Objective To observe the clinical effect of Qiye Shenan tablet combined with sumatriptan in the treatment of middle-aged and elderly patients with chronic migraine.MethodsA total of 124 elderly patients with chronic migraine treated in our hospital from July 2015 to December 2015 were selected.The patients were divided into two groups according to the principle of randomization, with 62 cases in each group.The control group was treated with sumatriptan, The observation group was treated with Qiye Shenan tablet on this basis.The curative effect of the two groups, the relevant indicators and adverse reactions were analyzed.ResultsThe effective rate was 95.16% in the observation group, which was higher than that in the control group (80.65%, P<0.05).After treatment, the VAS score and the main symptom scores of the observation group were (1.86±0.42,3.48±0.59), respectively, which were lower than those in the control group (3.19±0.50,5.06±0.64) (P<0.05).The level of nitric oxide (NO) in the observation group was (33.04±3.86)μmol/L, which was lower than that in the control group (40.92±4.28)μmol/L(P<0.05).The adverse reaction rate was 11.29% in the observation group, which was lower than that in the control group (17.74%), but there was no significant difference between the two groups.ConclusionQiye Shenan tablet can improve the therapeutic effect of chronic migraine in the elderly, reduce the pain of the patients and improve the related symptoms, and the safety of medication.

AIM:Clopidogrel and aspirin are com-monly used drugs for the secondary prevention of cerebrovascular disease.Due to drug resistance,their preventive effect is often affected.This article explores the clinical value of clopidogrel and aspirin pharmacogenetic genetic testing in the secondary prevention of ischemic stroke.METHODS:220 pa-tients with mild ischemic stroke or TIA admitted to our hospital from 2021.7 to 2022.9 were included and randomly divided into individualized treatment group and clopidogrel conventional treatment group(control group).The patients were followed up for one year to observe stroke recurrence and hemorrhagic events.RESULTS:(1)Compared with the control group,the recurrence rate of ischemic stroke in the individualized treatment group after 1-year follow-up was slightly lower(5.82％vs.7.92％,P＞0.05),the risk of cerebral hemorrhage was simi-lar,but the risk of other occurrences was increased(6.79％vs.0.99％,P＜0.05).(2)COX regression analy-sis showed that ESRS(HR 2.576,95％CI 1.226-5.413,P=0.013)and history of hypertension(HR 5.517,95％CI 1.624-18.737,P=0.006)were associated with recurrence of ischemic stroke,independent of anti-thrombotic regimen(HR 0.918,95％CI 0.291-2.894,P=0.883).CONCLUSION:Aspirin GPIBA,PTGS1,and ITGB3 gene polymorphisms have limited signifi-cance in guiding antiplatelet medication.Selecting aspirin maintenance therapy for clopidogrel CYP2C19*2*3 allele carriers cannot significantly re-duce the risk of recurrence of minor ischemic stroke and may increase other bleeding risks.COX regression analysis shows that ESRS and history of hypertension are independent risk factors for stroke recurrence.