| Objectives: To compare the clinical effects of stellate ganglion block(SGB)and flunarizine hydrochloride capsule in the treatment of migraine without aura,so as to provide reference for the clinical treatment of migraine without aura.Methods: A total of 64 patients with migraine without aura were selected from August 2020 to October 2022 in the outpatient and ward of Pain Department of the First People’s Hospital of Yunnan Province.Sixty-four patients were randomly divided into an experimental group and a control group,32 patients in each group.In the experimental group,on the basis of oral administration of "acetaminophen 500 mg twice per day",ultrasound-guided stellate ganglion block was performed once every five days,and a total of six SGB treatments were performed.In the control group,on the basis of oral administration of "acetaminophen 500 mg twice a day" treatment,oral administration of "flunarizine hydrochloride capsule 5mg once a day" treatment.The treatment cycle of patients in both groups was one month,and the follow-up time was six months.The right anterior cerebral artery blood flow velocity(R-ACA)and blood flow velocity were recorded before treatment and one month later to evaluate the changes of cerebral hemodynamics.The pre-treatment and post-treatment 1-month digital analog pain scores(NRS)were recorded,and NRS was used to evaluate the pain changes before and after treatment.The patient’s Hamilton Anxiety Scale(HAMA),Self-Rating Sleep Scale(SRSS),and headache count,duration,severity,concomitant symptoms,and overall score were measured before treatment and 1 month after treatment.HAMA was used to evaluate the improvement of anxiety level.SRSS assessed changes in sleep quality;Five indicators of headache to assess changes in headache severity.The changes of headache comprehensive degree in the two groups one month after treatment were compared to evaluate the short-term efficacy of the two treatment methods.Adverse reactions and serious complications were recorded to evaluate the safety of the treatment plan.Follow-up records were kept of patients requiring hospitalization or pain medication within 6 months of completion of treatment and of NRS scores after 6 months of treatment.To evaluate the long-term efficacy of two treatments,Based on these data,we compared the clinical effects of two treatments,stellate ganglion block(SGB)and flunarizine hydrochloride capsule,on migraine without aura.Results:1.There is no significant difference in general data such as gender,age and course of disease between the experimental group and the control group.2.R-ACA systolic blood flow velocity: compared within the group,after one month of treatment,the systolic blood flow velocity of cerebral artery in the two groups were increased,and the difference was statistically significant(P<0.05).The experimental group was superior to the control group in comparison among groups,and the difference was statistically significant(P<0.05).3.Digital analog pain score: Comparison within the same group.After one month of treatment,the NRS scores of the two groups were decreased,and the difference was statistically significant(P<0.05).The experimental group was superior to the control group in comparison among groups,and the difference was statistically significant(P<0.05).4.HAMA score: comparison within the same group.After one month of treatment,the HAMA scores of the two groups were decreased,and the difference was statistically significant(P<0.05).The experimental group was superior to the control group in comparison among groups,and the difference was statistically significant(P<0.05).5.SRSS score: compared within the same group,the SRSS scores of the two groups were decreased after one month of treatment with statistically significant difference(P<0.05).The experimental group was superior to the control group in comparison among groups,and the difference was statistically significant(P<0.05).6.Headache times,time,degree,concomitant symptoms and comprehensive score: comparison within the group.After one month of treatment,the times,time,degree,concomitant symptoms and comprehensive score of headache in the two groups were all reduced,and the difference was statistically significant(P<0.05).The experimental group was superior to the control group in comparison among groups,and the difference was statistically significant(P<0.05).7.Short-term curative effect: The experimental group is superior to the control group in improving the comprehensive degree of headache,and the difference is statistically significant(P<0.05),indicating that the experimental group is superior to the control group in short-term curative effect.8.Safety analysis: two cases of vomiting and fatigue in the experimental group during the treatment;In the control group,there were three cases of vomiting and fatigue.No such symptoms as hypotension and syncope were observed in the two groups,and the difference was not statistically significant(P>0.05).The two treatments had high safety.9.Long-term efficacy: All the patients were followed up.The NRS scores of the two groups after six months of treatment were significantly different from those before treatment(P < 0.05).The NRS scores after six months were also statistically significant between groups(P < 0.05).Within six months after treatment,there were eight cases requiring hospitalization or oral analgesics in the experimental group.In the control group,there were 18 cases requiring hospitalization or oral administration of analgesics,and the difference was statistically significant(P<0.05).It indicated that the long-term curative effect of experimental group was superior to that of control group.Conclusions: SGB combined with acetaminophen is more effective than flunarizine hydrochloride capsule combined with acetaminophen in improving cerebral blood circulation,pain degree,anxiety state,sleep effect,headache attack times,headache duration,headache severity with accompanying symptoms in patients with migraine without aura.SGBs combined with acetaminophen require fewer readmissions or oral analgesics,and are superior to flunarizine hydrochloride capsules combined with acetaminophen for both short-term and long-term efficacy.SGB combined with acetaminophen in the treatment of adult migraine can be clinically promoted. |
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