目的 观察文拉法辛治疗前庭性偏头痛的临床疗效。方法 选取2018年1月—2020年1月上海市杨浦区市东医院头晕门诊就诊的112例前庭性偏头痛患者，按随机数字表法将所有患者分为对照组和治疗组，每组各56例。对照组患者给予一般治疗，治疗组在对照组基础上口服盐酸文拉法辛缓释胶囊，75 mg/次，1次/d。两组疗程均为12周。比较两组临床症状、头痛视觉模拟量表（VAS）评分、眩晕残障程度评定量表（DHI）评分、14项汉密尔顿焦虑量表（HAMA）评分，24项汉密尔顿抑郁量表（HAMD）评分。结果 与治疗前比，治疗后两组患者头晕每月平均发作次数减少，VAS评分显著降低（P<0.05）；治疗后，治疗组头晕每月平均发作次数和VAS评分均低于对照组（P<0.05）。与治疗前比较，治疗后两组患者DHI评分均显著降低（P<0.05），且治疗组低于对照组（P<0.05）。与治疗前比，治疗后两组患者HAMA评分、HAMD评分均显著降低（P<0.05）；治疗后，治疗组HAMA评分、HAMD评分低于对照组（P<0.05）。结论 在前庭性偏头痛的预防性治疗方面，健康宣教、改善生活方式、避免诱发因素有疗效，但加用文拉法辛更加显出了优势，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

上海市卫生和计划生育委员会青年课题（20174Y0161）；杨浦区卫健系统“好医师”建设工程（2020—2023年度）资助项目