A型肉毒杆菌毒素与阿米替林治疗慢性每日偏头痛的比较。
Botulinum toxin type A versus amitriptyline for the treatment of chronic daily migraine.
作者信息
Magalhães Elza, Menezes Carla, Cardeal Mauricio, Melo Ailton
机构信息
Division of Neurology and Epidemiology, Federal University of Bahia, Av Reitor Miguel Calmon, s/n, Salvador, Bahia, Brazil.
出版信息
Clin Neurol Neurosurg. 2010 Jul;112(6):463-6. doi: 10.1016/j.clineuro.2010.02.004. Epub 2010 Apr 18.
OBJECTIVE
To compare the effects of botulinum toxin type A with those of amitriptyline on the treatment of chronic daily migraines.
METHODS
Chronic migraine sufferers were randomized into two groups and treated with 25 or 50mg/day of amitriptyline or 250U of botulinum toxin type A. A reduction of at least 50% in the number of pain episodes, in the intensity of pain, and in the number of drug doses for pain and reports of improvement by the patient or by the examiner were the main endpoints.
RESULTS
Seventy-two subjects were enrolled in the study. A reduction of at least 50% in the number of days of pain was recorded in 67.8% of the patients in the BTX-A group and 72% (n=23) of the patients in the AM group (p=0.78; RR=0.94; CI=0.11-8). The reduction in the intensity of pain, as assessed using the visual analogical scale, was 50% in the BXT-A group and 55.6% in the AM group (p=0.79; RR=1.11; CI=0.32-3.8). The reduction in the number of pain drug doses was 77% for the toxin group and 71% for the amitriptyline group (p=0.76; RR=0.92; CI=0.45-1.88).
CONCLUSIONS
Botulinum toxin type A was as effective as amitriptyline for the prophylactic treatment of chronic daily migraines.
目的
比较A型肉毒毒素与阿米替林治疗慢性每日偏头痛的效果。
方法
慢性偏头痛患者被随机分为两组，分别接受25或50毫克/天的阿米替林治疗或250单位的A型肉毒毒素治疗。主要终点为疼痛发作次数、疼痛强度、止痛药物剂量减少至少50%，以及患者或检查者报告有改善。
结果
72名受试者参与了该研究。A型肉毒毒素组67.8%的患者和阿米替林组72%（n = 23）的患者疼痛天数减少至少50%（p = 0.78；RR = 0.94；CI = 0.11 - 8）。使用视觉模拟量表评估，A型肉毒毒素组疼痛强度降低50%，阿米替林组降低55.6%（p = 0.79；RR = 1.11；CI = 0.32 - 3.8）。毒素组止痛药物剂量减少77%，阿米替林组减少71%（p = 0.76；RR = 0.92；CI = 0.45 - 1.88）。
结论
A型肉毒毒素在预防性治疗慢性每日偏头痛方面与阿米替林效果相当。
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