盐酸氟桂利嗪治疗偏头痛的临床疗效及其对血浆降钙素基因相关肽水平的影响

目的分析盐酸氟桂利嗪治疗偏头痛的临床疗效及其对血浆降钙素基因相关肽(CGRP)水平的影响。方法选取2014年8月-2018年12月航天中心医院神经内科头痛门诊及住院病房收治的偏头痛患者45例,随访至第30天时根据随访日记将头痛发作频次≥3次/月的24例患者纳入研究并开始给予盐酸氟桂利嗪进行预防性治疗,连续治疗30 d。24例患者中5例未能完成试验、1例因出现哮喘而退出试验,最终共18例患者完成试验。比较18例患者用药前及用药30 d后头痛发作情况包括头痛发作频次、头痛程度、视觉模拟评分法(VAS)评分及头痛持续时间],并记录用药期间不良反应发生情况;比较8例患者用药前及用药30 d后血浆CGRP水平。结果(1)18例患者用药前与用药30 d后头痛程度和头痛持续时间比较,差异无统计学意义(P>0.05);用药30 d后头痛发作频次和VAS评分低于用药前(P<0.05)。(2)8例患者用药30 d后血浆CGRP水平低于用药前(P<0.05)。(3)18例患者治疗期间均未出现明显不良反应。结论盐酸氟桂利嗪可有效降低偏头痛患者头痛发作频率及强度,其机制可能与降低血浆CGRP水平有关。

Clinical Effect of Flunarizine Hydrochloride on Migraine Disorders and Its Impact on Plasma Calcitonin Gene-related Peptide Level

Objective To analyze the clinical effect of flunarizine hydrochloride on migraine disorders and its impact on plasma calcitonin gene-related peptide(CGRP)level.Methods From August 2014 to December 2018,a total of 45 patients with migraine disorders were selected in the Headache Clinic and Inpatient Ward of Neurology Department,Aerospace Center Hospital,thereinto 24 patients with headache attack frequency≥3 times/month were involved according to the 30-day follow-up diary,and then they were treated with flunarizine hydrochloride as preventive therapy.Among the 24 involved patients,5 cases failed to complete the trial,1 case withdrew from the trial due to asthma,and the 18 patients finally completed the trial.Headache attack condition(including headache attack frequency,headache degree,VAS score and duration of headache)of the 18 enrolled patients were compared before medication and 30 days after medication,and incidence of adverse reactions was recorded during treatment,moreover plasma CGRP level of 8 patients were compared before medication and 30 days after medication.Results(1)There was no statistically significant difference in headache degree or duration of headache before medication and 30 days after medication in the 18 enrolled patients(P>0.05),while headache attack frequency and VAS score 30 days after medication were statistically significantly lower than those before medication(P<0.05).(2)Plasma CGRP level 30 days after medication was statistically significantly lower than that before medication in the 8 enrolled patients(P<0.05).(3)No one of the 18 enrolled patients occurred any obvious adverse reactions during treatment.Conclusion Flunarizine hydrochloride can effectively reduce the attack frequency and intensity of migraine in patients with migraine disorders,and its mechanism may be related to the decrease of plasma CGRP level.