CAJ | 학술논문

目的探讨彩超水囊引导下A型肉毒毒素注射联合红外偏振光治疗慢性偏头痛的临床价值.方法选取91例慢性偏头痛患者,按随机数字表法分为4组:对照组(A组,共22例)应用尼莫地平片治疗慢性偏头痛2个月；红外偏振光治疗组(B组,共22例)应用红外偏振光治疗慢性偏头痛,共治疗50 ～60 d；肉毒素治疗组(C组,共24例)应用彩超水囊引导下额肌、颞肌及枕肌等肌肉A型肉毒毒素肌肉注射治疗慢性偏头痛；联合治疗组(D组,共23例)同时应用彩超水囊引导下额肌、颞肌及枕肌等肌肉A型肉毒毒素肌肉注射联合红外偏振光治疗慢性偏头痛,红外偏振光治疗50 ～ 60 d.研究时间持续6个月,调查每例慢性偏头痛患者治疗前3个月、治疗后1、3和6个月头痛发作情况,行偏头痛残疾程度评估问卷(MIDAS)评分及生活质量评价量表评分,比较慢性偏头痛发作频率、发作持续时间、发作严重程度、使用止痛药物情况及其慢性偏头痛恢复状况,并观察其不良反应.结果治疗中脱失11例,A组3例,B组2例,C组4例,D组2例.A组、B组与C组及D组治疗后1、3和6个月后偏头痛残疾程度评估问卷评分显著低于治疗前评分,差异有统计学意义(P＜0.01)；生活质量评价量表评分显著高于治疗前评分,差异有统计学意义(P＜0.01).D组在治疗后1、3和6个月,MIDAS评分及生活质量评价量表评分与A组、B组与C组治疗后1、3和6个月比较,差异有统计意义(P＜0.05).2例出现头昏,未予任何处理均在2周后消失,21例患者注射后额纹、鱼尾纹不同程度变浅或消失.结论彩超水囊引导下A型肉毒毒素肌肉注射联合红外偏振光治疗慢性偏头痛发作临床疗效显著,不良反应轻微,值得临床推广.
목적 탐토채초수낭인도하A형육독독소주사연합홍외편진광치료만성편두통적림상개치.방법 선취91례만성편두통환자,안수궤수자표법분위4조:대조조(A조,공22례)응용니막지평편치료만성편두통2개월；홍외편진광치료조(B조,공22례)응용홍외편진광치료만성편두통,공치료50 ～60 d；육독소치료조(C조,공24례)응용채초수낭인도하액기、섭기급침기등기육A형육독독소기육주사치료만성편두통；연합치료조(D조,공23례)동시응용채초수낭인도하액기、섭기급침기등기육A형육독독소기육주사연합홍외편진광치료만성편두통,홍외편진광치료50 ～ 60 d.연구시간지속6개월,조사매례만성편두통환자치료전3개월、치료후1、3화6개월두통발작정황,행편두통잔질정도평고문권(MIDAS)평분급생활질량평개량표평분,비교만성편두통발작빈솔、발작지속시간、발작엄중정도、사용지통약물정황급기만성편두통회복상황,병관찰기불량반응.결과 치료중탈실11례,A조3례,B조2례,C조4례,D조2례.A조、B조여C조급D조치료후1、3화6개월후편두통잔질정도평고문권평분현저저우치료전평분,차이유통계학의의(P＜0.01)；생활질량평개량표평분현저고우치료전평분,차이유통계학의의(P＜0.01).D조재치료후1、3화6개월,MIDAS평분급생활질량평개량표평분여A조、B조여C조치료후1、3화6개월비교,차이유통계의의(P＜0.05).2례출현두혼,미여임하처리균재2주후소실,21례환자주사후액문、어미문불동정도변천혹소실.결론 채초수낭인도하A형육독독소기육주사연합홍외편진광치료만성편두통발작림상료효현저,불량반응경미,치득림상추엄.
Objective To observe the clinical efficacy and safety of local injection of botulinum toxin A ( BTX-A ) combined with infrared polarized light for patients with chronic migraine ( CM ). Methods Ninety-one patients with CM were randomly divided into 4 groups.Group A served as the control group in which Nimodipine was used to treat CM ( n =22 ) ; in group B infrared polarized light was used to irradiate the area of the CM for 50 to 60 d ( n =22 ) ; in group C subcutaneous injections of BTX-A were used ( n =24 ) ; and in group D infrared polarized light irradiation of the affected area was combined with subcutaneous injections of BTX-A ( n =23 ).The onset of headaches,their severity,quality of life,as well as side effects were recorded using the migraine disability assessment scale (MIDAS) and the short form of the medical outcomes study form (MOS-SF).The results obtained before and after 6 months of treatment were compared. Results Both of MIDAS and MOS-SF assessment showed significant differences before treatment and after 1,3 and 6 months of treatment in all groups.After 1,3 and 6 months of treatment,the MIDSA and MOS-SF results revealed statistically significant differences between groups A and D,as well as between groups B and C. Conclusion BTX-A injection combined with infrared polarized light exerts significant therapeutic effects on CM with few side effects.