维拉帕米对丛集性头痛发作的预防作用

摘要

目的 研究维拉帕米对丛集性头痛(Cluster Headache,CH)发作及头痛程度的影响,为CH的防治提供参考.方法 将60例CH患者随机分为对照组与实验组,每组30例.对照组给予强的松、氟桂利嗪、高压氧等常规治疗,实验组在常规治疗基础上加用维拉帕米,3次/d,持续用药3周.记录用药1周、2周、3周后CH发作频率,采用视觉模拟评分法(VAS)评价头痛程度,采用心境状态量表(POMS)及WHO简易生活质量量表-BREF(WHOQOL-BREF)评价患者情绪及生活质量变化,治疗前、后测量患者血浆5-羟色胺(5-HT)、降钙素基因相关肽(CGRP)水平变化.结果 治疗2周、3周后,实验组头痛发作次数少于对照组(P＜0.05);治疗1周、2周、3周后,实验组头痛VAS评分均低于对照组(P＜0.05);两组治疗后除了愤怒评分比较差异无统计学意义(P＞0.05)外,实验组焦虑、抑郁、疲劳、精力评分均低于对照组(P＜0.05);实验组治疗后生理功能、心理功能、社会功能及总体健康评分均高于对照组(P＜0.05);实验组治疗后5-HT浓度高于对照组,而CGRP低于对照组(P＜0.05).结论 维拉帕米治疗CH可减少头痛发作次数,减轻头痛程度,改善患者生活质量,对CH发作有一定的预防作用.%Objective To study the impact of verapamil on the attack and headache degree in patients with cluster headache (CH) and to provide some references for the control of CH.Methods 60 patients with CH were randomly divided into a control group and an experimental group,30 for each group.The control group were treated with prednisone,flunarizine,hyperbaric oxygen therapy,and other conventional therapy;in addition,the experimental group were treated with verapamil,3 times/d,for 3 weeks.The attack frequency of CH was recorded 1,2,and 3 weeks after the medication.The headache degree was evaluated by visual analogue scale (VAS) and the mood and quality of life by mood status scale (POMS) and simple quality of life amounts WHO table-BREF (WHOQOL-BREF).The plasma levels of 5-hydroxytryptamine (5-HT) and ealcitonin gene-related peptide (CGRP) were measured.Results 2 and 3 weeks after the treatment,the attack frequencies of CH were lower in the experimental group than in the control group (P ＜ 0.05).1,2,and 3 weeks after the treatment,the scores of headache VAS were lower in the experimental group than in the control group (P ＜ 0.05).The anxiety,depression,fatigue,and mental scores were lower and the scores of physiological function,psychological function,social function,and general health were higher in the experimental group than in the control group (P ＜ 0.05).The 5-HT concentration was higher and the CGRP was lower in the experimental group than in the control group (P ＜ 0.05).Conclusions Verapamil for CH can reduce the attack frequency,relieve headache degree,and improve the patients' quality of life and has remarkable preventive effect for CH.