慢性每日头痛回顾性分析

CLINIACL FEATURES OF CHRONIC DAILY HEADACHE:A RETROSPECTIVE STUDY

目的:分析慢性每日头痛(CDH)的临床特征。方法:回顾性研究102例CDH的亚型、原发性头痛的类型,以及药物过量性头痛(MOH)/很可能的MOH患者所用止痛药的种类、撤除止痛药的疗效。结果:CDH亚型中,MOH/很可能的MOH 91例(89.2%);原发性头痛的类型中,偏头痛74例(72.5%)。91例MOH/很可能的MOH中,服用含咖啡因的复合止痛剂者83例(91.2%);29例(31.9%)停用止痛药后头痛恢复为原有发作形式,7例(7.7%)未停用止痛药,55例(60.4%)失访。不同性别之间上述特点不全相同。结论:大多数CDH患者有药物过量,停用止痛药是其有效的治疗办法,但是患者依从性差,因此有必要对患者进行CDH相关教育,以提高疗效。

Objective： To observe the clinical features of chronic daily headache （CDH）. Methods： In a retrospective study of 102 patients with CDH, we investigated the subtype of CDH and the type of primary headache. We also analyzed the type of medicine overused, method and efficacy of withdrawal for medication-overuse headache （MOH）/probable MOH. Results： Among the 102 CDH patients, 89.2% had MOH/probable MOH, and 72.5% had migraine as primary headache. Among 91 patients with MOH/ probable MOH, 91.2% overused combination analgesics containing caffeine. 29 patients （31.9%） succeeded in withdrawal and returned to the primary episodic pattern. 7 patients （7.7%） failed in withdrawal. The remaining 55 patients （60.4%） dropped out. There were significant differences in some clinical characteristics of CDH in females as compared with males. Conclusion ： These results suggest that most CDH patients overused analgesics and withdrawal is an effective therapy. However, because of poor compliance of the patients, it is essential to intensify the education about CDH and improve compliance, so as to increase therapeutic efficacy of withdrawal.