慢性偏头痛首次预防性疗效影响因素和服药依从性研究

Factors affecting preventive treatment outcome of chronic migraine and persistence to treatment recommendations

目的探讨影响慢性偏头痛(CM)患者首次口服预防用药治疗效果的因素并评估患者服药依从性。方法分析185例CM患者预防用药4周后的治疗效果,从人口学特征、偏头痛特点、头痛家族史、药物过度使用史等方面分析可能影响患者预防治疗结局的因素;同时随访患者服药4周、12周的依从性。结果预防治疗4周后,64.8%CM患者治疗有效(n=107),35.2%患者无效(n=58)。分析发现预防治疗起效与每月头痛天数少有关,15~20d/月较26~30d/月的患者效果好(OR=2.82,95%CI:1.33~5.97,P=0.007)。治疗12周后只有35.8%(n=59)患者坚持服药。结论 CM预防治疗效果与头痛频率相关,仅1/3的患者坚持服药12周,提示在CM的预防治疗中应加强患者的依从性。

Objective To investigate the factors affecting the efficacy of first oral prophylaxis in patients with chronic migraine(CM)and to assess the patients medication compliance.Methods The therapeutic effects of 185 patients with CM after 4 weeks of treatment were analyzed.The factors that may affect the outcome of preventive treatment were analyzed from the aspects of demographic characteristics,migraine characteristics,family history of headache and history of drug overuse.The patients were followed up for 4 and 12 weeks to observe their medication compliance.Results 107 patients(64.8%)were classified as responders,68 patients(35.2%)were classified as non-responders after 4 weeks of treatment.The analysis found that the effectiveness of preventive treatment was related to the number of days of headache,and the effect was better in patients with 15 to 20 d/month of headache compared with 26 to 30 d/month(OR=2.82,95%CI:1.33-5.97,P=0.007).Fifty-nine patients(35.8%)were persistent to pharmacological prophylaxis after 12 weeks of treatment.Conclusion The preventive therapeutic effect of CM is related to the frequency of headache.Patients compliance should be strengthened.