【摘要】 目的探讨美托洛尔联合氟西汀预防偏头痛的疗效及可能机制。方法将112例偏头痛患者按照随机数字表法随机分为观察组和对照组,每组各56例。观察组给予琥珀酸美托洛尔联合氟西汀治疗;对照组给予琥珀酸美托洛尔治疗。比较两组受试者治疗前和治疗后头痛发作次数、头痛发作程度、头痛发作天数、颅内动脉血流情况。记录两组治疗前、治疗后2周、治疗后4周、治疗后6周血清5羟色胺(5-HT)水平。结果两组治疗后头痛发作次数、头痛发作程度、头痛发作时间均较治疗前有明显改善(P<0.05),且观察组改善幅度优于对照组,差异有统计学意义(P<0.01);两组治疗后大脑中动脉(MCA)、前动脉(ACA)、后动脉(PCA)、椎动脉(VA)、基底动脉(BA)血流情况均较治疗前改善(P<0.05),且观察组改善幅度优于对照组,差异有统计学意义(P<0.01);两组治疗前血清5-HT水平比较差异无统计学意义(P>0.05),观察组治疗后2周、4周、6周血清5-HT水平较治疗前明显提高(P<0.01),且提高幅度大于同期对照组,差异有统计学意义(P<0.01);观察组未出现严重不良反应。观察组偏头痛复发率低于对照组,差异有统计学意义(P<0.05)。结论琥珀酸美托洛尔联合氟西汀预防性治疗偏头痛,比起单药应用,起效更快,疗效更明显,复发率更低;可有效改善患者偏头痛症状和颅内血流状况,疗效确切,其主要机制可能与提升患者体内5-HT浓度有关。更多还原

【Abstract】 Objective To study effect of metoprolol combined with fluoxetine treating migraine and its possible mechanism. Methods During the period of 2011 January to 2014 December,112 cases of migraine patients were selected as the research object. 112 patients were randomly divided into observation group and control group,56 cases in each group. The observation group included 56 patients,who were given Metoprolol Tablets combined fluoxetine treatment. The patients of control group of 56 patients were treated with Metoprolol. The statistics of the two subjects,episodes of headache degree,headache days,intracranial arterial blood flow headache before and after the treatment were made. The records of serum level of 5- HT of the two groups before treatment,2 weeks after the treatment,4 weeks after the treatment,6 weeks after the treatment were made. Results Headache attack frequency,headache degree,headache time improved in two groups after treatment than before treatment( P < 0. 05). The observation group improved better than the control group,and there were significant differences( P < 0. 01). The two group after treatment,MCA,ACA,PCA,VA,BA were improved compared with before treatment( P < 0. 05),and the observation group improved better than the control group,and there were significant differences( P < 0. 01). The serum 5- HT level was not statistically different between the two groups before treatment( P > 0. 05),the observation group after treatment for 2 weeks,4 weeks,6 weeks,the levels of serum 5-HT than before treatment significantly increased( P < 0. 01),which was greater than the same period in the control group,and there were significant differences( P < 0. 01). There was no serious adverse reaction in the observation group. The migraine recurrence rate of the observation group’s was lower than the control group,and there were significant differences( P < 0. 05). Conclusion Metoprolol combined with fluoxetine treating migraine,compared with the single drug application,has faster onset,and its curative effect is more obvious,and the recurrence rate is lower. It can effectively improve the patients’ migraine symptoms and intracranial blood flow condition,and its curative effect is accurate,and its main mechanism is to enhance 5- HT concentration in patients.更多还原