度洛西汀防治慢性偏头痛伴焦虑抑郁障碍的疗效分析

Therapeutic effects of duloxetine on chronic migraine complicated by anxiety and depression

目的探讨度洛西汀治疗伴焦虑抑郁障碍的慢性偏头痛的临床疗效。方法选择于河北医科大学第一医院治疗的偏头痛患者117例,对照组予盐酸氟桂利嗪胶囊和洛索洛芬钠治疗,观察组在对照组基础上给予盐酸度洛西汀肠溶胶囊。观察治疗前及疗程完成后第6周末患者头痛发作频率、持续时间(h)及头痛等级。同时评估汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分及激越分量表(BPRS)评分情况。结果治疗后,观察组HAMD评分为(9.2±3.6)分、HAMA为(6.2±2.1)分、BPRS为(4.5±1.6)分,偏头痛每周发作次数(0.30±0.11)次,每次持续(2.65±1.36)h,与治疗前比较差异有统计学意义(P<0.05),观察组优于对照组(P<0.05)。治疗前,2组患者发作次数、持续时间比较差异无统计学意义(P>0.05)。2组偏头痛发作频率及每次发作持续时间较治疗前均显著降低(P<0.05);观察组发作次数少于对照组,持续时间低于对照组,差异有统计学意义(P<0.05)。对照组和观察组头痛分级治疗前差异无统计学意义(P>0.05);对照组观察组头痛等级为0级的升高至16.4%,比例为Ⅲ的降低至14.5%,差异有统计学意义(P<0.05);观察组头痛等级为0级的升高至24.2%,比例为Ⅲ的降低至6.5%,差异有统计学意义(P<0.05)。结论联合盐酸度洛西汀肠溶胶囊用于缓解焦虑抑郁症、降低偏头痛发作频率和减轻偏头痛程度等方面有确切的疗效,能够明显提高患者生活质量。

Objective To observe the therapeutic effects of duloxetine on chronic migraine complicated by anxiety and depression. Methods A total of 117 patients with migraine who were diagnosed in health examination center of the first hospital of Hebei Medical University were enrolled in the study. The subjects in control group were treated by flunarizine hydrochloride capsule and loxoprofen sodium,however,the patients in observation group,on the basis of control group,were treated by duloxetine hydrochloride enteric capsule,with a treatment course of 6 weeks for both groups. Before treatment and at the end of treatment,the seizure frequency of migraine,duration（ h） and grades of headache were observed. At the same time,the scores of Hamilton depression rating scale（ HAMD）,Hamilton anxiety scale（ HAMA） and agitation scale（ BPRS）were evaluated and compared between two groups. Results After treatment,there were significant differences in HAMD scores（ 9. 2 ± 3. 6） points,HAMA（ 6. 2 ± 2. 1） points,BPRS（ 4. 5 ± 1. 6） points,seizure frequency of migraine（ 0. 30 ±0. 11） times / week,duration（ 2. 65 ± 1. 36） h in observation group,as compared with those before treatment（ P〈0. 05）.Moreover these indexes in observation group were suprior to those in control group（ P〈0. 05）. Conclusion The combined treatment with duloxetine hydrochloride enteric capsule can relieve anxiety-depression,decrease the seizure frequency of migraine and alleviate the degree of migraine,thus,which can improve obviously patient＇s life quality.