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泡腾型阿司匹林 - 甲氧氯普胺组合治疗偏头痛发作的疗效与耐受性。使用安慰剂的随机双盲研究

[Efficacy and tolerance of an effervescent aspirin-metoclopramide combination in the treatment of a migraine attack. Randomized double-blind study using a placebo].

作者信息

Henry P, Hiesse-Provost O, Dillenschneider A, Ganry H, Insuasty J

机构信息

Service de Neurologie, Hôpital Pellegrin Tripode, Bordeaux.

出版信息

Presse Med. 1995 Feb 4;24(5):254-8.

PMID:7899379
Abstract

OBJECTIVES

A double blind, randomized, multicenter, parallel group study was carried out to compare the efficacy and tolerance of aspirin 900 mg-metoclopramide 10 mg effervescent association (AAM) with those of placebo in the treatment of acute migraine attack. All patients were selected according to the International Headache Society criteria.

METHODS

A total of 303 out-patients with an acute migraine attack were treated orally with either AAM (n = 152) or placebo (n = 151).

RESULTS

The aspirin-metoclopramide association was significantly more effective than placebo at relieving headache (principal criterion) within 2 h of treatment (54.3% versus 25.9% : p < 0.001), producing entire resolution of acute migraine attack (14.2% versus 5.3% : p = 0.017), reducing the percentage of patients requiring rescue medication (44.3% versus 63.2% : p = 0.001) and increasing the percentage of patients able to resume their usual activities (44.1% versus 22.1% : p = 0.003). AAM also provided more frequent relief from associated symptoms as compared with placebo (37.4% versus 22.1% : p = 0.006). The therapeutic efficacy was rated as good or excellent by 39.7% of patients in the AAM group compared with 20.7% in the placebo group (p < 0.001). Moreover 64.2% of AAM treated patients said they would be prepared to take the treatment again compared with 46.4% who received placebo (p < 0.001). The percentage of patients reporting adverse events was not different between the two treatments (20.4% AAM versus 18.5% placebo : p = 0.684). The most commonly reported symptoms were gastro-intestinal disorders. Similar number of gastralgia occurred with AAM (n = 4) and placebo (n = 3).

CONCLUSION

It is concluded that the aspirin-metoclopramide association may be used as a first intention treatment of acute migraine attack in out-patients.

摘要

目的

开展一项双盲、随机、多中心、平行组研究,比较阿司匹林900毫克 - 甲氧氯普胺10毫克泡腾片组合(AAM)与安慰剂治疗急性偏头痛发作的疗效和耐受性。所有患者均根据国际头痛协会标准选取。

方法

共有303例急性偏头痛发作的门诊患者口服AAM(n = 152)或安慰剂(n = 151)进行治疗。

结果

在治疗2小时内,阿司匹林 - 甲氧氯普胺组合在缓解头痛(主要标准)方面明显比安慰剂更有效(54.3% 对25.9%:p < 0.001),使急性偏头痛发作完全缓解(14.2% 对5.3%:p = 0.017),降低需要急救药物的患者百分比(44.3% 对63.2%:p = 0.001),并增加能够恢复日常活动的患者百分比(44.1% 对22.1%:p = 0.003)。与安慰剂相比,AAM对相关症状的缓解也更频繁(37.4% 对22.1%:p = 0.006)。AAM组39.7%的患者将治疗效果评为良好或优秀,而安慰剂组为20.7%(p < 0.001)。此外,接受AAM治疗的患者中有64.2%表示愿意再次接受该治疗,而接受安慰剂治疗的患者中这一比例为46.4%(p < 0.001)。两种治疗方法报告不良事件的患者百分比无差异(AAM为20.4%,安慰剂为18.5%:p = 0.684)。最常报告的症状是胃肠道疾病。AAM组(n = 4)和安慰剂组(n = 3)出现胃痛的人数相似。

结论

得出结论,阿司匹林 - 甲氧氯普胺组合可作为门诊急性偏头痛发作的首选治疗方法。

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