Larsen B H, Christiansen L V, Andersen B, Olesen J
Department of Neurology, Rigshospitalet, Copenhagen, Denmark.
Acta Neurol Scand. 1990 May;81(5):464-7. doi: 10.1111/j.1600-0404.1990.tb00996.x.
In a double-blind cross-over study we compared tolfenamic acid with paracetamol in out-patients with common migraine (migraine without aura). Each patient was treated during (at least) 4 attacks with one of the following alternatives: tolfenamic acid 200 mg, tolfenamic acid 400 mg, paracetamol 500 mg or paracetamol 1000 mg in a randomized sequence. The same sequence of treatments was applied to (preferably) 4 more attacks. Dosage was repeated after 2 h if the attack had not abated. Escape medication was allowed after 4 h if the treatment was inefficient. A total of 83 patients were admitted to the study, but 3 dropped out, while 10 completed less than 4 attacks. Seventy completed 4 attacks, and 58 completed all 8. The total number of attacks treated was 545. We found a significant superiority of tolfenamic acid over paracetamol with regard to effect on pain after 2 h (p less than 0.01), patients' global evaluation (p less than 0.001), and use of escape medication (p less than 0.02). The trend was the same for duration of attacks, confinement to bed during attack and nausea, but the results were not statistically significant. There was no significant difference between the smaller and the larger dose of either drug nor between the need for escape medication, although the trend favoured tolfenamic acid. Side effects were few. Tolfenamic acid is evidently valuable in treatment of migraine.
在一项双盲交叉研究中，我们将托芬那酸与对乙酰氨基酚用于普通偏头痛（无先兆偏头痛）门诊患者进行比较。每位患者至少4次发作时接受以下其中一种治疗：200毫克托芬那酸、400毫克托芬那酸、500毫克对乙酰氨基酚或1000毫克对乙酰氨基酚，治疗顺序随机。（最好）再用同样的治疗顺序治疗4次以上发作。如果发作未缓解，2小时后重复给药。如果治疗无效，4小时后允许使用解救药物。共有83名患者纳入研究，但3名退出，10名完成的发作少于4次。70名完成4次发作，58名完成全部8次发作。治疗的发作总数为545次。我们发现，在2小时后对疼痛的影响（p<0.01）、患者总体评估（p<0.001）以及解救药物的使用（p<0.02）方面，托芬那酸显著优于对乙酰氨基酚。在发作持续时间、发作时卧床情况和恶心方面趋势相同，但结果无统计学意义。两种药物的较小剂量和较大剂量之间以及解救药物使用需求之间均无显著差异，尽管趋势有利于托芬那酸。副作用较少。托芬那酸在偏头痛治疗中显然很有价值。
