丛集性头痛发作前驱期口服佐米曲普坦的疗效和安全性  

Effectiveness and safety of oral zolmitriptan in the prodromal phase of cluster headache

作　　者：刘唯 陆佳洁 郭效宁 许春阳 严满云 张全全 倪健强[1] 陆海锋 赵红如[1] LIU Wei;LU Jiajie;GUO Xiaoning;XU Chunyang;YAN Manyun;ZHANG Quanquan;NI Jianqiang;LU Haifeng;ZHAO Hongru(Department of Neurology,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215031,China;Department of Neurology,the Second People′s Hospital of Changshu,Changshu,Jiangsu 215501;Department of Neurology,the People′s Hospital of Jiangyin,Jiangyin 214499;Department of Neurology,the Traditional Chinese Medicine Hospital of Kunshan,Kunshan 215399)

机构地区：[1]苏州大学附属第一医院神经内科,江苏苏州215031 [2]常熟市第二人民医院神经内科,江苏常熟215501 [3]江阴市人民医院神经内科,江苏江阴214499 [4]昆山市中医院神经内科,江苏昆山215399

出　　处：《徐州医科大学学报》2023年第3期201-204,共4页Journal of Xuzhou Medical University

摘　　要：目的 探讨发作性丛集性头痛(eCH)患者前驱期口服佐米曲普坦的疗效和安全性。方法 对处于丛集期内且存在前驱期的23例eCH患者,收集基线头痛发作资料,并分别在3次连续头痛发作的前驱期15 min内予以佐米曲普坦口服治疗,比较基线及前驱期药物治疗后的头痛特征,评估前驱期口服佐米曲普坦治疗后的头痛严重程度和头痛持续时间。结果 23例eCH患者基线头痛视觉模拟评分(VAS)最严重程度评分(VASmax)中位数为9,3次前驱期药物治疗后VASmax中位数均为5,前驱期药物治疗后的VASmax均明显低于基线(P<0.01)。基线头痛发作持续时间(75.7±38.1)min, 3次前驱期药物治疗后头痛持续时间分别为(48.2±24.5)min、(45.7±21.8)min、(52.6±31.9)min,均明显短于基线期(P<0.01)。3次前驱期服药30 min后头痛程度为轻度或无痛的比例分别为13/23(56%)、16/23(70%)、14/23(61%),3次治疗后头痛程度为轻度或无痛的比例差异无统计学意义。服用佐米曲普坦后不良反应的发生率为10.1%,包括头部昏沉感、颈部僵硬、瞌睡和轻度胸闷,程度均较轻。结论 前驱期口服佐米曲普坦可以显著缩短发作性丛集性头痛持续时间,降低头痛发作严重程度,在丛集期内疗效具有一致性,且安全性良好。Objective To explore the effectiveness and safety of oral zomitriptan in the prodromal stage of patients with episodic cluster headache(eCH).Methods A total of 23 patients with definite prodromal stage during cluster period were selected.Their baseline headache attack data were collected,while zomitriptan was orally administered within 15 min of the prodromal stage for consecutive three attacks.Their headache characteristics at baseline and after treatment were compared to evaluate the severity and duration of headache after oral zomitryptan treatment in the prodromal phase.Results The median of maximum visual analog scale score(VASmax)of the 23 eCH patients was 9,while the median of VASmax after three times of treatment in the prodromal phase were all 5.The VASmax after treatment in the prodromal phase was significantly lower than that of baseline(P<0.01).The baseline headache duration was(75.7±38.1)min.After three times of treatment in the prodromal phase,the duration of headache was(48.2±24.5)min,(45.7±21.8)min and(52.6±31.9)min,respectively,which was significantly shorter than the baseline(P<0.01).The proportion of mild pain or painless 30 min after treatment in the prodromal phase was 13/23(56%),16/23(70%)and 14/23(61%),respectively,and there was no statistical difference among three times of treatment.Furthermore,the incidence of adverse reactions after taking zolmitriptan was 10.1%,including light-headedness,neck stiffness,sleepiness and mild chest tightness.The de-gree of adverse reactions was mild.Conclusions Oral administration of zolmitriptan in the prodromal period can remarkably shorten the duration of cluster headache,and reduce the severity of headache,with a consistent effectiveness in the prodromal phase to some extent,and good safety.

关 键 词：发作性丛集性头痛 前驱期 佐米曲普坦 疗效 安全性 

分 类 号：R747.2[医药卫生—神经病学与精神病学]