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血府逐瘀口服液治疗紧张型头痛随机临床试验

Effect of Xuefu zhuyu oral liquid on tension-type headache: A randomized clinical trial.

机构信息

Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

出版信息

Phytomedicine. 2024 Dec;135:156112. doi: 10.1016/j.phymed.2024.156112. Epub 2024 Oct 5.

Abstract

BACKGROUND

Tension-type headache (TTH) is the most common neurological disorder worldwide, incurring immense social and economic costs and affecting quality of life. However, due to adverse reactions and inadequate effectiveness, there is still an unmet need for treatment. Xuefu zhuyu oral liquid (XZOL) is a Chinese patent medicine widely used for TTH in China, but evidence of its efficacy remains scant.

PURPOSE

The aim of this study was to assess the efficacy and safety of XZOL for TTH patients.

METHODS

This multicenter, double-blind, randomized placebo-controlled trial enrolled 174 patients with TTH in six centers in China from March 2020 to October 2021. Patients were randomly assigned to receive XZOL or a matched placebo for 4weeks. The primary outcome was the change in the mean headache intensity as measured by a visual analogue scale (VAS) from baseline to the end of treatment (Week 4). Secondary outcomes were the change in VAS from baseline to Week 12, the area-under-the-headache curve (AUC), response rate, number of headache days, average headache duration, rescue medication use proportion, etc. RESULTS: Of the 174 patients who were randomized, 160 completed the study. There was no significant difference in the mean change in VAS from baseline to the end of treatment between the XZOL group and the placebo group (-0.29; (95 % CI:0.81 to 0.23; p = 0.279) in the full analysis set (FAS), while there were statistically significant results (-0.9; 95 % CI:1.47 to -0.33; p = 0.002) in the per-protocol set (PPS). There were no significant differences in any of the secondary outcomes. The incidence of adverse events was similar in the two groups.

CONCLUSION

XZOL may be an alternative option to relieve pain for TTH patients with high compliance in clinical practice. However, XZOL did not improve headache measurements in the FAS population.

摘要

背景

紧张型头痛(TTH)是全球最常见的神经疾病,造成巨大的社会和经济成本,并影响生活质量。然而,由于不良反应和疗效不足,治疗需求仍未得到满足。血府逐瘀口服液(XZOL)是一种广泛用于中国 TTH 的中药,但疗效证据仍然不足。

目的

本研究旨在评估 XZOL 治疗 TTH 患者的疗效和安全性。

方法

这项多中心、双盲、随机安慰剂对照试验纳入了来自中国 6 个中心的 174 例 TTH 患者,于 2020 年 3 月至 2021 年 10 月进行。患者被随机分为 XZOL 组或匹配的安慰剂组,治疗 4 周。主要结局是从基线到治疗结束(第 4 周)时视觉模拟量表(VAS)测量的平均头痛强度变化。次要结局包括从基线到第 12 周时 VAS 的变化、头痛曲线下面积(AUC)、应答率、头痛天数、平均头痛持续时间、解救药物使用比例等。

结果

在随机的 174 例患者中,有 160 例完成了研究。在 FAS 中,XZOL 组和安慰剂组从基线到治疗结束时 VAS 平均变化无显著差异(-0.29;95%CI:0.81 至 0.23;p = 0.279),而在 PPS 中存在统计学显著结果(-0.9;95%CI:1.47 至 -0.33;p = 0.002)。在任何次要结局中均无显著差异。两组不良反应发生率相似。

结论

在临床实践中,XZOL 可能是一种缓解 TTH 患者疼痛的替代选择,具有较高的依从性。然而,在 FAS 人群中,XZOL 并未改善头痛测量结果。

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