A型肉毒毒素治疗偏头痛的临床疗效观察

Therapeutic effect of botulinum toxin type A in the treatment of migraine

目的探讨A型肉毒毒素局部注射治疗偏头痛的疗效与安全性。方法治疗组31例采用A型肉毒毒素注射治疗，对照组30例采用利多卡因＋泼尼松龙治疗，两组均采用颅周固定位点注射。分别于治疗前1个月、治疗后第l、2、3个月评定头痛发作天数、头痛发作次数、疼痛程度、偏头痛残疾程度及不良反应。结果治疗后第1、2、3个月，治疗组偏头痛发作天数、发作次数、残疾程度均较治疗前缓解（P〈0．05），治疗后第1、2个月时缓解最明显。对照组治疗后第1、2个月时，偏头痛发作天数、发作次数、残疾程度也均较治疗前减少（P〈0．05），但到第3个月时较治疗前差异无统计学意义（P〉0．05）；治疗组与对照组各时点比较，偏头痛发作天数、发作次数、残疾程度均明显缓解（P〈0．05）。治疗组与对照组各时点偏头痛疼痛程度均较治疗前减轻（P〈0．05），且治疗组与对照组各时点比较均减轻（P〈0．05）。各组均无严重的不良反应出现。结论A型肉毒毒素治疗偏头痛有效、安全，并且能减轻残疾程度。

Objective To observe the clinical efficacy and safety of local injection of botulinum toxin type A （BTXA） in the treatment of Migraine. Methods 31 patients in the treatment group were in jected BTXA 25 U at 10 positions at the muscles. 30 patients in the control group were given 2% lidocaine 1 ml plus prednisolone acetate 1 ml at the same muscle sites as in the treatment group. Days, frequency, and intensity of headache were evaluated by visual analogue scale （ VAS）, migraine disability was evaluated by migraine disability assessment guestionnaire （MIDAS）, and adverse reactions were assessed on 1 month before the treatment and 1st, 2st, 3st months after the treatment. Results The therapeutic effect between the treatment and control groups was significantly different in terms of days, frequency, and intensity of headache and migraine disability. Compared with preinjeetion, days and frequency of headache and mi graine disability were decreased significantly after injection in treatment group, lasting more than 2 months. No patients in two groups reported any serious treatmentrelated adverse event. Conclusions Botulinum toxin type A in the treatment of Migraine is effective and relative safe, and can decrease migraine disability.