle-aged and elderly people is safe and has multiple effects, and is worth further research and application.

 

References:

[1] Shoal RS, Forster MJ. Coenzyme Q, oxidative stress and aging[J]. Mitochondrion, 2007, 7(suppl): 103-111.

[2] SONG Yi, LIAO Yuan, XU Jiayu. An experimental study of coenzyme Q10 to alleviate locomotor fatigue in mice [J]. Modern Preventive Medicine, 2010, 37(3): 449-450.

[3] ZHANG J-Z, CHI L-L, SHEN Y-L. Production of coenzyme Q10 and its application in medicine[J]. Production of coenzyme Q10 and its application in medicine[J]. Journal of Shanghai Institute of Applied Technology, 2004, 4(4): 301-305.

[4] PENG Liang, HAN Yanbin, WANG Yanwu. Experimental study on the effect of coenzyme Q10 on immune function in mice[J]. Chinese Journal of Hygiene and Inspection, 2010, 20(12): 3125-3127.

Clinical efficacy analysis of coenzyme Q10 combined with flunarizine in the treatment of migraine headache

 Abstract：Objective To investigate the clinical efficacy of coenzyme Q10 combined with flunarizine in the treatment of migraine. Methods 104 migraine patients admitted to the Third People's Hospital of Mianyang City, Sichuan Province, from January to June 2023 were selected for the study, and were divided into a control group and an observation group using the randomized numerical table method, with 52 cases in each group. The control group was treated with flunarizine, while the observation group was treated with coenzyme Q10 combined with flunarizine, and both groups were treated continuously for 6 months. Compare and analyze the clinical efficacy of the two groups and the occurrence of adverse reactions during the treatment period. Cerebral hemodynamic indexes (mean blood flow velocity of the posterior cerebral artery, mean blood flow velocity of the middle cerebral artery, mean blood flow velocity of the anterior cerebral artery), oxidative stress status (oxidized low-density lipoprotein (ox-LDL), argyrophilic esterase (ArE)), migraine symptoms (duration of migraine attacks, degree of migraine pain) and the incidence of adverse reactions during the treatment period were compared in the two groups before and after 6 months of treatment. Migraine symptoms (migraine attack duration, migraine pain, migraine attack frequency), and migraine pain were assessed using a numeric rating scale (NRS).

 

Results After 6 months of treatment, the total clinical effectiveness rate of patients in the observation group was higher than that of the control group, and the difference was statistically significant (P＜0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P＞0.05). After 6 months of treatment, the average blood flow rate of middle cerebral artery, average blood flow rate of anterior cerebral artery, average blood flow rate of posterior cerebral artery, ox-LDL, frequency of migraine attacks and duration of migraine attacks of the patients in the two groups were lower or shorter than those in the control group, and the differences were statistically significant (P < 0.05). After 6 months of treatment, the PON-1 and ArE of both groups increased compared with the pre-treatment period, and the observation group was higher than the control group, and the differences were statistically significant (P<0.05). The differences in NRS scores between the two groups were not statistically significant when comparing patients before treatment and after 6 months of treatment (P＞0.05). The clinical efficacy of coenzyme Q10 combined with flunarizine in the treatment of migraine is remarkable, which can effectively improve the cerebral hemodynamics and oxidative stress status of the patients, and the safety is good.

 

Migraine is a common neurological disorder that can lead to severe disability, loss of productivity, and increased economic burden on families and society [1-2]. In China, the prevalence of primary migraine is as high as 23.8% [3]. In China, the prevalence of primary migraine is as high as 23.8% [3], and migraine occurs more often in young and middle-aged people, which can seriously affect the quality of life of patients [4].

 

At present, there is no cure for migraine, and the main goal of clinical treatment of migraine is to relieve migraine symptoms. It has been reported in the literature that flunarizine is a commonly used drug in the treatment of migraine, which can inhibit the inward flow of excess calcium ions into vascular smooth muscle cells, relieve cerebral vasospasm, improve cerebral blood flow kinetics, and thus effectively relieve migraine symptoms [5-6].

 

Overseas studies have pointed out that coenzyme Q10 is an antioxidant that can be used to improve the clinical characteristics of migraine [7]. However, there is still a lack of clinical evidence to support the efficacy of coenzyme Q10 in the treatment of migraine in China. Therefore, this study investigated the clinical efficacy of coenzyme Q10 combined with flunarizine in the treatment of migraine and its effect on cerebral hemodynamics, with the aim of providing an evidence-based basis for clinical application.

 

1 Objects and Methods

1.1 Subject of the study

A total of 104 migraine patients admitted to our hospital from January to June 2023 were selected for the study, and were divided into a control group and an observation group using a randomized numeric table method, with 52 cases in each group. Inclusion criteria:

(1) The diagnostic criteria for migraine are met [8];

② Age 18-80 years old; ③ Duration of the disease ≥ 1 year, frequency of migraine attacks > 2 times / month; ④ No contraindications to the drugs used in this study. Exclusion criteria: ① headache caused by other diseases; ② combined with liquid system diseases or digestive system diseases;

(iii) Combination of other craniocerebral diseases;

④ Combined mental illness;

⑤ Combined serious heart, lung, liver, and kidney dysfunction;

(vi) Combined infectious diseases.

 

The baseline data of gender, age, disease duration, body mass index, smoking history, alcohol consumption history and comorbidities of the two groups were comparable, with no statistically significant differences (P ＞ 0.05). The study was approved by the Medical Ethics Committee of the Third People's Hospital of Mianyang City, Sichuan Province [Approval No. 2022 (18)], and all patients were informed of the study and signed an informed consent form.

 

1.2 Methodology

Patients in the control group were treated with oral flunarizine, 5 mg/times, once /d. Patients in the observation group were treated with oral coenzyme Q10 combined with flunarizine, flunarizine 5 mg/times, once /d; coenzyme Q10 10 mg/times, three times /d. Patients in the two groups were treated continuously for 6 months, and were followed up once a week during the treatment period.  All patients completed the 6-month treatment, and there was no case dropout. All patients completed the treatment for 6 months, and no case was dropped. During the acute attack of migraine, NSAIDs were given according to the "Chinese Guidelines for the Diagnosis and Treatment of Migraine (2022 Edition)"[8] .

 

1.3 Observation indicators

1.3.1 Comparison and analysis of the clinical efficacy of the two groups after 6 months of treatment  

After 6 months of treatment, cure was defined as complete disappearance of migraine and other clinical symptoms, with no recurrence one month after stopping the drug; significant effect was defined as >75% reduction in the frequency of migraine attacks and >50% shortening of migraine duration; effective was defined as 50%～75% reduction in the frequency of migraine attacks and 25%～50% reduction in migraine duration; and ineffective was defined as <50% reduction in the frequency of migraine attacks and <25% reduction in the duration of migraine [8]. Ineffective is a reduction in the frequency of migraine attacks <50% and the duration of migraine <25% [8]. Total effective rate = (number of cured cases + number of cases with apparent effect + number of effective cases) / total number of cases × 100%.

 

1.3.2 Comparison and analysis of cerebral hemodynamic indicators before and after treatment in the two groups of patients  

The mean blood flow velocity of the posterior cerebral artery, middle cerebral artery, and anterior cerebral artery were measured by Doppler color ultrasonography before and after 6 months of treatment, respectively.

 

1.3.3 Comparison and analysis of oxidative stress before and after treatment in the two groups of patients  

Before and after 6 months of treatment, 5 ml of fasting venous blood was drawn from patients of both groups, and the levels of paraoxonase 1 (PON-1) and oxidized low density lipoprotein (ox-LDL) were measured by enzyme-linked immunosorbent assay; the levels of arylesterase (ArE) were measured by colorimetric analysis. The levels of arylesterase (ArE) were determined by colorimetric analysis.

 

1.3.4 Comparison and analysis of migraine symptoms before and after treatment of the two groups of patients  

The duration of migraine attacks, the degree of migraine pain, and the frequency of migraine attacks were recorded before and after 6 months of treatment, respectively. A numerical rating scale (NRS) was used to assess the migraine pain level of the two groups, and a higher NRS score indicated more severe pain [9].

 

1.3.5 Comparison and analysis of the occurrence of adverse reactions during the treatment of the two groups of patients  

Adverse effects during the treatment period were recorded, mainly including nausea, drowsiness, fatigue, gastrointestinal discomfort, and so on.

 

1.4 Data analysis and processing

SPSS 27.0 statistical software was used to analyze the data. Measurement data with normal distribution were expressed as "x ± s", and the t-test was used to compare the means between groups; count data were expressed as cases (%), and the χ2 test was used to compare the data between groups. p < 0.05 was regarded as statistically significant difference.

 

2 Results

2.1 Comparison of the clinical efficacy of the two groups of patients after 6 months of treatment

After 6 months of treatment, the total clinical effectiveness rate of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). The difference was statistically significant (P < 0.05).

 

2.2 Comparison of cerebral hemodynamic indexes before and after treatment in two groups of patients

Before treatment, there was no statistically significant difference between the mean blood flow velocities of the middle cerebral artery, anterior cerebral artery, and posterior cerebral artery in the two groups (P ＞ 0.05); after 6 months of treatment, the mean blood flow velocities of the middle cerebral artery, anterior cerebral artery, and posterior cerebral artery were lower than those in the control group, with a statistically significant difference (P ＜ 0.05). The differences were statistically significant (P < 0.05).

 

2.3 Comparison of oxidative stress status between the two groups of patients before and after treatment

Before treatment, there was no statistically significant difference in PON-1, ox-LDL and ArE between the two groups (P > 0.05). After 6 months of treatment, the PON-1 and ArE of both groups increased compared with those before treatment, and the observation group was higher than the control group, with statistically significant differences (P < 0.05); the ox-LDL of both groups decreased compared with those before treatment, and the observation group was lower than the control group, with statistically significant differences (P < 0.05). The difference was statistically significant (P < 0.05).

 

2.4 Comparison of migraine symptoms before and after treatment between the two groups of patients

Before treatment, there was no statistically significant difference in the duration of migraine attacks, NRS score, and frequency of migraine attacks between the two groups (P ＞ 0.05); after 6 months of treatment, the duration of migraine attacks, NRS score, and frequency of migraine attacks of the two groups were shorter or lower than before treatment, and the duration of migraine attacks and frequency of migraine attacks of the observation group were shorter or lower than that of the control group (P ＜ 0.05). In the observation group, the duration of migraine attacks and the frequency of migraine attacks were shorter or lower than those in the control group, and the differences were statistically significant (P < 0.05). The differences were statistically significant (P < 0.05).

 

2.5 Comparison of the occurrence of adverse reactions during treatment between the two groups of patients

There was no statistically significant difference in the total incidence of adverse reactions during treatment between the two groups (P ＞ 0.05). See Table 6.

Table 6 Comparison of the occurrence of adverse reactions during treatment in the two groups [cases (%)

 

3 Discussion

Flunarizine is the first-line drug recommended by the European Headache Consortium for the treatment of migraine, and can reduce the frequency of migraine attacks by more than 50% per month [10]. Previous studies in China have shown that flunarizine can significantly reduce the frequency of migraine attacks, alleviate the pain level, and effectively shorten the duration of migraine attacks [11]. Flunarizine has a strong lipid solubility and can easily cross the blood-brain barrier to act on the cerebral blood vessels, thus inhibiting cerebral vasospasm, and can effectively improve cerebral microcirculation and neuronal metabolism, thus relieving migraine symptoms [12-13]. However, the clinical efficacy of flunarizine alone is limited, and it is often necessary to combine it with other drugs [14].

 

According to the results of this study, after 6 months of treatment, the total clinical effectiveness rate of patients in the observation group was higher than that of the control group, and the duration of migraine attacks and the frequency of migraine attacks were shorter than or lower than those of the control group, with statistically significant differences. The difference is statistically significant, indicating that the combination of coenzyme Q10 and flunarizine in the treatment of migraine is clinically effective, and can effectively shorten the duration of migraine attacks and reduce the frequency of migraine attacks. Several studies have demonstrated that coenzyme Q10 can directly participate in the reaction of peroxyl radicals, synergize with vitamin E to enhance antioxidant capacity, and enhance human immune function, improve the oxidative state of the brain, and reduce the occurrence of abnormal energy metabolism, thus suppressing migraine attacks and shortening the duration of migraine attacks [15-16]. It has been reported that coenzyme Q10 can effectively reduce the frequency and duration of migraine attacks [17]. A meta-analysis of 371 adult migraine patients showed that coenzyme Q10 could significantly reduce the duration and frequency of migraine attacks [18].

 

The results of this study showed that after 6 months of treatment, the mean blood flow velocity of middle cerebral artery, the mean blood flow velocity of anterior cerebral artery, the mean blood flow velocity of posterior cerebral artery, and ox-LDL of patients in both groups were lower than or shorter than that of the control group, and the mean blood flow velocity of PON-1, and ArE of patients in both groups were higher than those of the control group, with the difference being statistically significant.

 

Coenzyme Q10 combined with flunarizine can effectively improve cerebral hemodynamics and oxidative stress in migraine patients. Overseas studies have shown that supplementation of coenzyme Q10 can up-regulate the expression of antioxidant defense system enzymes and inhibit oxidative stress [19].

 

Studies in China have also shown that coenzyme Q10 can effectively inhibit oxidative stress in the treatment of rheumatoid arthritis and hypertension combined with arrhythmia [20-21]. The results of this study showed that there was no statistically significant difference in the total incidence of adverse reactions between the two groups. This suggests that the safety of coenzyme Q10 combined with flunarizine in the treatment of migraine is better.

 

In conclusion, the clinical efficacy of coenzyme Q10 combined with flunarizine in the treatment of migraine headache is remarkable, and it can effectively improve the cerebral hemodynamics and oxygenation stress status of the patients, and the safety is good. However, the sample size of this study is small and the follow-up period is short, so the long-term efficacy of coenzyme Q10 combined with flunarizine in the treatment of migraine has not been clarified, and needs to be further investigated in the future.

 

References:

[1]HOVAGUIMIAN A, ROTH J. Management of chronic migraine[J]. bmj, 2022, 379(1): e067670.

[2] SUN Jian. Observation on the clinical efficacy of headache Ning capsule combined with nimodipine in the treatment of migraine[J]. China Modern Drug Application, 2019, 13(12): 127-129.

[3] Yao G, Cao HQ, Zhu YG. Current status and challenges of basic headache research in China[J]. Chinese Journal of Neurology, 2020, 19(5): 433-438.

[4] Shi Xiuli, Bei Lingna, Zhu Li. Clinical efficacy of copper acupuncture and gua sha combined with acupoint thermal pain stimulation in the treatment of chronic migraine[J]. Journal of Practical Clinical Medicine, 2022, 26(19): 46-49, 54. GÖRÜRK, GÜRH, İSMI O, et al. The effectiveness of propranolol, flunarizine, amitriptyline and botulinum toxin in vestibular [5]migraine complaints and prophylaxis: a non-randomized controlled study[J]. Braz J Otorhinolaryngol, 2022, 88(6): 975-981.

[6] RASHID S M U, SUMARIA S, KOOHI N, et al. Patient experience offlunarizine for vestibular migraine: single center observational study[J]. Brain Sci, 2022, 12(4): 415.

[7] PAROHAN M, SARRAF P, JAVANBAKHTM H, et al. The synergistic effects of nano-curcumin and coenzyme Q10 supplementation in migraine prophylaxis: a randomized, placebo-controlled, double-blind trial[J]. Nutr Neurosci, 2021, 24(4): 317-326.

[8] Chinese Association of Physicians, Neurologists Branch, Headache and Sensory Disorders Committee of the Chinese Society of Research Hospitals. Chinese migraine diagnosis and treatment guidelines (2022 edition)[J]. Chinese Journal of Pain Medicine, 2022, 28(12): 881-898.

[9]HE S H, RENNE A, ARGANDYKOV D, et al. Comparison of an emoji-based visual analog scale with a numeric rating scale for pain assessment[J]. jama, 2022, 328(2): 208-209.

[10]DELIGIANNI C I, SACCO S, EKIZOGLU E, et al. European Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention-part 2: Flunarizine[J]. J Headache Pain, 2023, 24(1): 128.

[11] CHEN Jie, TIAN Huijuan, ZHANG Wei, et al. Effects of Chuanxiong Qingcheng Granules combined with flunarizine on cranial hemodynamics and levels of ET-1, 5-HT and CGRP in migraine patients[J]. Guizhou Medicine, 2022, 46(2): 302-303.

[12]LI W, LIU R T, LIU W D, et al. The effect of topiramate versus flunarizine on the non-headache symptoms of migraine[J]. Int J Neurosci, 2023, 133(1): 19-25.

[13]ZHU J L, CHEN J H, ZHANG K X. Clinical effect of flunarizine combined with duloxetine in the treatment of chronic migraine comorbidity of depression and anxiety disorder[J]. Brain Behav, 2022, 12(8): e2689.

[14] LI Yuyu, MA Bo, XU Li. Study on the effect of heptaphylloside sodium tablets combined with flunarizine hydrochloride in the treatment of migraine[J]. Chinese Family Medicine, 2022, 20(7): 1102-1105.

[15] PAROHAN M, SARRAF P, JAVANBAKHT M H, et al. Effect of coenzyme Q10 supplementation on clinical features of migraine: a systematic review and dose- response meta-analysis of randomized controlled trials[J]. Nutr Neurosci, 2020, 23(11): 868-875.

[16]MANTLE D, HEATON R A, HARGREAVES I P. Coenzyme Q10, ageing and the nervous system: an overview[J]. Antioxidants (Basel), 2021, 11(1): 2.

[17] LUO Guochen, ZHAO Ruichao.  Effects of oral coenzyme Q10 on inflammatory factors and headache symptoms in migraine patients[J]. Medical Theory and Practice, 2021, 34(3): 410-412.

[18]SAZALI S, BADRIN S, NORHAYATI M N, et al. Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine-a meta-analysis[J]. BMJ Open, 2021, 11(1): e039358.

[19]AKBARI A, MOBINI G R, AGAH S, et al. Coenzyme Q10 supplementation and oxidative stress parameters: a systematic review and meta-analysis of clinical trials[J]. trials[J]. Eur J Clin Pharmacol, 2020, 76(11): 1483-1499.

[20] Zhu Keda, Wang Rinjie, Liu Fengyun, et al. Effects of coenzyme Q10 on the levels of pro-inflammatory cytokines and oxidative stress in patients with rheumatoid arthritis[J] . Guangxi Medicine, 2020, 42(4): 417-420, 460.

[21] LIU Cui, GAO Xiang. Efficacy and mechanism of action of coenzyme Q10 in the adjuvant treatment of hypertension combined with arrhythmia in the elderly[J]. International Journal of Geriatrics, 2023, 44(2): 218-222.