[偏头痛患者生活质量的西班牙研究（二）。药物消费情况及主观疗效]

Pascual J, Leira R, Láinez J M, Alberca R, Titus F, Morales F, Díez-Tejedor E, García de Polavieja J

Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander.

Neurologia. 1999 May;14(5):204-9.

OBJECTIVES

The response to the different antimigraine medications is variable. In this study we have analysed the profile of prescription of these antimigraine medications, both preventive and symptomatic, by a group of spanish neurologists and examined the subjective efficacy of these compounds.

PATIENTS AND METHODS

Neurologists from 7 hospitals in different spanish regions interviewed 305 patients (at least 40 per hospital) who met migraine diagnostic criteria. They used an ad hoc questionnaire in which the antimigraine medications, both symptomatic and preventive, taken by the patients, as well as their subjective response were registered. Patients with transformed migraine or tension-type headache more than 2 days per week were excluded.

RESULTS

Analgesics, non-steroidal anti-inflammatory drugs, ergotics and sumatriptan had been taken by 99, 69, 54 and 40% of the 305 interviewed patients, respectively. A subjective good response was refered to by 9% of patients who had taken analgesics, 23% of patients who had taken non-steroidal anti-inflammatory drugs, 39% of those who had taken ergotics and 63% of patients with sumatriptan. The current symptomatic treatment was: analgesics 34% of cases, non-steroidal anti-inflamatory drugs 26%, ergotics 13% and sumatriptan 63%. Regarding preventive treatments, 108 patients (35%) had been treated with calcium-antagonists, 87 (29%) with beta-blockers, 55 (18%) with amitriptyline and only 7 (2.2%) with valproic acid. The percentages of good responses to these drugs were: 55% for beta-blockers, 42% for calcium-antagonists and 31% for amitriptyline.

CONCLUSIONS

Our data confirm that analgesics are not efficacious in the majority of migraine patients and that the advent of sumatriptan has clearly improved the quality of migrane symptomatic treatment, even though about one-third of migraine patients do not respond to this drug. This study confirm that calcium-antagonists are the antimigraine preventive treatment most frequently prescribed in our country, even though their subjective efficacy is lower than that of beta-blockers.

目的

对不同抗偏头痛药物的反应存在差异。在本研究中，我们分析了一组西班牙神经科医生对这些预防性和症状性抗偏头痛药物的处方情况，并考察了这些药物的主观疗效。

患者与方法

来自西班牙不同地区7家医院的神经科医生对305例符合偏头痛诊断标准的患者（每家医院至少40例）进行了访谈。他们使用了一份专门设计的问卷，记录患者服用的症状性和预防性抗偏头痛药物以及他们的主观反应。排除每周偏头痛转变型或紧张型头痛超过2天的患者。

结果

在305例接受访谈的患者中，分别有99%、69%、54%和40%的患者服用过镇痛药、非甾体抗炎药、麦角制剂和舒马曲坦。服用镇痛药的患者中有9%、服用非甾体抗炎药的患者中有23%、服用麦角制剂的患者中有39%、服用舒马曲坦的患者中有63%表示主观反应良好。当前的症状性治疗情况为：镇痛药占34%的病例，非甾体抗炎药占26%，麦角制剂占13%，舒马曲坦占63%。关于预防性治疗，108例患者（35%）接受过钙拮抗剂治疗，87例（29%）接受过β受体阻滞剂治疗，55例（18%）接受过阿米替林治疗，只有7例（2.2%）接受过丙戊酸治疗。这些药物的良好反应率分别为：β受体阻滞剂为55%，钙拮抗剂为42%，阿米替林为31%。