尼莫地平联合甲磺酸倍他司汀治疗前庭性偏头痛的临床效果  

Clinical efficacy of combined nimodipine and betahistine mesilate in the treatment of vestibular migraine

作　　者：戚江丽 QI Jiangli(Department of Neurology,Nanfang Hospital,Ganzhou(Ganzhou People′s Hospital),Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]南方医院赣州医院(赣州市人民医院)神经内科,江西省赣州市341000

出　　处：《临床合理用药》2025年第10期13-16,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察尼莫地平联合甲磺酸倍他司汀治疗前庭性偏头痛(VM)的临床效果。方法回顾性分析2022年6月—2023年9月赣州市人民医院收治的92例VM患者临床资料,根据治疗方法不同分为观察组47例和对照组45例。对照组予甲磺酸倍他司汀片治疗,观察组在对照组基础上加用尼莫地平片治疗,治疗3个月比较2组治疗效果,治疗前后眩晕发作次数、持续时间与疼痛评分、血清学指标[5-羟色胺(5-HT)、降钙素基因相关肽(CGRP)、基质金属蛋白酶-9(MMP-9)]水平、生活与睡眠质量评分,以及不良反应。结果观察组患者治疗总有效率为95.74%,高于对照组的82.22%(χ^(2)=4.339,P=0.037);治疗3个月后,2组眩晕发作次数、持续时间、疼痛评分与CGRP、MMP-9水平及匹兹堡睡眠质量指数(PSQI)评分均较治疗前减少或降低,5-HT水平与世界卫生组织生存质量测定量表(WHOQOL-BREF)评分均较治疗前上升,且观察组减少、降低/上升的程度大于对照组(P<0.01);观察组与对照组不良反应总发生率比较差异无统计学意义(10.64%vs.6.67%,χ^(2)=0.457,P=0.499)。结论尼莫地平联合甲磺酸倍他司汀治疗VM的临床效果较好,可改善患者眩晕、疼痛的症状,改善血清5-HT、CGRP、MMP-9水平,提高生活和睡眠质量,且安全性较高。Objective To evaluate the therapeutic effects of nimodipine and betahistine mesilate combination therapy for vestibular migraine(VM).Methods A retrospective analysis was conducted on the clinical data of 92 VM patients admitted to Ganzhou People′s Hospital from June 2022 to September 2023.Patients were divided into an observation group(n=47)and a control group(n=45)based on their treatment methods.The control group received betahistine mesilate tablets,while the observation group received additional nimodipine tablets on the basis of the control group.The therapeutic effects of the two groups were compared after 3 months of treatment.The changes in the number and duration of vertigo attacks,pain scores,serum levels of 5-HT,CGRP and MMP-9,as well as quality of life and sleep quality scores were compared between the two groups before and after treatment.Adverse reactions were also compared.Results The total effective rate was 95.74%in the observation group,higher than that of the control group(82.22%)(χ^(2)=4.339,P=0.037).After 3 months of treatment,both groups showed a significant decrease in the frequency and duration of vertigo attacks,pain scores,CGRP,MMP-9 levels and PSQI scores compared with before treatment,while the levels of 5-HT and the WHOQOL-BREF scores increased.The observation group showed a greater decrease,reduction,or increase compared to the control group(P<0.01).There was no significant difference in the overall incidence of adverse reactions between the two groups(10.64%vs.6.67%,χ^(2)=0.457,P=0.499).Conclusion The combined use of nimodipine and betahistine mesilate demonstrated significant clinical efficacy in treating vestibular migraine.It effectively alleviated vertigo and headache symptoms,improved serum levels of 5-HT,CGRP and MMP-9,and enhanced quality of life and sleep quality.Moreover,the combination therapy exhibited a high safety profile.

关 键 词：前庭性偏头痛 尼莫地平 甲磺酸倍他司汀 5-羟色胺 降钙素基因相关肽 基质金属蛋白酶-9 

分 类 号：R74[医药卫生—神经病学与精神病学]