Seim M B, March J A, Dunn K A
Department of Emergency Medicine, East Carolina University School of Medicine, University Medical Center of Eastern Carolina-Pitt County, Greenville, NC 27858, USA.
Acad Emerg Med. 1998 Jun;5(6):573-6. doi: 10.1111/j.1553-2712.1998.tb02463.x.
To compare i.v. ketorolac with i.v. prochlorperazine as the initial treatment of migraine headaches in the ED.
A prospective, double-blind comparison study was performed, using a convenience sample of 64 patients suffering from migraine headaches presenting to the ED at a tertiary care university teaching hospital. Patients were randomly assigned to receive either 10 mg of prochlorperazine i.v. or 30 mg of ketorolac i.v.. Patients scored the severity of their headaches using a 10-cm visual analog pain scale. An initial mark was made on the scale at the time of entry into the study and later another mark was made on a new unmarked pain scale 1 hour after medication administration. Changes in pain scores within each treatment group and between groups were analyzed using the Wilcoxon rank sum test.
Prior to treatment, the patients assigned to receive prochlorperazine had a median score of 9.2 cm (mean +/- SD pain score of 8.3 cm +/- 2.1 cm), while the patients receiving ketorolac had a median score of 9.0 (mean pain score of 8.4 cm +/- 1.7 cm). There was no significant difference between the pain scores of the participants in the 2 groups prior to treatment (p = 0.80). One hour after medication administration, the patients in the prochlorperazine group had a median score of 0.5 cm (mean 2.1 +/- 3.2 cm), while those patients receiving ketorolac had a median pain score of 3.9 (mean 4.0 +/- 3.3 cm). The decrease in pain score was significant for both groups of patients (p = 0.0001). The change in pain score for the patients in the prochlorperazine group (median 7.1) was significantly greater than the change in pain score for the patients in the ketorolac group (median 4.0; p = 0.04).
Although both drugs were associated with a significant reduction in pain scores, benefit over a placebo agent was not tested. Furthermore, the patients who received prochlorperazine i.v. for migraine headaches had a statistically significant greater decrease in their pain scores than did those receiving ketorolac i.v.
比较静脉注射酮咯酸与静脉注射丙氯拉嗪作为急诊科偏头痛初始治疗的效果。
进行了一项前瞻性、双盲对照研究，选取了一所三级医疗大学教学医院急诊科的64例偏头痛患者作为便利样本。患者被随机分配接受静脉注射10mg丙氯拉嗪或30mg酮咯酸。患者使用10厘米视觉模拟疼痛量表对头痛严重程度进行评分。在进入研究时在量表上做初始标记，用药1小时后在新的未标记疼痛量表上再做一次标记。使用Wilcoxon秩和检验分析各治疗组内及组间疼痛评分的变化。
治疗前，分配接受丙氯拉嗪的患者中位数评分为9.2厘米（平均±标准差疼痛评分为8.3厘米±2.1厘米），而接受酮咯酸的患者中位数评分为9.0（平均疼痛评分为8.4厘米±1.7厘米）。两组参与者治疗前的疼痛评分无显著差异（p = 0.80）。用药1小时后，丙氯拉嗪组患者中位数评分为0.5厘米（平均2.1±:3.2厘米），而接受酮咯酸的患者中位数疼痛评分为3.9（平均4.0±3.3厘米）。两组患者的疼痛评分均显著降低（p = 0.0001）。丙氯拉嗪组患者疼痛评分的变化（中位数7.1）显著大于酮咯酸组患者疼痛评分的变化（中位数4.0；p = 0.04）。
虽然两种药物均与疼痛评分显著降低相关，但未测试其优于安慰剂的效果。此外，静脉注射丙氯拉嗪治疗偏头痛的患者疼痛评分下降在统计学上显著大于静脉注射酮咯酸的患者。
