Abstract:ObjectiveTo investigate the improvement of migraine symptoms in patients with insulin resistance (IR) by alpha lipoic acid (ALA).? Methods A total of 80 IR patients with migraine who received treatment at Yan′an University Affiliated Hospital from January 2015 to December 2016 were selected and divided into experimental group and control group randomly (n=40, each). The experimental group patients received ALA combined with IR routine treatment, and control group patients received IR routine treatment, both groups were treated for one month. The clinical characteristics before the treatment, the frequency, duration, degree of migraine attack and levels of inflammatory cytokines before and after the treatment, and the clinical efficacy and adverse drug reactions after the treatment were compared between two groups.? Results The headache frequency score, headache degree score and headache duration score of the two groups were significantly lower than those before treatment (all P<0.05), and those scores were lower in experimental group after the treatment (all P<0.05). The level of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin (IL) -6 of the two groups were significantly lower than those before treatment (all P<0.05), and they were lower in experimental group compared with control group after the treatment (all P<0.05). The clinical efficacy in experimental group was significantly higher than that in control group (80.00%? vs? 50.00%, P<0.05). No digestive tract symptoms such as nausea, abdominal pain and diarrhea were found in both groups after treatment, and no abnormal liver and kidney functions were observed.? Conclusion ALA combined with IR routine treatment could improve the inflammatory cytokines level and migraine symptoms in patients with IR, which has a significant clinical efficacy and reliable safety.