左乙拉西坦联合氟桂利嗪治疗难治性偏头痛的临床疗效及安全性分析

Clinical Effect and Safety of Levetiracetam Combined with Flunarizine on Refractory Migraine

目的分析左乙拉西坦联合氟桂利嗪治疗难治性偏头痛(RM)的临床疗效及安全性。方法选择2012年1月—2014年2月在都江堰市人民医院神经内科头痛门诊就诊的RM患者82例,按照患者就诊顺序分为观察组和对照组,各41例。对照组患者仅给予左乙拉西坦治疗,观察组患者给予左乙拉西坦联合氟桂利嗪治疗,两组患者均连续治疗24周。比较两组患者治疗前及治疗4周末、12周末、24周末头痛症状(包括头痛程度、头痛发作次数及头痛持续时间),治疗24周末临床疗效及治疗期间药物不良反应。结果治疗前和治疗4周末两组患者头痛程度得分、头痛发作次数及头痛持续时间比较,差异均无统计学意义(P>0.05);治疗12周末和24周末观察组患者头痛程度得分低于对照组,头痛发作次数少于对照组,头痛持续时间短于对照组(P<0.05)。治疗24周末,观察组患者临床疗效优于对照组(u=-1.491,P<0.05);观察组不良反应发生率为24.4%,对照组为19.5%,差异无统计学意义(P>0.05)。结论左乙拉西坦联合氟桂利嗪治疗RM的临床疗效确切,能有效缓解患者头痛症状,且安全性高。

Objective To analyze the clinical effect and safety of levetiracetam combined with flunarizine on refractory migraine. Methods From January 2012 to February 2014, a total of 82 patients with refractory migraine were selected in Headache Clinic of Department of Neurology,People＇ s Hospital of Dujiangyan, and they were divided into control group and observation group according to visiting sequence,each of 41 cases. Patients of control group were only given levetiracetam,while patients of observation group were given levetiracetam combined with flunarizine, both groups treated for 24 weeks. Headache symptoms（ including headache severity score, headache frequency and headache duration） before treatment and at 4th weekend,12 th weekend,24 th weekend of treatment,clinical effect at 24 th weekend and incidence of adverse reactions during treatment were compared between the two groups. Results No statistically significant differences of headache severity score,headache frequency or headache duration was found between the two groups before treatment or at 4th weekend of treatment（ P〈0. 05）,while at 12 th weekend,12 th weekend of treatment, headache severity score of observation group was statistically significantly lower than that of control group,headache frequency of observation group was statistically significantly less than that of control group,headache duration observation group was statistically significantly shorter than that of control group,respectively（ P〈0. 05）. At 24 th weekend of treatment,the clinical effect of observation group was statistically significantly better than that of control group（ u =-1. 491,P〈0. 05）. The incidence of observation group was 24. 4%,that of control group was 19. 5%,the difference was not statistically significantly different（ P〈0. 05）. Conclusion Levetiracetam combined with flunarizine has certain clinical effect in treating refractory migraine,can effectively relieve the headache symptoms,is with high safety.