维拉帕米联合强的松预防性治疗丛集性头痛的临床观察  

CLINICAL OBSERVATION OF VERAPAMIL HYDROCHLORIDE COMBINED WITH PREDNISONE IN PREVENTIVE TREATMENT OF CLUSTER HEADACHE

作　　者：李征[1] 于生元[1] 王晓琳[1] 刘若卓[1] 董钊[1] 

机构地区：[1]中国人民解放军总医院神经内科,北京100853

出　　处：《中国疼痛医学杂志》2012年第5期279-282,共4页Chinese Journal of Pain Medicine

摘　　要：目的:探讨盐酸维拉帕米联合强的松预防性治疗丛集性头痛的有效性及安全性。方法:采取随机、对照方法 ,将38例丛集性头痛患者随机分为2组,即维拉帕米单药组(A组,18例),维拉帕米强的松联合用药组(B组,20例)。采用视觉模拟评分法(visual analogue scale,VAS)进行疼痛程度评估,VAS≤3分为疼痛缓解,达到疼痛缓解后仍维持给药直至观察结束。在治疗开始时、1周末、2周末及4周末分别记录患者的头痛程度和频率、服药剂量和不良事件发生情况。结果:(1)与治疗前相比,2组疼痛程度均有缓解,B组头痛缓解程度在服药后1周末和4周末明显优于A组(P<0.05);(2)与治疗前相比,治疗后两组头痛发作频率均有下降(P<0.05),且B组头痛发作频率较A组明显减少(P<0.05);(3)在日均维拉帕米用量上,B组少于A组(P<0.05);(4)两组均未发生严重不良反应。结论:维拉帕米联合强的松是安全有效的丛集性头痛预防性药物,比单用维拉帕米效果好。Objective： To explore the efficacy and safety of verapamil hydrochloride combined with predni- sone in treatment of cluster headache. Methods： 38 patients with cluster headache were randomly divided into two groups： the verapamil group （group A, 18 cases） and verapamil combined with prednisone group （group B, 20 cases）. Visual analogue scale （VAS） was used to evaluate the degree of pain. VAS≤3 was regarded as pain relief, and the treatment continued after pain relief until the end of observation. The inten- sity of headache, attack frequency, dosage of verapamil and adverse events were assessed before and 1, 2, 4 weeks after treatment. Results： （1） Compared with before treatment, headache was relieved in both gr- oups. The extent of relief in group B was greater than that in group A at the end of 1 and 4 week （P 〈 0. 05）; （2） Compared with before treatment, frequency of headache decreased in both groups （P 〈 0. 05）. The extent of decrease in group B was greater than that in group A after treatment （P 〈 0. 05）; （3） The da- ily average dosage of verapamil in group B was less than that in group A （P 〈 0.05）; （4） There was no se- rious adverse events in both groups. Conclusion： Verapamil hydrochloride combined with prednisone is a safe and effective preventive treatment on cluster headache treatment, and better than single verapamil tre- atment.

关 键 词：丛集性头痛 盐酸维拉帕米 强的松 

分 类 号：R741[医药卫生—神经病学与精神病学]