盐酸度洛西汀治疗原发性头痛伴抑郁焦虑症状的临床研究

Clinical Research of Duloxetine in Primary Headache with Depression and Anxiety

目的观察抗抑郁剂盐酸度洛西汀对伴抑郁焦虑的原发性头痛的疗效。方法将伴抑郁焦虑障碍的原发性头痛患者112例随机分成治疗组和对照组,每组各56例,在接受尼莫地平、阿司匹林常规治疗的基础上,治疗组加用盐酸度洛西汀进行治疗。分别于治疗前、治疗4周末、8周末统计患者头痛发作次数、持续时间及减轻程度。同时采用汉密尔顿抑郁量表(HAMD)、焦虑量表(HAMA)评定两组患者抑郁和焦虑程度、疗效及药物安全性。结果(1)治疗后治疗组患者的每周头痛发作次数减少,头痛发作持续时间缩短,头痛程度减轻,与对照组比较差异均有统计学意义(P<0.01)。(2)治疗4周末、8周末治疗组的HAMD和HAMA评分与对照组的比较,差异均有统计学意义(P<0.01)。(3)治疗组基本恢复9例,显效22例,有效15例,无效10例;对照组基本恢复1例,显效11例,有效14例,无效28例,两组疗效间差异有统计学意义(P<0.01)。结论盐酸度洛西汀对于伴有抑郁焦虑的原发性头痛患者疗效显著。

Objective To observe the efficacy of antidepressant Duloxetine on depression and anxiety in primary headache patients. Methods One hundred twelve primary headache patients accompanied by depression and anxiety disorders were randomized into groups treatment and control, 56 in each. Both were given conventional therapy of nimodipine and aspirin, but treatment group given additional duloxetine. The attack frequency, duration and degree of headache were recorded 4, 8 weeks after treatment, and the degrees of depression and anxiety, effects and drug safety were evaluated using hemihon rating scale for depression （HAMD） and Hamilton anxiety （HAMA）. Results The attack frequency, duration and headache degree were significantly reduced in treatment group after treatment （P 〈 0. 01 ）. The scores of HAMD and HAMA fell by a significantly bigger margin in treatment group than in control （ P 〈 0. 01 ）. The total efficacy rate was 82% in treatment group, and 48% in control. Conclusion Duloxetine is significantly effective in treatment of primary headache with depression and anxiety.