肉毒毒素A治疗颈源性头痛的双盲研究

Treatment of cervicogenic headache with botulinum toxin A: a doable-blind trial

目的:颈部骨骼肌源性头痛目前尚无治疗的有效方法,观察肉毒毒素A治疗颈部骨骼肌源性头痛的疗效。方法:采用双盲原则,将40例颈源性头痛患者随机分为治疗组和对照组,分别接受浓度为50 u/ml肉毒毒素A溶液和生理盐水颈部多个肌筋膜扳机点注射。结果:头痛情况采用头痛月天数和头痛指数进行评估,治疗组在治疗后两周、四周时头痛月天数(2.0±2.4,2.2±2.6)和头痛指数(2.5±3.5,3.5±3.6)明显减低,和对照组(14.6±5.2,16.1±5.2和24.2±14.1,26.3±11.2)及治疗前(14.7±5.8和32.6±19.6)差异均有显著性意义(P<0.01)。结论:肉毒毒素A颈部肌筋膜扳机点注射是治疗颈部骨骼肌源性头痛的有效方法。

AIM: To detennine whether therapy with botulinum toxin A may prove to be an effective treatment for headaches of musculo-skeletal origin. METHODS: According to double-blind principle, 40 patients suffering from cer-vicogenic headache were divided into the treatment group and the control group. Each member of the treatment group received liquor diluting botulinum toxin A(50 units/ml), while each member of the control group received a placebo dose consisting only of saline. RESULTS: At both 2 and 4 weeks post injection, the treatment group showed a statistically significant reduction in: (1) the number of headache days per month (2. 0±2.4, 2. 2±2. 6) and (2) the headache index(2. 5±3. 5, 3. 5±3. 6), as compared with either the control group(14. 6±5. 2, 16.1±5. 2 and 24.2±14.1, 26.3±11.2) ( P < 0. 01) or the pre-injection treatment group(14.7±5.8 and 32. 6±19.6) (P <0.01) .CONCLUSION: The injection of botulinum toxin A into myofacial trigger points is an effective treatment for headaches of musculo-skeletal origin.