| Objective: Through this clinical observation research, we will evaluation the efficacy and safety of botulinum toxin type A in treating chronic migraine, and then make further efforts to evaluate the practical value of this medicine in treating chronic migraine.Methods: Between September 2012 and September 2014, patients were collected from General Hospital of Shenyang Military Region. The diagnosis criteria of chronic migraine standards(ICHD-3 β version) was consistent with the International Headache Society. All patients agree to apply the BTX-A treatment according to the given BTX-A treatment and sign the consent to treatment, The follow-up data were recorded each time(before treatment, after one month of treatment, after two months of treatment, after three month of treatment and after six month of treatment) as follow:the observed indicators of results and scoring, including frequency of migraine attack monthly, headache duration, extent of headache onset, VAS score(visual analogue scale), headache intensity(migraine scoring method), accompanying symptoms of headache onset, the number of people who taking pain medication and amount of medication in the acute phase, the number of headaches and curative effect of each grade for statistical analysis. At the same time, we record treatment-related adversereactions, to evaluate the safety of the drug.Results: 1. The differences in monthly migraine attack frequency, headache duration, VAS score, headache intensity and amount of medication in the acute phase are significantly improved(P <0.01) after treatment; the difference of the number of people who taking pain medication before and after treatment is not statistically significant( P> 0.05). 2. The differences of all these indicators in each period after treatment are not statistically significant( P> 0.05). 3. The differences of the attack number of headaches and curative effect of each pain grade between before and after treatment are statistically significant(P <0.01), showing that the treatment has decreased the number of headaches and the treatment has obvious curative effect, while the comparison during each period after treatment did not show statistically significant difference in these indicators(P> 0.05). 4. According to further statistical processing and analysis by the Kruskal-Wallis Test average rank, it can be concluded that: firstly,the frequency of migraine attack monthly, headache duration, VAS score and the number of pain medications were improved most obviously in the two months after treatment, headache intensity got the most significant improvement after three months of treatment; Secondly, the numbers of patients with severe headache decreased most obviously; Thirdly, the headache degree relieves obviously in the two months after treatment. 5. As to the safety, there are four cases of mild adverse reactions that did not affect their daily lives and get better a few days later, and there were two lost cases in the present study.Conclusions:The clinical trials shows that botulinum toxin type A has a significant effect in treating chronic migraine.In addition to the number of people who taking pain medication,all of the indicators alleviate obviously such as frequency of migraine attack monthly,headache duration,VAS score,headache intensity,amount of medication in the acute phase, etc.By calculation, the headache intensity which has a greater impact on patients’ daily lives ease most obviously after three months of treatment. According to the VAS score: severe headache changes most obviously of all and the degree of pain relieves notably after two months of treatment. Safety evaluation,there are four cases of mild adverse reactions in this research which relief spontaneously in a short period of time, indicating that the drug is safe in clinical applications and worth of clinical using in patients with chronic migraine. |
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