氟哌噻吨和美利曲辛合剂治疗伴有抑郁和/或焦虑症状紧张性头痛的研究

Randomized, open, controlled trial of flupenthixol/melitracen in treatment of tension type headache with depression and/or anxiety

目的:探索治疗伴有抑郁和/或焦虑状态紧张性头痛的有效方法,以及抗抑郁/焦虑药物在治疗该类紧张性头痛中的作用。方法:将伴有抑郁和/或焦虑状态的紧张性头痛患者138例随机分为2组,即氟哌噻吨和美利曲辛合剂(黛力新)及头痛发作时加用散立痛组(治疗组,最终完成57例)和头痛发作时单用散立痛组(对照组,最终完成52例),进行随机单盲对照研究,同时用汉密尔顿抑郁量表评分(HAMD)和汉密尔顿焦虑量表评分(HAMA)对其抑郁和/或焦虑状况进行治疗前及治疗后(第2,4,6周)的评估。结果:治疗组头痛每月发作天数显著减少(第2周P<0.05,第4,6周P<0.01),头痛发作持续时间缩短(第2,4,6周均P<0.01);同时HAMD及HAMA均显著减少(第2,4,6周均P<0.01)。结论:对于伴有抑郁和/或焦虑状态的紧张性头痛患者,除应用对症治疗外,应该加用抗抑郁/焦虑药物。

Objective:To search for effective therapy for tension type headache with depression and/or anxiety. Methods: 138 tension type headache patients with depression and/or anxiety were randomly divided into active group (treating with Sariton, 2 tablets, po, tid at headache episode and flu-penthixol/melitracen,2 tablets,po,qm for 6 weeks) and control group (treating with only Sariton,2 tablets, po, tid at headache episode). Every patient was evaluated with Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) before and 2,4,6 weeks after treatment beginning. Results:The differences in reducing headache episode days,shortening headache episode duration,decreasing HAMD and HAMA were significant between active and control group. Conclusion: Tension type headache patients with depression and/or anxiety should be treated with flupenthixol/melitracen besides using anodyne.