目的 觀察文拉法辛治療前庭性偏頭痛的臨床療效。方法 選取2018年1月—2020年1月上海市楊浦區(qū)市東醫(yī)院頭暈門診就診的112例前庭性偏頭痛患者，按隨機數(shù)字表法將所有患者分為對照組和治療組，每組各56例。對照組患者給予一般治療，治療組在對照組基礎(chǔ)上口服鹽酸文拉法辛緩釋膠囊，75 mg/次，1次/d。兩組療程均為12周。比較兩組臨床癥狀、頭痛視覺模擬量表（VAS）評分、眩暈殘障程度評定量表（DHI）評分、14項漢密爾頓焦慮量表（HAMA）評分，24項漢密爾頓抑郁量表（HAMD）評分。結(jié)果 與治療前比，治療后兩組患者頭暈每月平均發(fā)作次數(shù)減少，VAS評分顯著降低（P<0.05）；治療后，治療組頭暈每月平均發(fā)作次數(shù)和VAS評分均低于對照組（P<0.05）。與治療前比較，治療后兩組患者DHI評分均顯著降低（P<0.05），且治療組低于對照組（P<0.05）。與治療前比，治療后兩組患者HAMA評分、HAMD評分均顯著降低（P<0.05）；治療后，治療組HAMA評分、HAMD評分低于對照組（P<0.05）。結(jié)論 在前庭性偏頭痛的預(yù)防性治療方面，健康宣教、改善生活方式、避免誘發(fā)因素有療效，但加用文拉法辛更加顯出了優(yōu)勢，并且是安全的。

Objective To investigate the therapeutic effect of venlafaxine in treatment of vestibular migraine.Methods A total of 112 patients with vestibular migraine who were admitted to the dizziness clinic of Shidong Hospital of Yangpu Districkt in Shanghai from January 2018 to January 2020 were selected. All patients were divided into control group and treatment group according to random number table method, with 56 patients in each group. Patients in the control group were given general treatment. Patients in the treatment group were po administered with Venlafaxine Hydrochloride Sustained-Release Capsules on the basis of the control group, 75 mg/time, once daily. The treatment course of both groups was 12 weeks. After treatment, clinical symptoms, visual analog headache scale (VAS) scores, vertigo disability rating scale (DHI) scores, 14 items of Hamilton Anxiety Scale (HAMA) scores and 24 items of Hamilton Depression Scale (HAMD) scores were compared between the two groups.Results Compared with before treatment, the average frequency of dizziness episodes per month decreased, and VAS score was significantly decreased in two groups after treatment (P<0.05). After treatment, the average frequency of dizziness and VAS score in the treatment group were lower than those in the control group (P<0.05). Compared with before treatment, after treatment, DHI scores in two groups were significantly decreased (P<0.05), and the treatment group was lower than the control group (P<0.05). Compared with before treatment, HAMA score and HAMD score in two groups were significantly decreased after treatment (P<0.05). After treatment, HAMA score and HAMD score of treatment group were lower than those of control group (P<0.05).Conclusions In the preventive treatment of vestibular migraine, health education, lifestyle improvement, and avoidance of risk factors are effective, but the addition of venlafaxine appears to be more advantageous and safe.

R971

上海市衛(wèi)生和計劃生育委員會青年課題（20174Y0161）；楊浦區(qū)衛(wèi)健系統(tǒng)“好醫(yī)師”建設(shè)工程（2020—2023年度）資助項目