天舒片联合托吡酯治疗前庭性偏头痛患者的临床疗效  

Clinical efficacy of Tianshu Tablets combined with topiramate for the treatment of patients with vestibular migraine

作　　者：李向辉 平曼 杜宗攀 王伟[2] LI Xianghui;PING Man;DU Zongpan;WANG Wei(Department of Neurology,Daxing District Hospital of Integrated Chinese and Western Medicine,Beijing 100076,China;Department of Neurology,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]大兴区中西医结合医院神经内科,北京市100076 [2]首都医科大学附属北京宣武医院神经内科,北京市100053

出　　处：《广西医学》2025年第2期212-217,共6页Guangxi Medical Journal

基　　金：吴阶平医学基金会临床科研专项资助基金项目(320.6750.2023-3-15)。

摘　　要：目的 探讨天舒片联合托吡酯治疗前庭性偏头痛(VM)患者的临床疗效。方法 选取102例VM患者,随机分为观察组和对照组,每组51例。给予观察组天舒片联合托吡酯治疗,给予对照组托吡酯治疗,疗程均为3个月。比较两组患者治疗前后眩晕发作情况、眩晕障碍量表(DHI)评分、颈肌前庭诱发肌源性电位(cVEMP)相关参数、血清血管内皮功能指标[降钙素基因相关肽(CGRP)、内皮素1(ET-1)、一氧化氮(NO)]和基质金属蛋白酶9(MMP9)水平,以及两组患者治疗后的临床总有效率、治疗期间不良反应发生情况。结果 治疗后,两组患者的眩晕发作频率、持续时间、眩晕视觉模拟量表(VAS)评分和DHI中各维度得分及总分较治疗前降低或缩短,且观察组的上述指标低于或短于对照组(P<0.05)。治疗后,两组患者cVEMP的左、右侧p13-n23振幅较治疗前增加,双侧幅度不对称度较治疗前减小,且观察组cVEMP的左、右侧p13-n23振幅大于对照组,双侧幅度不对称度小于对照组(P<0.05)。治疗后,两组患者的血清CGRP、ET-1、NO、MMP9水平较治疗前下降,且观察组的上述指标水平低于对照组(P<0.05)。治疗后,观察组的临床总有效率高于对照组(P<0.05)。治疗期间两组患者的不良反应发生率差异无统计学意义(P>0.05)。结论 天舒片联合托吡酯治疗VM患者的临床疗效优于单纯托吡酯治疗,可改善患者眩晕发作情况和前庭功能,提高患者生活质量,纠正血管内皮功能紊乱,下调血清MMP9水平,且安全性较好。Objective To investigate the clinical efficacy of Tianshu Tablets combined with topiramate for the treatment of patients with vestibular migraine(VM).Methods A total of 102 patients with VM were selected,and they were randomly divided into observation group or control group,with 51 cases in each group.The observation group received Tianshu Tablets combined with topiramate for treatment,whereas the control group was treated with topiramate,for a 3⁃month course of treatment.Pre⁃and post⁃treatment vertigo episode,Dizziness Handicap Inventory(DHI)score,parameters related to cervical vestibular evoked myogenic potential(cVEMP),and levels of serum vascular endothelial function indices with respect to calcitonin gene⁃related peptide(CGRP),endothelin 1(ET⁃1),nitric oxide(NO),as well as matrix metalloproteinase 9(MMP9)level,clinical total effective rate after treatment and the occurrence status of adverse reactions during treatment were compared between patients of the two groups.Results After treatment,both groups exhibited decreased frequency of vertigo episode,shortened vertigo duration,and decreased VAS score for vertigo,various dimensions scores of DHI and total score for vertigo as compared with before treatment;furthermore,the observation group yielded lower or shorter indices as above as compared with the control group(P<0.05).After treatment,patients of both groups obtained increased left and right p13⁃n23 amplitude of cVEMP,reduced bilateral amplitude asymmetry as compared with before treatment,and the observation group depicted larger left and right p13⁃n23 amplitude of cVEMP,and smaller bilateral amplitude asymmetry as compared with the control group(P<0.05).After treatment,the levels of serum CGRP,ET⁃1,NO,and MMP9 of both groups were decreased as compared with before treatment,and the observation group expressed lower levels as above as compared with the control group(P<0.05).After treatment,the observation group interpreted a higher clinical total effective rate as compared with the control g

关 键 词：前庭性偏头痛 天舒片 托吡酯 前庭功能 血管内皮功能 基质金属蛋白酶9 

分 类 号：R747.2[医药卫生—神经病学与精神病学]