利多卡因和地塞米松静脉点滴联合利多卡因鼻腔滴入治疗中、重度发作期偏头痛

Combination of lidocaine and dexamethasone in the treatment of moderate and severe migraine attack

目的 :观察利多卡因、地塞米松静脉点滴联合利多卡因鼻腔滴入治疗中、重度发作期偏头痛的疗效及不良反应。方法 :将 58例中、重度发作期偏头痛患者随机分为 2组。对照组 2 8例 :常规口服去痛片、阿司匹林、肌内注射鲁米那 ;治疗组 30例 :除常规治疗外 ,另静脉点滴 2 0g/L利多卡因 (1mg/kg)加地塞米松 5mg ,同时头痛侧鼻腔内滴入利多卡因 0 .5ml。分别于治疗后 1h、2h和 4h时对 2组患者进行疼痛程度评分和有效率比较。结果 :①治疗后 1h时 ,治疗组和对照组疼痛评分和有效率差异无显著性 (P均 >0 .0 5) ;②与对照组相比 ,治疗后 2h、4h时治疗组疼痛评分明显降低、有效率明显升高 ,差异均有显著性 (P均 <0 .0 5) ;③治疗组均未出现明显的不良反应。结论 :利多卡因、地塞米松静脉点滴联合利多卡因鼻腔滴入治疗中、重度发作期偏头痛疗效显著 ,且安全。

Aim:To observe the effects of lidocaine and dexamethasone combination in the treatment of moderate and severe migraine.Methods: A total of 58 patients with moderate and severe migraine attack were randomly allocated into 2 groups: 28 patients (control group) were routinely given oral analgesic drug, aspirin, and intramuscular injection of luminal 100 mg; the other 30 patients (treatment group),in addition to the routine treatment, were intravenously given lidocaine (1 mg/kg) and dexamethasone (5 mg),at the same time lidocaine was dropped (0.5 ml) into the nostril on the side of headache.Changes in pain intensity were observed prior to and at 1 hour, 2 hour,and 4 hour after treatment.Results: Changes in pain intensity had no significant difference between 2 groups at 1 hour, but the difference at 2 hour and 4 hour were significant ( P < 0.05). No side effects were observed.Conclusion:Lidocaine and dexamethasone combination is effective and safe for relieving moderate and severe migraine attack.