氟桂嗪预防偏头痛的双盲疗效观察

氟桂嗪是一种选择性钙通道阻滞剂,可预防偏头痛发作。现将西比灵(盐酸氟桂嗪)和安慰剂对60例偏头痛进行双盲对照的疗效结果加以报道。临床资料病例选择:以病程>=1年,每月发作频度>=1次的普通或典型偏头痛患者为入选对象。入选病例共60例,其中男性18例,女性42例;年龄16～60岁(平均38.4岁);病程1～30年(平均10.9年)。典型偏头痛19     

典型偏头痛和普通型偏头痛TCD检查对照研究

对２５例典型偏头痛和３５例普通型偏头痛的ＴＣＤ进行对照研究，结果发现典型偏头痛发作期ＭＣＡ和ＰＣＡ在头痛侧平均血流速度明显加快，存在血管痉挛，普通型偏头痛发作期头痛侧与无症状侧平均血流速度无显著差异，提示典型偏头痛与普通型偏头痛的发病机理可能存在本质区别，前者多数由血管因素所致。     

盐酸氟桂利嗪胶囊治疗月经期偏头痛的临床疗效观察

目的探讨盐酸氟桂利嗪胶囊治疗月经期偏头痛的临床疗效及最佳治疗方案。方法将68例月经期偏头痛患者随机分为两组,A组为常规治疗组(每周服用盐酸氟桂利嗪胶囊5天,停用2天),B组为按生物节律周期治疗组(在月经来临前十天服用盐酸氟桂利嗪胶囊,连续服用20天)。所有患者均于睡前服用5mg盐酸氟桂利嗪胶囊,并记录头痛日记和药物不良反应;根据头痛程度、发作频率、持续时间和伴随症状的变化情况,经量化记分,于用药1个月、3个月、6个月进行疗效判定,同时比较药物不良反应的发生率。结果 1个月和3个月两组间盐酸氟桂利嗪胶囊疗效无明显差异(P>0.05),但6个月时,B组患者头痛程度、发作频率、持续时间、伴随症状与A组相比,明显减轻/减少(P<0.001);两组间药物不良发应发生率无差异(P>0.05)。结论盐酸氟桂利嗪胶囊能够有效的防治月经期偏头痛;根据生物节律周期即女性雌激素分泌水平变化给予盐酸氟桂利嗪胶囊防治月经期偏头痛疗效更佳。     

多虑平治疗偏头痛32例疗效观察

自1999—01～2003—12，笔者采用多虑平治疗偏头痛32例，疗效满意，报道如下。     

西比灵治疗偏头痛63例效果观察

我院2009-09—2012-08收治偏头痛的患者98例,对其中的63例使用选择性钙"超载"拮抗剂药物"西比灵"(盐酸氟桂嗪)进行治疗,收到满意治疗效果,现报道如下。1资料与方法1.1一般资料选取2009-09—2012-08我院收治的符合有关偏头痛标准患者98例作为研究对象,分成对照组与治疗组。治疗组63例,女35例,男31例,年龄13～54岁,平均27.3岁;对照组35例,女23例,男11例,年龄12～57岁,平     

氟桂利嗪联合血塞通治疗偏头痛的临床疗效

目的探讨氟桂利嗪与血塞通联合治疗偏头痛的临床疗效。方法 108例偏头痛患者随机分为观察组(n=54)与对照组(n=54),对照组给予氟桂利嗪治疗,观察组在对照组基础上加用血塞通治疗,对比2组治疗效果。结果 2组偏头痛发作频率及VAS评分较治疗前均显著降低(P0.01),疼痛持续时间显著缩短(P0.01),且治疗后观察组显著优于对照组(P0.01);观察组治愈率33.3%,显著高于对照组的16.7%;观察组有效率94.4%,显著高于对照组的75.9%。结论氟桂利嗪与血塞通联合治疗偏头痛,有较好的治愈率与有效率,值得临床推广。     

高压氧联合氟桂利嗪治疗偏头痛疗效分析

目的探讨高压氧联合氟桂利嗪治疗偏头痛的疗效。方法将120例偏头痛患者随机分为氟桂利嗪组、高压氧组和联合治疗组,对比分析各组间的有效率和1周治愈率。结果有效率:联合组(97.5%)高于高压氧组(82.5%)和氟桂利嗪组(80.0%),差异有统计学意义(P<0.05);1周治愈率:联合组(60.0%)、高压氧组(52.5%)高于氟桂利嗪组(22.5%),差异有统计学意义(P<0.01)。结论高压氧联合氟桂利嗪是治疗偏头痛的理想方法。     

正天丸与氟桂利嗪联合治疗偏头痛疗效观察

目的 观察正天丸与氟桂利嗪联合治疗偏头痛的临床疗效.方法 将80例偏头痛患者,随机分为2组,治疗组40例,服用正天丸6 g,3次/d,氟桂利嗪10 mg,每晚睡前服;对照组40例,服用氟桂利嗪10 mg,每晚睡前服;2组均连续治疗4周,观察2组疗效,比较有效率.结果 治疗组总有效率92.5% ,其中治愈12例(30.0%),显效15例(37.5%),好转20例(25.0%);对照组总有效率72.5%,其中治愈7例(17.5%),显效13例(32.5%),好转9例(22.5%);治疗组总有效率明显优于对照组(P＜0.05).结论 正天丸与氟桂利嗪联合治疗偏头痛疗效好且不良反应小,值得临床推广.     

Cerebrovascular CO2 reactivity in migraine with aura and without aura. A transcranial doppler study

Inntroduction – We studied by means of Transcranial Doppler (TCD) recordings the CO₂ cerebrovascular reactivity in migraine patients during the headache-free period. Material & methods - In three groups of subjects (15 controls, 15 suffering from migraine with aura and 15 from migraine without aura) the middle cerebral artery (MCA) mean flow velocity (MFV) was recorded under basal condition and hypocapnia induced by hyperventilation. Relative MFV, PI (Pulsatility Index) changes and Reactivity Index (RI) were calculated. Results - Reactivity Index values were: 0.019 ± 0.007 (mean ± SD) in control subjects: 0.029 ± 0.008 in migraine with aura; 0.022 ± 0.008 in migraine without aura. Statistical analysis showed a significantly (P < 0.05) increased RI in migraine with aura group. Conclusion – Cerebrovascular CO₂ reactivity is increased during the interictal period in migraine with aura patients.     

彩色经颅多普勒对儿童偏头痛血流动力学研究

了解偏头痛与血管舒缩功能异常的关系及偏头痛各期的血流动力学变化。方法：使用德国 Medilink生产 D 3000型彩色经颅多普勒超声（TCD）,对414例偏头痛患儿进行发作期,发作间歇期检测。结果：正常52例（12．6％）,异常362例（87．4％）,发作期异常96．6％,间歇期异常83．9％,两组相比P＜0．001。结论：ICD可以敏感而准确地反映偏头痛患儿在各个不同时期的脑血管舒缩功能及其血流动力学变化,偏头痛发作期检查优于间歇期,间歇期ThD特点平均血流速度（MIV）显著增快,脉动指数（PI）值显著减低。     

Cerebrovascular reactivity during the Valsalva maneuver in migraine, tension-type headache and medication overuse headache

The aim of this study was to investigate, by means of transcranial Doppler ultrasound (TCD), cerebrovascular reactivity during the Valsalva maneuver (VM) during the headache-free interval in patients with migraine (M), migraine plus tension-type headache (M+TTH), and migraine plus medication overuse headache (M+MOH). A total of 114 patients (n=60 M, n=38 M+TTH, n=16 M+MOH) and n=60 controls were investigated; diagnoses were made according to the International Headache Society criteria. All subjects underwent TCD monitoring and, simultaneously, non-invasive assessment of arterial blood pressure and end-tidal CO2. Two indices were determined: the cerebrovascular Valsalva ratio (CVR) was calculated as the maximum end-diastolic flow velocity acceleration during the late straining phase of the VM [cm/s2] and the centroperipheral Valsalva ratio (CPVR) was defined as the quotient of CVR to the concomitant arterial blood pressure acceleration [cm/mmHg x s]. The dynamic cerebrovascular autoregulatory response to the VM, measured as CVR, was increased in patients with M and M+TTH compared to age-matched healthy subjects. By contrast, CPVR (i.e. the quotient of the cerebrovascular to the peripheral autonomic response), was increased in M patients compared to healthy subjects and all other headache conditions tested. Cerebrovascular autoregulatory response during the VM was increased in M patients compared to age-matched normal healthy subjects, indicating a disturbed autonomic control of cerebral vasoreactivity. The CPVR seems to be a sensitive parameter for distinguishing between M patients and M+TTH or M+MOH patients.     

经颅多普勒评价颅缝早闭症手术前后脑血流动力学变化

目的:利用经颅多普勒(TCD)技术监测颅缝早闭症患儿手术前后脑血流动力学变化,评价颅缝早闭症手术的减压效果。方法:11例患儿按年龄分3个年龄组:0～3岁组4例;4～7岁组5例;11岁组2例。TCD以双侧大脑中动脉为靶血管,记录患儿手术前后的脑血流速度[收缩峰速度(Vs)和舒张期速度(Vd)]和搏动指数(PI),同时记录血压和脉搏数。结果:0～3岁组,手术后Vs、Vd明显提高(P<0.05),PI明显降低(P>0.05),4例患儿头颅X线平片均见指压纹;4～7岁组,手术后Vs、Vd提高,PI降低(P<0.05);11岁组,手术后Vs、Vd、PI改变不明显(P>0.05)。结论:手术对于改善较小患儿脑血流速度和PI的作用显著;对于稍大患儿舒张期脑血流的改善较收缩期血流明显、PI明显降低。提示手术减压效果明显,TCD可作为非损伤性评价颅狭症手术效果的简便工具。     

经颅多普勒与核磁共振血管造影对比检测颅内大动脉的临床价值探讨

目的比较经颅多普勒(transcranialDoppler,TCD)与核磁共振血管造影(magneticreso-nanceangiography,MRA)检测颅内大动脉的特点,探讨其临床应用价值。方法应用TCD和MRA检测16例患者共32根大脑中动脉,比较其检测结果。结果TCD检查显示,大脑中动脉闭塞3根,狭窄16根,流速增快9根,正常4根;MRA显示,大脑中动脉闭塞4根,狭窄13根,正常15根。TCD与MRA检查的符合率于大脑中动脉闭塞时为75.0%(3/4),狭窄时为81.3%(13/16),正常时86.7%(13/15)。结论TCD与MRA对颅内大动脉的检测具有较高的一致性,TCD较MRA方便、迅速、经济,MRA较TCD直观、全面,二者联合检测可比较准确地提供颅内血管情况。     

Visual cortex excitability in migraine before and after valproate prophylaxis: a pilot study using TMS

We examined the effect of standard migraine prophylaxis with sodium valproate on repeated measures of occipital excitability using transcranial magnetic stimulation (TMS). We predicted that, comparing pre- and post-treatment assessments, a reduction in clinical migraine parameters would be paralleled by a decrease in excitability measurements.A total of 31 migraine patients enrolled in the study, for assessment prior to and 1 month after commencement of sodium valproate prophylaxis. At each assessment, we used a standardized protocol to stimulate the occipital cortex with a 90-mm circular (coil A) and 70 mm figure-of-eight (coil B) coil. We recorded the threshold stimulation intensity at which subjects just perceived phosphenes. Subjects kept detailed records of headache parameters 1 month before and also during the study period.Valproate therapy significantly improved headache indexes, as expected. In MA subjects assessed with coil B, phosphene thresholds were significantly higher post-treatment than pre-treatment, but those for MO did not change. Modest correlations were observed in MA patients between increase in phosphene threshold and decrease in headache index. Although preliminary, the findings with coil B lend some support to the notion that effective migraine prophylaxis may be achieved through lowering cortical excitability by gamma-aminobutyric acid (GABA)-ergic intervention. Further investigation of the effect of sodium valproate or other similarly acting substances on cortical excitability in migraine is warranted.     

盐酸洛美利嗪治疗偏头痛的疗效观察

目的评价国产盐酸洛美利嗪治疗偏头痛的疗效及安全性。方法采取随机、双盲、安慰剂对照进行观察,将入选的53例患者随机分为盐酸洛美利嗪治疗组(27例,口服盐酸洛美利嗪片5mg,每日2次)及对照组(26例,口服安慰剂每日2次),疗程共12周。以头痛发作频率为主要评定指标,发作持续时间、程度、伴随症状及头痛综合评分为次要评定指标;并记录不良反应。结果(1)治疗组治疗第4周、第8周及第12周末时,头痛发作频率、头痛持续时间、头痛程度、伴随症状及头痛综合评分较对照组极显著降低(均P<0.01);(2)总有效率治疗组为81.5%,极显著优于对照组(7.7%)(P<0.005)。两组治疗期间均无严重不良反应。结论国产盐酸洛美利嗪是安全有效防治偏头痛发作的药物。     

颅内高压状态下TCD频谱参数与颅内压关系的实验研究

目的 探讨颅高压状态下经颅多普勒超声(TCD)频谱参数与颅内斥(ICP)的关系。方法 制备新西兰兔球囊注水法颅高压模型，监测大脑中动脉的TCD频谱，测量参数?结果 TCD频谱参数cf、PI、RI、Vd、Vm与ICP均呈指数关系，其中cf与ICP的相关系数最大。结论 TCD频谱参数与颅内压的升高密切相关。