阿米替林联合丙戊酸钠治疗药物过度使用性头痛的疗效  

Efficacy of amitriptyline combined sodium valproate in treatment of medication overuse headache

作　　者：张碧月[1] 陈雅芳[1] 黄银辉[2] 

机构地区：[1]福建医科大学附属第二医院神经内科,福建泉州362000 [2]晋江市医院神经内科,福建晋江362200

出　　处：《中国实用神经疾病杂志》2017年第22期9-12,共4页Chinese Journal of Practical Nervous Diseases

基　　金：晋江市科技计划项目;编号201514001

摘　　要：目的探讨阿米替林联合丙戊酸钠治疗药物过度使用性头痛的疗效。方法选取药物过度使用性头痛(medication overuse headache,MOH)患者,进行健康教育,建议停用各种止痛剂,并按照随机数字表分为治疗组和对照组,其中治疗组给予阿米替林+丙戊酸钠缓释片治疗(每晚口服阿米替林25mg+丙戊酸钠缓释片500mg),对照组仅予丙戊酸钠缓释片治疗(每晚口服丙戊酸钠缓释片500mg),疗程3个月。记录并比较2组患者头痛发作频率、头痛严重程度及药物不良反应发生情况。结果阿米替林联合丙戊酸钠治疗组,患者头痛发作频率、头痛严重程度显效改善率高于对照组(68.42%vs 25.00%,P<0.05),治疗组总体有效率明显高于对照组(89.47%vs 55.00%,P<0.05)。治疗组与对照组不良反应发生率无明显差别(10.52%vs 7.50%,P<0.05)。结论阿米替林联合丙戊酸钠治疗药物过度使用性头痛安全有效。Objective To observe the efficacy of amitriptyline combined sodium valproate in treatment of medication overuse headache. Methods Medication overuse headache （MOH） patients in our hospital were collected. They were asked to withdraw overused analgesics, and divided into two groups according to Random Number Table, treatment group and control group. Treat treatment group treated with amitriptyline combined sodium valproate （orally, amitriptyline tablets 25rag and sodium valproate 500rag per night）. Control group treated with orally sodium valproate 500rag per night. The treatment was lasted for 3 months. The headache attack frequencies,headache severity as well as adverse drug reaction after treatment between two groups were compared. Results Compared with control group, patients who were treated with amitriptyline combined sodium valproate had obvious improvement on headache severity and headache attack frequencies （68.42% vs 25.00% ,P〈0.05）. The overall effi- cient was obviously higher than that of control group（89.47% vs 55.00%, P〈0.05）. There is no obvious difference between treatment group and control group in adverse drug reaction occurrence rate（10.52% vs 7. 50% ,P〈0.05）. Conclusion Amitrip- tyline combined sodium valproate is effective and safe in MOH.

关 键 词：药物过度使用性头痛(MOH) 阿米替林 丙戊酸钠 头痛严重程度(VAS评分) 头痛致残程度(MIDAS评分) 

分 类 号：R969.3[医药卫生—药理学]