都梁丸联合托吡酯治疗难治性偏头痛的临床效果及安全性分析
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摘要
目的观察都梁丸联合托吡酯治疗难治性偏头痛的临床效果及安全性。方法选取延安大学附属医院收治的难治性偏头痛64例,按照治疗方法不同分为观察组与对照组两组各32例。观察组采用都梁丸联合托吡酯治疗,对照组采用托吡酯治疗。观察比较两组治疗后临床效果,治疗前后头痛评估指标和大脑动脉血流速度,以及治疗期间不良反应发生情况。结果治疗后,观察组总有效率90. 63%明显高于对照组总有效率71. 88%,差异有统计学意义(P <0. 05)。治疗前,两组疼痛评估指标及各大脑动脉血流速度比较差异均无统计学意义(P> 0. 05)。治疗后,两组头痛发作频率、头痛持续时间、头痛程度评分及大脑前动脉(ACA)、大脑中动脉(MCA)、椎动脉(VA)、基底动脉(BA)、大脑后动脉(PCA)血流速度均明显低于治疗前,且观察组头痛发作频率、头痛持续时间、头痛程度评分及ACA、MCA、VA、BA、PCA血流速度均明显低于对照组,差异有统计学意义(P <0. 05)。治疗期间,观察组不良反应总发生率12. 50%高于对照组不良反应总发生率9. 38%,但两组比较差异无统计学意义(P> 0. 05)。结论都梁丸联合托吡酯治疗难治性偏头痛临床效果良好,可以明显降低或缩短头痛发作频率、头痛持续时间及头痛程度,加速脑组织血流恢复,且安全性较好。
Objective To investigate the clinical efficacy and safety of Duliangwan combined with Topiramate in the treatment of refractory migraine. Methods A total of 64 patientswith refractory migraine of Yan'an university affiliated hospitalwere divided into observation group and control group according to different treatment methods,with 32 cases in each group. The control group was treated with Topiramate,and the observation group was treated with Duliangwan on the basis of the control group. The clinical efficacy of the two groups after treatment were compared. The headache attack indicators and cerebral arterial blood flow velocity of the two groups before and after treatment,the incidence of adverse reactions during the treatment was observed and analyzed. Results The total effective rate of the observation group( 90. 63%) was significantly higher than that of the control group( 71. 88%),which was significantly different( P < 0. 05). Before treatment,there were no significant differences in indicators of pain assessment and cerebral arterial blood flow velocity between the two groups( P > 0. 05). After treatment,the frequency of headache attack,duration of headache,and degree of headache as well as blood flow velocity of ACA,MCA,VA,BA and PCA were significantly lower in the two groups than those before treatment,and the difference was significant( P < 0. 05). After treatment,those indicators in observation group were significantly lower than those in the control group,and the difference was significant( P < 0. 05). The total incidence of adverse reactions during the treatment period in the observation group( 12. 50%) was higher than that in the control group( 9. 38%),but there was no significant difference between the two groups( P > 0. 05). Conclusion Duliangwan combined with Topiramate can have a positive effect on refractory migraine,which significantly reduce or shorten the frequency,duration and severity of headache attack,and accelerate blood flow velocity in brain tissues,with good safety.
Objective To investigate the clinical efficacy and safety of Duliangwan combined with Topiramate in the treatment of refractory migraine. Methods A total of 64 patientswith refractory migraine of Yan'an university affiliated hospitalwere divided into observation group and control group according to different treatment methods,with 32 cases in each group. The control group was treated with Topiramate,and the observation group was treated with Duliangwan on the basis of the control group. The clinical efficacy of the two groups after treatment were compared. The headache attack indicators and cerebral arterial blood flow velocity of the two groups before and after treatment,the incidence of adverse reactions during the treatment was observed and analyzed. Results The total effective rate of the observation group( 90. 63%) was significantly higher than that of the control group( 71. 88%),which was significantly different( P < 0. 05). Before treatment,there were no significant differences in indicators of pain assessment and cerebral arterial blood flow velocity between the two groups( P > 0. 05). After treatment,the frequency of headache attack,duration of headache,and degree of headache as well as blood flow velocity of ACA,MCA,VA,BA and PCA were significantly lower in the two groups than those before treatment,and the difference was significant( P < 0. 05). After treatment,those indicators in observation group were significantly lower than those in the control group,and the difference was significant( P < 0. 05). The total incidence of adverse reactions during the treatment period in the observation group( 12. 50%) was higher than that in the control group( 9. 38%),but there was no significant difference between the two groups( P > 0. 05). Conclusion Duliangwan combined with Topiramate can have a positive effect on refractory migraine,which significantly reduce or shorten the frequency,duration and severity of headache attack,and accelerate blood flow velocity in brain tissues,with good safety.
引文
[1]王涛,王枫.小剂量左乙拉西坦单药与氟桂利嗪联合预防难治性偏头痛的疗效研究[J].实用临床医药杂志,2017,21(21):153-154.
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[3]张金培,杨屹,靳艳.麻芎舒痛方治疗偏头痛的临床效果及对血清5-HT、NF-κB和炎症因子水平的影响[J].昆明医科大学学报,2017,38(8):40-43.
[4]朱明,张明忠,杨久云.养血清脑颗粒联合西医常规治疗血虚肝旺型偏头痛44例临床观察[J].中医药导报,2016,22(2):81-84.
[5]蒲圣雄,谭戈,邓勇,等.针刺对比药物预防治疗偏头痛有效性及安全性的Meta分析[J].重庆医科大学学报,2017,34(10):1293-1298.
[6]宋倩,赵守法,李礼,等.针刺与西药比较预防性治疗偏头痛的Meta分析[J].辽宁中医杂志,2016,42(4):821-826,插5.
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[8]赖吉珍,李可文,宋宁.头痛宁胶囊联合耳穴压豆预防性治疗偏头痛疗效观察[J].现代中西医结合杂志,2017,26(9):948-950.
[9]朱婉茸,张扶莉,许韬,等.头痛Ⅰ号方加减联合盐酸洛美利嗪治疗偏头痛的疗效及对血清NO、ET-1水平的影响[J].现代中西医结合杂志,2017,26(18):2008-2010.
[10]邵勇,曹丽平,陈之虎,等.定痛汤对无先兆性偏头痛病人血CGRP、SP的影响及临床疗效分析[J].中西医结合心脑血管病杂志,2016,14(18):2101-2103.
[11]潘燕,陈倩.祛风通络中药+头针治疗偏头痛急性发作疗效及对P物质、5-羟色胺、同型半胱氨酸的影响[J].现代中西医结合杂志,2017,26(30):3360-3362.
[12]赵岳峰.中西医结合治疗神经外科显微血管减压术后患者头痛的疗效观察[J].陕西中医,2016,37(10):1316-1317.
[13]许贤平,易飞.偏头痛患者焦虑抑郁状态调查[J].中国煤炭工业医学杂志,2013,16(1):148-150.
[14]王平.加味血府逐瘀汤联合尼莫地平治疗偏头痛临床观察[J].辽宁中医药大学学报,2016,18(3):180-183.
[15]袁海军,闫志河,陈跃祥,等.有先兆偏头痛误诊为青光眼[J].临床误诊误治,2011,24(8):33-34.
[16]赵永俊,陈春富.偏头痛类型及性别对患者生活质量影响的调查研究[J].临床荟萃,2013,28(1):20-22,25.
[17] Maertens J,Raad I,Petrikkos G,et al. Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy[J]. Clin Infect Dis,2016,39(11):1563-1571.
[18]袁芝梅,李晓秋,陈会生. A型肉毒毒素治疗慢性偏头痛的临床疗效和安全性观察[J].解放军医药杂志,2016,28(3):43-46.
[19]龚雪琴,张娟.酒石酸美托洛尔联合氟桂利嗪预防性治疗偏头痛的疗效观察[J].中西医结合心脑血管病杂志,2016,14(24):2957-2959.
[20]赵冬梅,程华丽.血塞通治疗老年偏头痛患者的临床效果及对血流动力学的影响[J].陕西中医,2016,37(4):430-431.
[21]韩芳,李双,孙凡,等.偏头痛的现代医学治疗现状[J].中西医结合心脑血管病杂志,2016,14(1):42-47.
[22]蔡佳,贺娟,徐贵丽.托吡酯防治偏头痛的系统评价[J].西南国防医药,2017,27(10):1101-1104.
[23]顾翠,沈跃玲,张平.托吡酯治疗偏头痛疗效及对神经元放电和脑血流的影响[J].现代中西医结合杂志,2017,26(6):605-607.
[24]王成云,董欣,金善泉,等.托吡酯抑制偏头痛模型大鼠三叉神经节内NALP3炎性小体和白介素-1β的表达[J].中华神经医学杂志,2016,15(8):783-787.
[25]刘明平,黄曼婷,毛禹康,等.川芎-天麻不同提取物对大鼠血瘀型偏头痛药效学差异研究[J].辽宁中医药大学学报,2016,18(2)5-7.
[2]郭丰存,郭燕洁,金杰.中西医结合治疗偏头痛肝阳上亢证临床研究[J].中医学报,2016,31(3):433-435.
[3]张金培,杨屹,靳艳.麻芎舒痛方治疗偏头痛的临床效果及对血清5-HT、NF-κB和炎症因子水平的影响[J].昆明医科大学学报,2017,38(8):40-43.
[4]朱明,张明忠,杨久云.养血清脑颗粒联合西医常规治疗血虚肝旺型偏头痛44例临床观察[J].中医药导报,2016,22(2):81-84.
[5]蒲圣雄,谭戈,邓勇,等.针刺对比药物预防治疗偏头痛有效性及安全性的Meta分析[J].重庆医科大学学报,2017,34(10):1293-1298.
[6]宋倩,赵守法,李礼,等.针刺与西药比较预防性治疗偏头痛的Meta分析[J].辽宁中医杂志,2016,42(4):821-826,插5.
[7] Karsy M,Hoang N,Barth T,et al. Combined hydroxyurea and verapamil in the clinical treatment of refractory meningioma:human and orthotopic xenograft studies[J]. World Neurosurg,2016,86(6):210-219.
[8]赖吉珍,李可文,宋宁.头痛宁胶囊联合耳穴压豆预防性治疗偏头痛疗效观察[J].现代中西医结合杂志,2017,26(9):948-950.
[9]朱婉茸,张扶莉,许韬,等.头痛Ⅰ号方加减联合盐酸洛美利嗪治疗偏头痛的疗效及对血清NO、ET-1水平的影响[J].现代中西医结合杂志,2017,26(18):2008-2010.
[10]邵勇,曹丽平,陈之虎,等.定痛汤对无先兆性偏头痛病人血CGRP、SP的影响及临床疗效分析[J].中西医结合心脑血管病杂志,2016,14(18):2101-2103.
[11]潘燕,陈倩.祛风通络中药+头针治疗偏头痛急性发作疗效及对P物质、5-羟色胺、同型半胱氨酸的影响[J].现代中西医结合杂志,2017,26(30):3360-3362.
[12]赵岳峰.中西医结合治疗神经外科显微血管减压术后患者头痛的疗效观察[J].陕西中医,2016,37(10):1316-1317.
[13]许贤平,易飞.偏头痛患者焦虑抑郁状态调查[J].中国煤炭工业医学杂志,2013,16(1):148-150.
[14]王平.加味血府逐瘀汤联合尼莫地平治疗偏头痛临床观察[J].辽宁中医药大学学报,2016,18(3):180-183.
[15]袁海军,闫志河,陈跃祥,等.有先兆偏头痛误诊为青光眼[J].临床误诊误治,2011,24(8):33-34.
[16]赵永俊,陈春富.偏头痛类型及性别对患者生活质量影响的调查研究[J].临床荟萃,2013,28(1):20-22,25.
[17] Maertens J,Raad I,Petrikkos G,et al. Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy[J]. Clin Infect Dis,2016,39(11):1563-1571.
[18]袁芝梅,李晓秋,陈会生. A型肉毒毒素治疗慢性偏头痛的临床疗效和安全性观察[J].解放军医药杂志,2016,28(3):43-46.
[19]龚雪琴,张娟.酒石酸美托洛尔联合氟桂利嗪预防性治疗偏头痛的疗效观察[J].中西医结合心脑血管病杂志,2016,14(24):2957-2959.
[20]赵冬梅,程华丽.血塞通治疗老年偏头痛患者的临床效果及对血流动力学的影响[J].陕西中医,2016,37(4):430-431.
[21]韩芳,李双,孙凡,等.偏头痛的现代医学治疗现状[J].中西医结合心脑血管病杂志,2016,14(1):42-47.
[22]蔡佳,贺娟,徐贵丽.托吡酯防治偏头痛的系统评价[J].西南国防医药,2017,27(10):1101-1104.
[23]顾翠,沈跃玲,张平.托吡酯治疗偏头痛疗效及对神经元放电和脑血流的影响[J].现代中西医结合杂志,2017,26(6):605-607.
[24]王成云,董欣,金善泉,等.托吡酯抑制偏头痛模型大鼠三叉神经节内NALP3炎性小体和白介素-1β的表达[J].中华神经医学杂志,2016,15(8):783-787.
[25]刘明平,黄曼婷,毛禹康,等.川芎-天麻不同提取物对大鼠血瘀型偏头痛药效学差异研究[J].辽宁中医药大学学报,2016,18(2)5-7.
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