作者：张绿明，邱石，李芹，吴涛，杜继臣

单位：

100049 北京市，航天中心医院（北京大学航天临床医学院）神经内科；通信作者：杜继臣，E-mail： djc189@126.com；注：张绿明、邱石为共同第一作者

Units：

Department of Neurology，Aerospace Center Hospital（Peking University Aerospace School of Clinical Medicine），Beijing100049，China；Corresponding author：DU Jichen，E-mail：djc189@126.com；Co-first author：ZHANG Lyuming，QIU Shi

关键词：

偏头痛；氟桂利嗪；降钙素基因相关肽；治疗结果

Keywords：

Migraine disorders；Flunarizine；Calcitonin gene related peptide；Treatment outcome

CLC：

R 747.2

DOI：

DOI：10.3969/j.issn.1008-5971.2020.03.022

Funds：

基金项目：航天中心医院青年创新基金项目（2016QN02）

摘要：

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。

Abstract：

Objective　To analyze the clinical effect of flunarizine hydrochloride on migraine disorders and its impacton plasma calcitonin gene-related peptide（CGRP）level. Methods　From August 2014 to December 2018，a total of 45patients with migraine disorders were selected in the Headache Clinic and Inpatient Ward of Neurology Department，AerospaceCenter 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 involvedpatients，5 cases failed to complete the trial，1 case withdrew from the trial due to asthma，and the 18 patients finally completedthe trial. Headache attack condition（including headache attack frequency，headache degree，VAS score and duration ofheadache）of the 18 enrolled patients were compared before medication and 30 days after medication，and incidence of adversereactions was recorded during treatment，moreover plasma CGRP level of 8 patients were compared before medication and 30days after medication. Results　（1）There was no statistically significant difference in headache degree or duration of headachebefore medication and 30 days after medication in the 18 enrolled patients（P>0.05），while headache attack frequency andVAS score 30 days after medication were statistically significantly lower than those before medication（P<0.05）.（2）PlasmaCGRP 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 migrainedisorders，and its mechanism may be related to the decrease of plasma CGRP level.

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