维拉帕米和泊尼松预防治疗丛集性头痛的疗效对比观察

Prophylactic treatment of cluster headache with verapamil and prednisone

目的 探讨维拉帕米预防治疗丛集性头痛发作的有效性、安全性和耐受性,并与泊尼松疗效进行对比.方法 采用前瞻性的方法,按照就诊号奇偶性将丛集性头痛患者分为维拉帕米组（23例）与泊尼松组（22例）,观察2组患者治疗前1周与治疗后第1周、第2周的发作频率、止痛药使用数量.结果 维拉帕米组治疗后第1周、第2周的头痛发作频率较治疗前第1周有明显减少,分别从每周8.78次减少至2.52和1.35次,差异有统计学意义（P＜0.05）;泊尼松组分别从每周8.09次减少至2.95和1.64次,差异有统计学意义（P＜0.05）;同一时间点2组之间差异无统计学意义（P＞0.05）.维拉帕米组止痛药使用数量从8.09片减少至1.65片和0.48片,差异有统计学意义（P＜0.05）;泊尼松组从7.77片减少至2.59片和1.36片,差异有统计学意义（P＜0.05）;同一时间点2组之间差异无统计学意义（P＞0.05）.结论 维拉帕米和泊尼松均能有效预防丛集性头痛发作,可根据患者的不同情况作出选择.

Objective To assess the efficacy, safety, and tolerability of verapamil as prophylactic therapy for patients withcluster headache, and compare its efficacy with that of prednisone.Methods Prospectively, according to the order of visit, a total of 45 patients with episodic cluster headache or chronic cluster headache were divided into verapamil treatment group （n=23, the odd） and prednisone treatment group （n=22, the even）. The seizure frequency, and times of and dosage of using acesodyne were observed in the 2 groups 1 week before treatment, 1 and 2 week after treatment.Results Mean frequency of headache occurrence decreased from 8.78 to 2.52 and 1.35 times,respectively, in the first and second week of treatment in the verapamil group （P=0.000） and from 8.09 to 2.95 and 1.64 times, respectively, at the corresponding time in the prednisone group （P=0.000）. Mean abortive agent consumption decreased from 8.09 to 1.65 and 0.48 pills, respectively, in the verapamil group （P=0.000） and from 7.77 to 2.59 and 1.36 pills, respectively, in the prednisone group （P=0.000） in the first and second week of treatment; no significant differences existed in the mean frequency of headache and abortive agent consumption between the 2 groups at the same time point （P〉0.05）. The side effects of verapamil were mild, including dizziness, constipation and bradycardia and those ofprednisone were insomnia, increased appetite combined with weight gain and discomfort of abdomen. Conclusion Both verapamil and prednisone prophylaxis therapy for episodic and chronic cluster headache yield significant reduction in headache frequency and abortive agent consumption; choices can be made according to different situations.