Ⅲ－6
緊張型頭痛の 急性期（頭痛時，頓服）治療にはどのような種類があり，どの程度有効か.　またどのように使い分けるか

 

4) Schachtel BP, Furey SA, Thoden WR. Nonprescription ibuprofen and
　 acetaminophen in the treatment of tension-type headache. J Clin
　 Pharmacol. 1996 Dec;36(12):1120-5.
論文抄録
A single-dose, double-blind, randomized clinical trial was conducted to examine the relative analgesic effectiveness of 400 mg of ibuprofen (n = 153), 1,000 mg of acetaminophen (n = 151), and placebo (n = 151) in volunteers with muscle contraction headache. At regular intervals during a 4-hour period, participants evaluated headache pain intensity on a 100-mm visual analog scale and headache pain relief on a six-category scale. Both active agents were significantly different from placebo at all time points and in reducing pain intensity and providing relief of headache overall. Similarly, ibuprofen at 400 mg differed significantly from acetaminophen at 1,000 mg on both rating scales. Participants receiving ibuprofen at 400 mg achieved complete relief of headache faster than those receiving acetaminophen at 1,000 mg or placebo, and more participants taking ibuprofen experienced complete relief of headache than those taking placebo or acetaminophen. Both ibuprofen at 400 mg and acetaminophen at 1,000 mg are efficacious analgesic agents for muscle contraction headache, and ibuprofen at 400 mg is significantly more effective than acetaminophen at 1,000 mg for treating this condition.
文献 PubMed－ID

PMID:9013368

エビデンスレベル

Ib

文献タイトル (日本語)

緊張型頭痛治療におけるイブプロフェンとアセトアミノフェン．

目的
Ibuprofen の有効性を検証すること
研究デザイン
無作為二重盲検プラセボ対照試験（ Randomized, double-blind, placebo-controlled study ）
研究施設
Whitehall-Robins Healthcare, Madison , New Jersey
研究期間
N/A
対象患者
1962 年の Ad Hoc committee の筋収縮性頭痛の診断基準を満たす 18 歳以上の患者 455 人
介入
Ibuprofen (400 mg) ， acetaminophen (1000 mg) ，偽薬の３群比較
主要評価項目とそれに用いた
統計学的手法
服用 30 分， 1 ， 2 ， 3 ， 4 時間後の頭痛強度を 100-mm visual analog headache pain intensity scale と 6 項目からなる headache pain relief scale で評価した．
結果

Ibuprofen 400 mg ， acetaminophen 1000 mg ともに偽薬に比べ有効であったが， ibuprofen の方がより勝っていた． Ibuprofen 服用者の方が， acetaminophen 服用者より早期に頭痛が改善し，より多くの患者で頭痛が完全に消失した．

結論
Ibuprofen 400 mg は 緊張型頭痛（筋収縮性頭痛）の急性期治療として acetaminophen より有効である．
備考

Publication Types:
* Clinical Trial
* Randomized Controlled Trial

MeSH Terms:
* Acetaminophen/adverse effects
* Acetaminophen/therapeutic use*
* Adult
* Analgesics, Non-Narcotic/adverse effects
* Analgesics, Non-Narcotic/therapeutic use*
* Comparative Study
* Double-Blind Method
* Drugs, Non-Prescription
* Female
* Humans
* Ibuprofen/adverse effects
* Ibuprofen/therapeutic use*
* Male
* Research Support, Non-U.S. Gov't
* Tension Headache/drug therapy*
* Time Factors

Substances:
* Analgesics, Non-Narcotic
* Drugs, Non-Prescription
* Acetaminophen
* Ibuprofen

作成者
飯塚高浩