头痛宁联合盐酸氟桂利嗪对无先兆性偏头痛的防治效果分析

目的 探讨头痛宁联合盐酸氟桂利嗪对无先兆性偏头痛发作间歇期的脑血流变化及防治效果。方法 选取四川大学华西第四医院老年科于2017年1月 - 2018年4月确诊的无先兆性偏头痛患者共90例，随机分为联合组（n = 45）和对照组（n = 45）。联合组给与头痛宁和盐酸氟桂利嗪，对照组给与盐酸氟桂利嗪，疗程均为3个月。比较2组TCD(经颅多普勒）情况和对偏头痛的防治情况。结果 头痛程度与TCD异常率呈正相关（Cramer’s V系数为0.293，P＜0.05)；治疗后，联合组改善脑血流变化的效果优于对照组；联合组HIT-6(头痛影响测定-6）、VAS（视觉模拟评分法）下降、头痛持续时间缩短，与对照组比较差异有统计学意义（Z = -2.669,P = 0.008；Z = -3.757,P＜0.001；Z = -2.172,P = 0.03);联合组治疗偏头痛的总有效率为86.70%，对照组为77.80%，联合组疗效优于对照组（Z = -2.586,P = 0.010)；联合组缓解率为91.10%，高于对照组缓解率（71.10%，χ2 = 5.874,P = 0.01）。结论 头痛宁与盐酸氟桂利嗪联合用药能更好地改善大脑血流情况，防治偏头痛的作用优于盐酸氟桂利嗪，且安全可靠。

Analysis on the prevention and treatment of migraine without aura with Toutongning capsule and flunarizine hydrochloride

Objective The aim of this study was to explore the effect of Toutongning capsule combined with flunarizine hydrochloride in preventing attacks of migraine without aura, and its effect on cerebral blood flow changes. Methods A total of 90 patients with migraine without aura diagnosed in the department of geriatrics at West China Fourth Hospital of Sichuan University from January 2017 to April 2018 were enrolled. Then they were randomly divided into combination group(n=45) and control group (n=45). The combination group was given Toutongning and flunarizine hydrochloride capsules, and the control group was given flunarizine hydrochloride capsule, for three months. TCD(Transcranial Doppler) and migraine prevention and treatment were compared between the two groups. Results Headache degree was positively correlated with TCD anomaly rate (Cramer's V coefficient was 0.293, P<0.05). After treatment, the effect of the combined group on improving cerebral blood flow changes was better than that of the control group. HIT-6(Headache Impact Test-6), VAS (Visual Analogue Scale) decreased and headache duration shortened in the combined group were statistically significant(Z=-2.669, P=0.008; Z=-3.757, P<0.001; Z=-2.172, P=0.03) compared with the control group. The total effective rate of the combined group was 86.70%, and that of the control group was 77.80%. The efficacy of the combined group was better than that of the control group (Z=-2.586, P=0.010). The remission rate of the combined group was 91.10%, higher than that of the control group (χ2=5.874, P=0.01). Conclusion The combination of Toutongning and flunarizine hydrochloride is more effective than flunarizine hydrochloride in preventing and treating migraine, which can improve the cerebral blood flow and is safe and reliable.