Steiner T J, Lange R
Division of Neuroscience and Psychological Medicine, Imperial College School of Medicine, London, UK.
Cephalalgia. 1998 Jan;18(1):38-43. doi: 10.1046/j.1468-2982.1998.1801038.x.
Therapies in current use for episodic tension-type headache (ETTH) are often unsatisfactory. Few trials have been conducted to demonstrate efficacy of any of them. This multicenter placebo-controlled randomized parallel-groups study compared the analgesic efficacy of single oral doses of ketoprofen 25 mg and acetaminophen 1000 mg as outpatient treatment of 1 attack of ETTH. Efficacy was assessed by patients as pain relief on a diary-entered 7-point categorical scale. A total of 457 patients treated 348 attacks, 330 of which were evaluable. There were no serious adverse events (AEs); gastrointestinal AEs were most common on all treatments. Total relief from pain after 2 h was recorded by 16% of patients on placebo, 28% on ketoprofen, and 22% on acetaminophen. Worthwhile effect or total relief (all other responses were regarded as treatment failures) were recorded by 36% on placebo, 70% on ketoprofen (p < 0.001), 61% on acetaminophen (p < 0.001). The difference between ketoprofen and acetaminophen was not significant (p = 0.24). Various secondary efficacy measures confirmed superiority of both active treatments over placebo, with some trends for slightly better outcome on ketoprofen that on acetaminophen. This study demonstrates that ketoprofen is an effective alternative to standard therapy in ETTH.
目前用于发作性紧张型头痛(ETTH)的治疗方法往往不尽人意。很少有试验能证明其中任何一种疗法的疗效。这项多中心安慰剂对照随机平行组研究比较了单次口服25毫克酮洛芬和1000毫克对乙酰氨基酚作为门诊治疗1次ETTH发作的镇痛效果。疗效由患者根据日记记录的7分分类量表上的疼痛缓解情况进行评估。共有457例患者接受了348次发作的治疗,其中330次可评估。没有严重不良事件(AE);胃肠道AE在所有治疗中最为常见。安慰剂组16%的患者、酮洛芬组28%的患者和对乙酰氨基酚组22%的患者在2小时后疼痛完全缓解。安慰剂组36%、酮洛芬组70%(p<0.001)、对乙酰氨基酚组61%(p<0.001)记录到有价值的效果或完全缓解(所有其他反应均视为治疗失败)。酮洛芬和对乙酰氨基酚之间的差异不显著(p = 0.24)。各种次要疗效指标证实了两种活性治疗均优于安慰剂,且有一些趋势表明酮洛芬的疗效略优于对乙酰氨基酚。这项研究表明,酮洛芬是ETTH标准治疗的有效替代药物。