Cameron J D, Lane P L, Speechley M
Department of Emergency Medicine, St. Joseph's Health Center, London, Ontario, Canada.
Acad Emerg Med. 1995 Jul;2(7):597-602. doi: 10.1111/j.1553-2712.1995.tb03596.x.
To compare the efficacy of IV chlorpromazine with that of IV metoclopramide in the treatment for acute migraine headache in the ED.
A prospective randomized double-blind trial was undertaken at two university-affiliated urban EDs with a combined annual census of more than 85,000 patients. Included in the study were patients presenting to the ED with a diagnosis of migraine headache. The subjects were randomized to receive 0.1 mg/kg/dose IV of either chlorpromazine (CPZ) or metoclopramide (MC), up to a total of three doses.
Ninety-one patients completed the protocol; 44 received MC and 47 received CPZ. The demographics of the two groups were similar. Both drugs provided, for the majority of patients, adequate pain relief as measured on a visual analog scale (VAS) completed every 15 minutes from T = 0 minutes to T = 45 minutes. The average pain relief over 45 minutes (delta VAS) for CPZ was 4.87 cm, vs 4.34 cm for MC (p = 0.35). There also was no statistically significant difference in blood pressure (BP) changes (delta BP < 2 mm Hg for both systolic and diastolic BPs, p = 0.47 and 0.33) or numbers of patients reporting adverse effects (AEs) (CPZ: 16 of 35; MC: 13 of 29, p = 0.43). There was no severe AE with either study drug.
Metoclopramide and chlorpromazine administered IV are both effective in the management of acute migraine headache. They are associated with similar minor side-effect profiles.
比较静脉注射氯丙嗪与静脉注射甲氧氯普胺治疗急诊科急性偏头痛的疗效。
在两所大学附属医院的城市急诊科进行了一项前瞻性随机双盲试验，两所医院的年总就诊人数超过85000人。纳入研究的是诊断为偏头痛的急诊科患者。受试者被随机分为接受0.1mg/kg剂量静脉注射氯丙嗪（CPZ）或甲氧氯普胺（MC），最多共三剂。
91名患者完成了方案；44名接受MC，47名接受CPZ。两组的人口统计学特征相似。两种药物对大多数患者都提供了足够的疼痛缓解，这是通过从T = 0分钟到T = 45分钟每15分钟完成一次的视觉模拟量表（VAS）来衡量的。CPZ在45分钟内的平均疼痛缓解（VAS变化量）为4.87cm，而MC为4.34cm（p = 0.35）。血压（BP）变化（收缩压和舒张压的BP变化量均<2mmHg，p = 0.47和0.33）或报告不良反应（AE）的患者数量（CPZ：35例中的16例；MC：29例中的13例，p = 0.43）也没有统计学上的显著差异。两种研究药物均未出现严重AE。
静脉注射甲氧氯普胺和氯丙嗪在急性偏头痛的治疗中均有效。它们的轻微副作用相似。
