偏头痛药物治疗进展

Advances in pharmaceutic managements of migraine

偏头痛是疾病负担极其严重的神经血管性疾病,需予以有效的急性期和预防性治疗。不同于既往仅依据临床经验选择药物,近年以偏头痛发病机制为靶点的特异性治疗给偏头痛的管理带来革命。地坦类和吉泮类药物可以有效减少头痛及其他相关症状,亦对传统镇痛药或曲坦类药物治疗无效者有效。多种降钙素基因相关肽及其受体单克隆抗体可以有效减少头痛发作,尤其是临床难以处理的伴发焦虑和抑郁障碍、药物过度使用性头痛或多种传统预防性药物治疗失败的患者。本文综述偏头痛药物研究进展及其对临床实践的影响。

Migraine is a neurovascular disorder with great burden so that effective abortive and preventive treatment is needed. Different from the previous choice of drugs based on clinical experience,the specific treatment targeting the pathogenesis of migraine has revolutionized the management of migraine in recent years. Ditans and gepants can not only effectively relief headache and related symptoms but also be effective for those who are refractory to the abortive treatment by traditional painkillers or triptans. A variety of monoclonal antibodies against calcitonin gene-related peptide(CGRP)and CGRP receptor can effectively reduce headache attacks, especially when accompanied by other difficult clinical situations. This paper reviews the research progress of migraine drugs and its impact on clinical practice.