摘要
目的观察传统治疗、联合用药或联合用药加重复经颅磁刺激(rTMS)治疗慢性每日头痛(CDH)的疗效。方法CDH患者104例分为三组。A组37例,口服盐酸氟桂利嗪5 mg/d;B组34例,口服盐酸氟桂利嗪5 mg/d联合氟哌噻吨0.5 mg/d+美利曲辛10 mg/d;C组33例,口服盐酸氟桂利嗪5 mg/d联合rTMS(5 Hz)外用治疗大脑左侧前额叶背外侧皮质。治疗2周后,比较疗效和不良反应事件发生情况。结果治疗结束时,B组和C组的VAS疼痛评分、头痛发作频率、急性止痛药物使用频率、焦虑和抑郁评分均低于治疗前(P<0.05),且两组治疗结束时和治疗后第1周VAS疼痛评分和头痛发作频率低于A组(P<0.05),但是治疗后第4、8周,C组VAS疼痛评分和头痛发作频率低于B组和A组(P<0.01)。仅B组发生3例不良反应事件。结论与传统药物治疗相比,联合用药或联合用药加高频rTMS治疗均能有效治疗CDH,联合用药起效更迅速,但联合rTMS疗效持久。
Objective To observe the efficacy of conventional treatment,combined use of medicine or combined use of medicine and repetitive transcranial magnetic stimulation(rTMS)in treating chronic daily headache(CDH).Methods A total of 104 patients with CDH was divided into three groups.Flunarizine 5 mg/d was orally taken in group A(37 cases).Flunarizine 5 mg/d combined with flupentixol 0.5 mg/d plus melitracen 10 mg/d were orally taken in group B(34 cases).Flunarizine 5 mg/d orally taken plus rTMS(5 Hz)of the dorsal lateral prefrontal cortex were used in group C(33 cases).After treated for 2 weeks,headache severity,frequency of headache attacks,the rate of analgetic use,anxiety and depression state,and adverse effects were compared among the three groups.Results After treatment,the VAS pain scores,headache frequency,the rate of analgetics use and the scores of anxiety and depression were decreased in groups of B and C(P<0.05).The VAS pain score and headache frequency at the end of treatment and the 1st week after treatment were lower in groups of B and C than those in group A(P<0.05),but which at the 4th and 8th week after treatment were lower in group C than those in groups of A and B(P<0.01).There were only 3 cases with mild adverse responses in group B.Conclusion Compared with conventional treatment,combined use of medicine or combined use of medicine plus rTMS can effectively treat the patients with CDH,of which the efficacy of combined use of medicine is better in onset time and combined use of medicine plus rTMS has a longer efficacy.
作者
刘燕平
林岩
张群
江文静
乌欣蔚
张楠
李瑞华
麻琳
LIU Yanping;LIN Yan;ZHANG Qun(Department of Neurology,Qilu Hospital of Shandong University,Jinan 250012,CHINA)
出处
《江苏医药》
CAS
2020年第5期502-506,共5页
Jiangsu Medical Journal
关键词
慢性每日头痛
氟哌噻吨
美利曲辛
重复经颅磁刺激
Chronic daily headache
Flupentixol
Melitracen
Repetitive transcranial magnetic stimulation
