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目的:探讨加巴喷丁和托吡酯联合文拉法辛对慢性偏头痛伴广泛性焦虑障碍患者的临床疗效及安全性。方法:连续选取2018年6月至2020年2月广西医科大学第二附属医院慢性偏头痛伴广泛性焦虑障碍患者127例，按照随机数字表法分为加巴喷丁联合文拉法辛组（观察组，64例）和托吡酯联合文拉法辛组（对照组，63例），均治疗6个月。于治疗前和治疗3、6个月后记录每个月头痛发作天数、头痛视觉模拟评分（VAS）、偏头痛特异性生命质量问卷V2.1（MSQ V2.1）评分、头痛影响测定-6（HIT-6）评分、匹兹堡睡眠质量指数（PSQI），并评估疗效，观察药物不良反应。结果:观察组57例完成3个月治疗，53例完成6个月治疗；对照组56例完成3个月治疗，50例完成6个月治疗。两组治疗3和6个月后每个月头痛发作天数、头痛VAS、HIT-6和PSQI明显小于治疗前[观察组：（16.31 ± 5.02）和（15.69 ± 6.31） d比（22.62 ± 3.27） d、（3.67 ± 1.60）和（1.91 ± 1.05）分比（5.09 ± 1.43）分、（49.34 ± 11.01）和（47.34 ± 9.05）分比（60.25 ± 11.61）分、（10.09 ± 2.81）和（9.68 ± 2.74）分比（13.50 ± 2.81）分；对照组：（14.58 ± 7.37）和（9.92 ± 5.07） d比（23.05 ± 5.24） d、（4.74 ± 1.15）和（3.16 ± 1.60）分比（5.90 ± 2.06）分、（42.77 ± 8.02）和（40.09 ± 9.72）分比（59.37 ± 9.08）分、（9.66 ± 2.71）和（8.62 ± 2.07）分比（14.61 ± 2.79）分]，差异有统计学意义（n P<0.05）。观察组治疗3和6个月后头痛VAS明显小于同期对照组，差异有统计学意义（n P<0.05）。两组治疗3和6个月后MSQ V2.1功能限制、功能丧失、情感功能评分及总分均明显小于治疗前[观察组：（17.62 ± 9.81）和（16.01 ± 5.73）分比（36.96 ± 9.55）分、（12.17 ± 5.60）和（11.09 ± 3.27）分比（17.06 ± 6.08）分、（8.42 ± 2.17）和（8.94 ± 1.90）分比（11.40 ± 4.09）分、（33.24 ± 9.61）和（28.62 ± 5.04）分比（62.75 ± 14.02）分；对照组：（17.08 ± 8.73）和（16.79 ± 5.19）分比（36.82 ± 9.68）分、（9.04 ± 4.48）和（8.90 ± 3.46）分比（17.26 ± 6.01）分、（6.92 ± 2.61）和（5.15 ± 1.74）分比（11.30 ± 5.47）分、（31.65 ± 9.17）和（30.66 ± 6.04）分比（62.91 ± 11.18）分]，差异有统计学意义（n P0.05）。n 结论:加巴喷丁或托吡酯联合文拉法辛均能减少慢性偏头痛伴广泛性焦虑障碍患者头痛程度，减少每个月头痛发作天数，改善睡眠，提高生命质量，疗效相似，但加巴喷丁不良反应仍需高度关注。“,”Objective:To investigate the clinical efficacy and safety of gabapentin or topiramate combined with venlafaxine in the treatment of chronic migraine patients with generalized anxiety disorder.Methods:From June 2018 to February 2020, 127 patients with chronic migraine complicated with generalized anxiety disorder in the Second Affiliated Hospital of Guangxi Medical University were selected. The patients were divided into gabapentin combined with venlafaxine group (observation group, 64 cases) and topiramate combined with venlafaxine group (control group, 63 cases) according to the random number table method, and all patients were treated for 6 months. The headache attack days per month, headache visual analogue scale (VAS), migraine specific quality of life questionnaire V2.1 (MSQ V2.1), headache impact measurement-6 (HIT-6) score, Pittsburgh sleep quality index (PSQI) score were recorded before treatment and 3 and 6 months after treatment.Results:In observation group, 57 cases completed 3 months of treatment, and 53 cases completed 6 months of treatment. In the control group, 56 cases completed 3 months of treatment, and 50 cases completed 6 months of treatment. The headache attack days per month, headache VAS, HIT-6 and PSQI 3 and 6 months after treatment in 2 groups were significantly lower than those before treatment, observation group: (16.31 ± 5.02) and (15.69 ± 6.31) d vs. (22.62 ± 3.27) d, (3.67 ± 1.60) and (1.91±1.05) scores vs. (5.09 ± 1.43) scores, (49.34 ± 11.01) and (47.34 ± 9.05) scores vs. (60.25 ± 11.61) scores, (10.09 ± 2.81) and (9.68 ± 2.74) scores vs. (13.50 ± 2.81) scores; control group: (14.58 ± 7.37) and (9.92 ± 5.07) d vs. (23.05 ± 5.24) d, (4.74 ± 1.15) and (3.16 ± 1.60) scores vs. (5.90 ± 2.06) scores, (42.77 ± 8.02) and (40.09 ± 9.72) scores vs. (59.37 ± 9.08) scores, (9.66 ± 2.71) and (8.62 ± 2.07) scores vs. (14.61 ± 2.79) scores, and there were statistical differences (n P<0.05). The headache VAS 3 and 6 months after treatment in observation group was significantly lower than that in control group, and there was statistical difference (n P<0.05). The functional limitations, function loss, emotional function scores and total score of MSQ V2.1 3 and 6 months after treatment in 2 groups were significantly lower than those before treatment, observation group: (17.62 ± 9.81) and (16.01 ± 5.73) scores vs. (36.96 ± 9.55) scores, (12.17 ± 5.60) and (11.09 ± 3.27) scores vs. (17.06 ± 6.08) scores, (8.42 ± 2.17) and (8.94 ± 1.90) scores vs. (11.40 ± 4.09) scores, (33.24 ± 9.61) and (28.62 ± 5.04) scores vs. (62.75 ± 14.02) scores; control group: (17.08 ± 8.73) and (16.79 ± 5.19) scores vs. (36.82 ± 9.68) scores, (9.04 ± 4.48) and (8.90 ± 3.46) scores vs. (17.26 ±6.01) scores, (6.92 ± 2.61) and (5.15 ± 1.74) scores vs. (11.30 ± 5.47) scores, (31.65 ± 9.17) and (30.66 ± 6.04) scores vs. (62.91 ± 11.18) scores, and there were statistical differences (n P0.05).n Conclusions:Gabapentin or topiramate combined with venlafaxine can reduce the degree of headache in chronic migraine patients with generalized anxiety disorder, reduce the number of headache days per month, improve sleep and improve the quality of life. However, the adverse reactions of gabapentin still need to be paid more attention.