氟哌噻吨美利曲辛联合右佐匹克隆治疗伴抑郁和(或)焦虑状态及失眠症状的慢性紧张型头痛的临床疗效研究  

Efficacy of Flupentixol and Melitracen Tablets Combined with Dexzopiclone in the Treatment of Chronic Tension-type Headache with Depression,Anxiety and Insomnia

作　　者：李英杰[1] 李亚楠[1] 郭英俊[1] 徐谦[1] 王冰洁[1] 孔桂良[1] 

机构地区：[1]中国人民解放军第251医院神经内科,河北省张家口市075000

出　　处：《中国全科医学》2013年第8期864-866,共3页Chinese General Practice

摘　　要：目的探讨氟哌噻吨美利曲辛联合右佐匹克隆治疗伴有抑郁和(或)焦虑状态及失眠症状的慢性紧张型头痛(CTH)的有效性及安全性。方法选取2011年2—11月于我院神经内科门诊就诊的100例伴有抑郁和(或)焦虑状态及失眠症状的CTH患者,随机分为氟哌噻吨美利曲辛联合右佐匹克隆治疗组(联合组)及氟哌噻吨美利曲辛单药治疗组(单药组)各50例,疗程8周。用疼痛视觉模拟评分(VAS)卡尺、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、匹茨堡睡眠质量指数量表(PSQI)评定疗效,采用不良反应症状量表(TESS)及8周末实验室检查结果评定治疗的安全性。结果单药组及联合组患者VAS、HAMD、HAMA、PSQI评分同组内治疗前后比较,差异均有统计学意义(P<0.05)。其中单药组治疗2周末VAS、HAMD、HAMA评分与治疗前比较,差异均有统计学意义(P<0.05),治疗8周末VAS、HAMD、HAMA、PSQI评分与治疗前比较,差异均有统计学意义(P<0.05);联合组治疗2周末及8周末VAS、HAMD、HAMA、PSQI评分与治疗前比较,差异均有统计学意义(P<0.05);两组治疗8周末VAS、HAMD、HAMA、PSQI评分分别与2周末比较,差异均有统计学意义(P<0.05)。联合组治疗前VAS、HAMD、HAMA、PSQI评分与单药组比较,差异均无统计学意义(P>0.05);联合组在治疗2周末HAMA、PSQI评分与单药组比较,差异均有统计学意义(P<0.05);治疗8周末PSQI评分与单药组比较,差异有统计学意义(P<0.05)。两组治疗后2周TESS评分〔(3.23±1.36)分vs.(3.11±1.42)分〕及8周TESS评分〔(3.96±1.31)分vs.(3.94±1.44)分〕比较,差异均无统计学意义(t=0.43,P=0.68;t=0.07,P=0.94)。两组患者血尿常规、肝肾功能、血压及心电图治疗前后均无异常变化。结论氟哌噻吨美利曲辛联合右佐匹克隆治疗抑郁和(或)焦虑状态及失眠症状的CTH疗效更好,在改善睡眠质量和焦虑情绪方面起效快,耐受性好,无明显不良反应。Objective To investigate the efficacy and safety of flupentixol and melitracen tablets combined with dexzopiclone in the treatment of chronic tension-type headache(CTH)with depression,anxiety and insomnia.Methods 100 CTH patients with depression,anxiety and insomnia admitted to neurology department of our hospital from February 2011 to November 2011 were randomly divided into combination group(treated by flupentixol and melitracen tablets combined with dexzopiclone) and single group(treated only by flupentixol and melitracen tablets) with each group 50 cases,and the treatment course was 8 weeks.Visual analog score(VAS),Hamilton depression rating scale(HAMD),Hamilton anxiety rating scale(HAMA) and Pittsburg sleep quality index scale(PSQI) were used to assess the efficiency and treatment emergent symptom scale(TESS) and laboratory results after 8-week treatment were used to assess safety.Results The scores of VAS,HAMD,HAMA and PSQI between the two groups at different times before and after treatment all showed statistically significant differences(P<0.05).The scores of VAS,HAMD and HAMA in single group after two weeks treatment showed statistically significant differences compared with before treatment(P<0.05),and the scores of VAS,HAMD,HAMA and PSQI after eight weeks treatment showed statistically significant differences compared with before treatment(P<0.05).The scores of VAS,HAMD,HAMA and PSQI in combination group after two weeks treatment and eight weeks treatment all showed statistically significant differences compared with before treatment(P<0.05).The scores of VAS,HAMD,HAMA and PSQI in the two groups after eight weeks treatment all showed statistically significant differences compared with after two weeks treatment(P<0.05).The scores of VAS,HAMD,HAMA and PSQI in combination group showed no statistically significant difference compared with single group before treatment(P>0.05).The scores of HAMA and PSQI in combination group showed statistically significant differences compared with single group after two w

关 键 词：紧张性头痛 抑郁 焦虑 入睡和睡眠障碍 氟哌噻吨美利曲辛 右佐匹克隆 

分 类 号：R747.2[医药卫生—神经病学与精神病学]