Peroutka S J
Spectra Biomedical, Inc, Burlingame, CA 94010, USA.
Headache. 1998 Jan;38(1):18-22. doi: 10.1046/j.1526-4610.1998.3801018.x.
The past decade has seen significant advances in both the scientific and clinical understanding of migraine. At present, a considerable body of data indicates that migraine is characterized by at least three major pathophysiological features: dopaminergic hypersensitivity, inflammation, and relatively "low" 5-HT levels. Clinically, blocking dopamine receptors, reducing inflammation, and/or stimulating a subpopulation of 5-HT1 receptors are effective monotherapeutic approaches in many migraineurs. However monotherapeutic approaches to migraine do not provide rapid, consistent, and complete relief in all migraineurs. Therefore, if monotherapy is suboptimal, it follows logically that concurrent therapy (ie, polytherapy) aimed at modulating two or three of the biological systems should be more efficacious than modulating only a single system. The rationale for the combination use of dopamine antagonists, anti-inflammatory agents, and 5-HT1 agonists are described in the present report.
在过去十年中，偏头痛的科学和临床认识都取得了重大进展。目前，大量数据表明，偏头痛至少具有三个主要病理生理特征：多巴胺能超敏反应、炎症以及相对“低”的5-羟色胺水平。临床上，阻断多巴胺受体、减轻炎症和/或刺激5-HT1受体亚群在许多偏头痛患者中是有效的单一治疗方法。然而，偏头痛的单一治疗方法并不能在所有偏头痛患者中提供快速、持续和完全的缓解。因此，如果单一疗法效果欠佳，那么逻辑上针对调节两个或三个生物系统的联合疗法（即多药疗法）应该比仅调节单一系统更有效。本报告描述了联合使用多巴胺拮抗剂、抗炎药和5-HT1激动剂的理论依据。
