小剂量氯丙嗪静脉注射治疗偏头痛急性发作

Treatment of acute migraine attack with intravenous low dose chlorpromazine

目的 :了解小剂量氯丙嗪静脉注射治疗偏头痛急性发作的疗效及副作用。方法 :4 6例诊断明确的偏头痛病人在用药前常规检查血压、心率 ,随后将氯丙嗪 12 .5mg溶入 5 %葡萄糖注射液 2 0mL中缓慢静脉注射 (5～ 10min内 ) ,如果 2 0min内无效 ,则换用其他药物。疗效的判断以头痛消失或仅有轻微头痛 ,且伴随症状消失为有效。 5 2例对照组按同样的方法接受安慰剂治疗。结果 :4 6例病人中35例 (76 % )头痛在用药中或用药后 2 0min内消失 ,而对照组仅 2例 (4% )在用药后 2 0min消失。用氯丙嗪的病人中有 3例出现直立性低血压。结论 :小剂量氯丙嗪静脉注射治疗偏头痛急性发作是有效的 。

AIM: To evaluate the effect and adverse reaction of intravenous low dose chlorpromazine (CPZ) in the treatment of the acute migraine attack. METHODS: This was a prospective, randomized, non-blind, placebo-controlled clinical trial. After the blood pressure and heart rate was assessed, all of the patients with a clinical diagnosis of common or classic migraine, who presented to the study were divided into two groups. Forty-six patients with the acute migraine attack (seventeen patients had the diagnosis of migraine with aura and twenty nine patients migraine without aura) received the intravenous chlorpromazine 12.5 mg in 5 % glucose injection 20 mL within 5-10 min. Fifty-two patients with the acute migraine attack (twenty\|one patients had the diagnosis of migraine with aura and thirty\|one patients migraine without aura) were given a bolus intravenous injection of 0.9 % sodium chloride injection 20 mL or 5 % glucose injection placebo. If response was inadequate within 20 min, the sequence was broken, and the other drug was given. RESULTS: Among those receiving CPZ, 76 % (35/46) had sufficient relief from their headache and could carry on their activities of daily living, compared with 4 %(2/52) in the control group within 20 min. This difference was statistically significant. Three of patients received chlorpromazine had orthostatic hypotension. CONCLUSION: The result shows that intravenous low dose chlorpromazine is effective in the treatment of acute, migraine attack. The only significant side effect is orthostatic hypotension, but it is mild.