氟桂利嗪联合卡马西平治疗偏头痛的效果观察

Effect of flunarizine combined with carbamazepine in the treatment of migraine

目的:探讨氟桂利嗪联合卡马西平治疗偏头痛的效果和安全性。方法:将2018年1-12月在余姚市人民医院治疗的偏头痛患者88例,根据治疗方法不同分为对照组(n=44)和观察组(n=44),对照组予以氟桂利嗪单药治疗,观察组予以氟桂利嗪联合卡马西平治疗。比较两组临床疗效、不良反应发生率、治疗前后简明36项健康问卷生活质量评定量表(SF-36)评分以及主要脑动脉血流速度。结果:观察组治疗总有效率显著高于对照组(90.91%比72.73%,χ2=5.437,P<0.05),不良反应发生率与对照组差异无统计学意义(15.91%比11.36%,P>0.05)。观察组患者治疗后SF-36各维度评分均显著高于对照组[生理机能:(86.15±8.24)分比(93.78±9.73)分,生理职能:(67.15±12.96)分比(87.93±13.78)分,躯体疼痛:(59.59±15.75)分比(73.25±18.34)分,一般健康状况:(58.92±14.83)分比(69.12±17.93)分,精力:(64.98±15.45)分比(72.48±16.78)分,社会功能:(78.62±14.91)分比(87.26±15.72)分,情感职能:(60.25±18.45)分比(69.12±15.72)分,精神健康:(74.91±16.45)分比(87.12±17.93)分]、脑动脉血流速度显著低于对照组[大脑前动脉:(57.12±8.94)cm/s比(52.73±9.02)cm/s;大脑中动脉:(75.82±11.92)cm/s比(63.09±11.25)cm/s;大脑后动脉:(49.87±10.64)cm/s比(45.10±9.25)cm/s;椎动脉颅内段:(46.20±4.02)cm/s比(44.12±4.03)cm/s;基底动脉:50.10±6.95)cm/s比(46.52±7.21)cm/s],两组差异均有统计学意义(t=3.969、7.287、3.748、2.908、2.181、2.645、2.427、3.329、2.293、5.152、2.244、2.424、2.371,均P<0.05)。结论:氟利嗪联合卡马西平能够显著提高偏头痛治疗效果,改善患者生活质量和脑动脉血流速度,安全性高。

Objective:To explore the effect and safety of flunarizine combined with carbamazepine in the treatment of migraine.Methods:From January 2018 to December 2018,88 migraine patients treated in Yuyao People's Hospital were divided into control group(n=44)and observation group(n=44)according to different treatment methods.The control group was given flunarizine,and the observation group was treated with flunarizine combined with carbamazepine.The clinical efficacy and the incidence of adverse reactions were compared between the two groups through evaluation of the SF-36 scale score before and after treatment and the main cerebral arterial blood flow velocity.Results:The total effective rate in the observation group was significantly higher than that in the control group(90.91%vs.72.73%,χ2=5.437,P<0.05),and the incidence of adverse reactions had no statistically significant difference between the two groups(15.91%vs.11.36%,P>0.05).The scores of the SF-36 scale in the observation group after treatment were significantly higher than those in the control group[PF:(86.15±8.24)points vs.(93.78±9.73)points;RP:(67.15±12.96)points vs.(87.93±13.78)points;BP:(59.59±15.75)points vs.(73.25±18.34)points;GH:(58.92±14.83)points vs.(69.12±17.93)points;VT:(64.98±15.45)points vs.(72.48±16.78)points;SF:(78.62±14.91)points vs.(87.26±15.72)points;RE:(60.25±18.45)points vs.(69.12±15.72)points;MH:(74.91±16.45)points vs.(87.12±17.93)points],the cerebral arterial blood flow velocity was significantly lower than the control group[ACA:(57.12±8.94)cm/s vs.(52.73±9.02)cm/s;MCA:(75.82±11.92)cm/s vs.(63.09±11.25)cm/s;PCA:(49.87±10.64)cm/s vs.(45.10±9.25)cm/s;VA:(46.20±4.02)cm/s vs.(44.12±4.03)cm/s;BA:(50.10±6.95)cm/s vs.(46.52±7.21)cm/s](PF:t=3.969,RP:t=7.287;BP:t=3.748;GH:t=2.908;VT:t=2.181;SF:t=2.645;RE:t=2.427;MH:t=3.329;ACA:t=2.293;MCA:t=5.152;PCA:t=2.244;VA:t=2.424;BA:t=2.371,P<0.05).Conclusion:Flunarizine combined with carbamazepine can significantly improve the treatment effect of migraine,improve the quality of life and cerebral arterial blood flow velocity of patients,and has high safety.