CAJ | 학술논문

目的：分析左乙拉西坦联合氟桂利嗪治疗难治性偏头痛（ RM ）的临床疗效及安全性。方法选择2012年1月—2014年2月在都江堰市人民医院神经内科头痛门诊就诊的RM患者82例，按照患者就诊顺序分为观察组和对照组，各41例。对照组患者仅给予左乙拉西坦治疗，观察组患者给予左乙拉西坦联合氟桂利嗪治疗，两组患者均连续治疗24周。比较两组患者治疗前及治疗4周末、12周末、24周末头痛症状（包括头痛程度、头痛发作次数及头痛持续时间），治疗24周末临床疗效及治疗期间药物不良反应。结果治疗前和治疗4周末两组患者头痛程度得分、头痛发作次数及头痛持续时间比较，差异均无统计学意义（ P＞0.05）；治疗12周末和24周末观察组患者头痛程度得分低于对照组，头痛发作次数少于对照组，头痛持续时间短于对照组（ P＜0.05）。治疗24周末，观察组患者临床疗效优于对照组（u＝－1.491， P＜0.05）；观察组不良反应发生率为24.4％，对照组为19.5％，差异无统计学意义（P＞0.05）。结论左乙拉西坦联合氟桂利嗪治疗RM的临床疗效确切，能有效缓解患者头痛症状，且安全性高。
목적：분석좌을랍서탄연합불계리진치료난치성편두통（ RM ）적림상료효급안전성。방법선택2012년1월—2014년2월재도강언시인민의원신경내과두통문진취진적RM환자82례，안조환자취진순서분위관찰조화대조조，각41례。대조조환자부급여좌을랍서탄치료，관찰조환자급여좌을랍서탄연합불계리진치료，량조환자균련속치료24주。비교량조환자치료전급치료4주말、12주말、24주말두통증상（포괄두통정도、두통발작차수급두통지속시간），치료24주말림상료효급치료기간약물불량반응。결과치료전화치료4주말량조환자두통정도득분、두통발작차수급두통지속시간비교，차이균무통계학의의（ P＞0.05）；치료12주말화24주말관찰조환자두통정도득분저우대조조，두통발작차수소우대조조，두통지속시간단우대조조（ P＜0.05）。치료24주말，관찰조환자림상료효우우대조조（u＝－1.491， P＜0.05）；관찰조불량반응발생솔위24.4％，대조조위19.5％，차이무통계학의의（P＞0.05）。결론좌을랍서탄연합불계리진치료RM적림상료효학절，능유효완해환자두통증상，차안전성고。
Objective To analyze the clinical effect and safety of levetiracetam combined with flunarizine on refractory migraine.Methods From January 2012 to February 2014, a total of 82 patients with refractory migraine were selected in Headache Clinic of Department of Neurology, People′s Hospital of Dujiangyan, and they were divided into control group and observation group according to visiting sequence, each of 41 cases.Patients of control group were only given levetiracetam, while patients of observation group were given levetiracetam combined with flunarizine, both groups treated for 24 weeks.Headache symptoms ( including headache severity score, headache frequency and headache duration ) before treatment and at 4th weekend, 12th weekend, 24th weekend of treatment, clinical effect at 24th weekend and incidence of adverse reactions during treatment were compared between the two groups.Results No statistically significant differences of headache severity score, headache frequency or headache duration was found between the two groups before treatment or at 4th weekend of treatment ( P>0.05), while at 12th weekend, 12th weekend of treatment, headache severity score of observation group was statistically significantly lower than that of control group, headache frequency of observation group was statistically significantly less than that of control group, headache duration observation group was statistically significantly shorter than that of control group, respectively (P<0.05).At 24th weekend of treatment, the clinical effect of observation group was statistically significantly better than that of control group (u=-1.491, P<0.05).The incidence of observation group was 24.4%, that of control group was 19.5%, the difference was not statistically significantly different ( P>0.05) .Conclusion Levetiracetam combined with flunarizine has certain clinical effect in treating refractory migraine, can effectively relieve the headache symptoms, is with high safety.