Jones J, Pack S, Chun E
Department of Emergency Medicine, Butterworth Hospital, Michigan State University College of Human Medicine, Grand Rapids 49503, USA.
Am J Emerg Med. 1996 May;14(3):262-4. doi: 10.1016/S0735-6757(96)90171-0.
To compare the efficacy of intramuscular prochlorperazine and metoclopramide in the short-term treatment of migraine headache in the emergency department 86 eligible adult patients with moderate to severe migraine headache were evaluated prospectively at a university-affiliated community hospital. After randomization, each subject received a 2-mL intramuscular injection of sterile saline, prochlorperazine (10 mg), or metoclopramide (10 mg). No other analgesics were administered during the 60-minute study period; patient assessment of relief was followed using visual analog scales. Reduction in median headache scores was significantly better among those treated with prochlorperazine (67%) compared to metoclopramide (34%) or placebo (16%). Similarly, symptoms of nausea and vomiting were significantly relieved in the prochlorperazine group (chi 2 = 17.1, P < .001). However, rescue analgesic therapy was necessary in the majority of patients treated with prochlorperazine (16/28) and metoclopramide (23/29) after the 60-minute study period. Although intramuscular prochlorperazine appears to provides more effective relief than metoclopramide, these results do not recommend either drug as single-agent therapy for acute migraine headache.
为比较肌肉注射氯丙嗪和胃复安在急诊科短期治疗偏头痛的疗效，在一所大学附属医院对86例符合条件的中重度偏头痛成年患者进行了前瞻性评估。随机分组后，每位受试者接受2毫升无菌生理盐水、氯丙嗪（10毫克）或胃复安（10毫克）的肌肉注射。在60分钟的研究期间未给予其他镇痛药；使用视觉模拟量表跟踪患者的缓解评估情况。与胃复安（34%）或安慰剂（16%）相比，氯丙嗪治疗组的中位头痛评分降低幅度明显更大（67%）。同样，氯丙嗪组的恶心和呕吐症状得到明显缓解（χ2 = 17.1，P <.001）。然而，在60分钟的研究期后，大多数接受氯丙嗪治疗的患者（16/28）和胃复安治疗的患者（23/29）都需要使用急救镇痛疗法。虽然肌肉注射氯丙嗪似乎比胃复安能提供更有效的缓解，但这些结果不推荐将这两种药物作为急性偏头痛的单药治疗。
