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目的观察氯吡格雷治疗偏头痛患者的疗效及安全性,及其对偏头痛患者血小板聚集率(PAR)、血浆溶血磷脂酸(LPA)及血管内皮素-1(ET-1)的影响。方法将60例偏头痛发作期患者随机分为观察组32例和对照组30例。对照组接受常规治疗:急性发作时加服麦角胺咖啡因片1片/次;口服尼莫地平40 mg/次,3次/d,盐酸氟桂利嗪胶囊2粒/次,1次/d,睡前口服。观察组在对照组常规治疗的基础上加用氯吡格雷口服,75 mg/次,1次/d。两组均连续治疗30 d。监测治疗前后偏头痛发作频率、持续时间、严重程度、伴随症状及药物的不良反应,同时测定PAR、LPA、ET-1。结果观察组的治愈率和总有效率均显著高于对照组(χ2=4.2178,3.9720,P<0.05)。治疗30 d后,观察组的PAR、LPA、ET-1均显著低于治疗前(t=8.1816,5.2797,4.4709,P<0.01)和对照组(t=6.7543,2.4861,2.0546,P<0.01或P<0.05);两组患者药物不良反应发生率比较差异无统计学意义(χ2=1.0966,P>0.05)。结论偏头痛的发生及其严重程度与PAR、LPA及ET-1水平密切相关,在常规治疗偏头痛的基础上加用氯吡格雷可显著地提高疗效,降低PAR、LPA及ET-1水平,并不增加不良反应。
Objective To investigate the efficacy and safety of clopidogrel in the treatment of migraine and its effect on platelet aggregation rate (PAR), plasma lysophosphatidic acid (LPA) and endothelin-1 (ET-1) in migraine patients. Methods Sixty patients with migraine attack were randomly divided into observation group (32 cases) and control group (30 cases). The control group received routine treatment: acute attack of ergotamine plus caffeine tablets 1 /; oral nimodipine 40 mg / time, 3 times / d, flunarizine hydrochloride capsules 2 capsules / time, 1 / d , Before going to bed orally. The observation group was treated with clopidogrel orally, 75 mg / time, once a day on the basis of routine treatment in the control group. Both groups were treated for 30 days. The frequency of migraine attacks, the duration, the severity, the accompanying symptoms and adverse drug reactions were monitored before and after treatment. PAR, LPA and ET-1 were measured simultaneously. Results The cure rate and total effective rate in the observation group were significantly higher than those in the control group (χ2 = 4.2178,3.9720, P <0.05). The levels of PAR, LPA and ET-1 in the observation group after 30 days of treatment were significantly lower than those before treatment (t = 8.1816,5.2797,4.4709, P <0.01) and the control group (t = 6.7543,2.4861,2.0546, P <0.01 or P <0.05). There was no significant difference in adverse drug reactions between the two groups (χ2 = 1.0966, P> 0.05). Conclusions The occurrence and severity of migraine are closely related to the levels of PAR, LPA and ET-1. Adding clopidogrel on the basis of conventional treatment of migraine can significantly improve the therapeutic effect, decrease the levels of PAR, LPA and ET-1, Does not increase adverse reactions.