A型肉毒毒素颅周肌肉注射治疗慢性偏头痛临床观察

Pericranial intramuscular injection of botulinum toxin type A for treatment of chronic migraine

目的观察A型肉毒毒素（BTX—A）治疗慢性偏头痛的临床疗效和不良反应。方法101例慢性偏头痛患者随机分为BTX-A组和对照组，分别于治疗前、治疗后1、2、3、6个月进行头痛影响测验（HIT-6）评分，在治疗前、治疗后3、6个月进行偏头痛致残评定量表（MIDAS）评估，比较两组之间的HIT-6、MIDAS及止痛药物使用量。结果BTX—A组治疗后HIT-6评分和MIDAS评分与对照组比较均有明显改善（P〈0．05或0．01），止痛药物的使用较对照组明显减少（P〈0．01），疗效可维持6个月，且不良反应轻微。结论BTX—A颅周肌肉注射治疗慢性偏头痛效疗显著，不良反应轻微。

Objective To evaluate the efficacy and adverse effects of botulinum toxin type A （BTX-A） in treatment of chronic migraine. Methods One hundred and one patients with chronic migraine were randomly divided into BTX-A group and control group. The headache impact test （HIT-6） scores were measured at 0, 1, 2, 3 and 6 months after treatment, and the mi- graine disability assessment scale （MIDAS） scores were measured at 0, 3 and 6 months after treatment. HIT-6 scores, MIDAS scores and the use of analgesics were compared between the two groups. Results There were significant differences in HIT-6 scores （P〈0.05） and MIDAS scores （P〈0.01） between the two groups. The doses of analgesics in BTX-A group were reduced significantly （P〈0.01）. The therapeutic effect of BTX-A lasted for 6 months, and no obvious adverse effects were observed. Conclusion Pericranial intramuscular injection of BTX-A is an effective and safe therapeutic method for chronic migraine.