加巴喷丁联合星状神经节阻滞治疗慢性紧张性头痛的临床研究  

Clinical research on gabapentin and stellate ganglion block in the treatment of chronic tension-type headache

作　　者：陈建军[1] 黄跃金[1] 邬至平[1] 黄慧芬[1] 

机构地区：[1]丽水市中心医院神经内科,浙江丽水323000

出　　处：《中国临床药理学杂志》2015年第21期2099-2101,共3页The Chinese Journal of Clinical Pharmacology

基　　金：浙江丽水市科技计划基金资助项目(20100415)

摘　　要：目的：探讨加巴喷丁联合星状神经节阻滞对慢性紧张性头痛患者的临床疗效和安全性。方法慢性紧张性头痛患者166例，随机分为试验组83例和对照组83例，所有研究对象均口服加巴喷丁治疗，起始剂量100～200 mg· d－1，根据疗效逐渐调整。试验组患者联合星状神经节阻滞，每周二、五各1次；对照组患者加服乙哌立松50 mg，每天3次。治疗前及每周五用视觉模糊评分评价疼痛强度，治疗前及治疗第2，4周的周五评价抑郁焦虑情况，治疗前及治疗4周后进行生活质量评定。结果治疗后，2组患者疼痛评分较治疗前显著降低（P＜0．01），但组间差异无统计学意义（P＞0．05）。试验组患者加巴喷丁药量明显少于对照组（ P ＜0．01）。治疗后，2组患者抑郁和焦虑均有明显减轻（P＜0．01）；治疗14 d，试验组和对照组比较，差异无统计学意义（P＞0．05）；治疗28 d，试验组患者抑郁均明显低于对照组（ P＜0．01），而焦虑比较差异无统计学意义（ P＞0．05）。结论加巴喷丁联合星状神经节阻滞对慢性紧张性头痛患者疗效较好，患者依从性好，不良反应发生率低。Objective To evaluate the clinical efficacy and safety of gabapentin combined with stellate ganglion block in the treatment of chro-nic tension-type headache.Methods One hundred and sixty-six pa-tients with chronic tension -type headache were randomly divided into experiment group （ n=83 ） and control group （ n=83 ） .All of the sub-jects received oral gabapentin at initial dose of 100-200 mg？ d-1 , the dose could be adjusted gradually according to the therapeutic effect.Pa-tients in experiment group combined with stellate ganglion block, 2 times a week; patients in control group took eperisone 50 mg, orally, three times a day.The pain （ assessed before the treatment and every Friday during treatment period ） , depression and anxiety （ assessed before the treatment and every other Friday during treatment period） , quality of life assessment（ assessed before and after the treatment ） of the two groups were observed.Results The pain scores were significantly lower after treatment （ P〈0.01 ） , but there was no significant difference between the two groups （ P〉0.05 ） .The increase of gabapentin in experiment group was obviously less than that in control group （ P〈0.01）.The de-pression and anxiety after treatment significantly reduced than that of before treatment （P〈0.01）;14 d after treatment, there was no significant difference between two groups （P〉0.05）;28 d after treatment, depression scores of patients in experiment group were significantly lower than that in control group （P〈0.01）, but there were no significant differences in anxiety between the two groups （P〉0.05）.Conclusion Patients with chronic tension-type headache took gabapentin combined with stellate ganglion block had better curative effect and compliance with less side effect.

关 键 词：慢性紧张性头痛 加巴喷丁 星状神经节阻滞 疼痛 焦虑 

分 类 号：R747.1[医药卫生—神经病学与精神病学] R977.4[医药卫生—临床医学]