慢性紧张性头痛的定量感觉检查及心理健康水平

A study of quantitative sensation and psychologic health condition in patients with chronic tension-type headache.

目的探讨慢性紧张性头痛(chronic tension-type headache,CTTH)患者定量感觉阈值的改变及与精神、心理障碍的关系。方法用定量感觉检测(quantitative sensory test,QST)仪对CTTH组96例及健康对照组用Limits法测定颞肌及颈后的冷觉(cold sensation,CS)、温觉(warm sensory,WS)、冷痛觉(cold pain,CP)、热痛觉(heatpain,HP)阈值,比较两组阈值,并用症状自评量表(symptom check list 90,SCL-90)、汉密尔顿焦虑量表(Hamilton anxi-ety scale,HAMA)和汉密尔顿抑郁量表(Hamilton depression scale,HAMD)对两组进行心理健康状况筛查。结果 SCL-90评分,CTTH组在躯体化、强迫、抑郁、焦虑、恐怖等因子分明显高于对照组(P<0.01);CTTH组出现焦虑、抑郁障碍67例(70%)。头痛伴焦虑抑郁组QST阈值降低,阈值与对照组比较有统计学差异(P<0.01);头痛无焦虑抑郁组QST阈值较对照组降低(P<0.05),但较头痛伴抑郁焦虑组高(P<0.05)。结论 CTTH患者存在不良心理水平,焦虑、抑郁在CTTH的发病过程中有重要作用。QST显示痛、温觉过敏,提示CTTH患者头痛发作可能还与中枢对疼痛的敏感性增高有关。

Objective To study the characteristics of quantitative sensory test（QST） and psyche-disorder in patients with chronic tension-type headache（CTTH）.Methods The method of limits was used to measure the values of QST thermal thresholds including CS,WS,CP and HP and List-90（SCL-90）,Hamilton Depression Scale（HAMD） and Hamilton Anxiety Scale（HAMA） were used to assess psychological health condition.Results The scores of somatization,compulsive,depression,anxiety and phobia in SCL-90 in the patients with CTTH were significantly higher than those in the controls（P0.01）.There were 67 cases（70%）of anxiety and /or depression neurosis in the patients with CTTH.QST showed that the thresholds in the patients with CTTH with anxiety and depression,are significantly lower than that in the controls（P0.01）.The thresholds in the CTTH patients without anxiety and depression were lower than those in controls（P0.05）,but higher than those in CTTH patients with anxiety and depression（P0.05）.Conclusions 1.The psychologic health condition of patients with CTTH is worse than that in normal subjects.2.The anxiety and depression might play an important role in.the pathogenesis of CTTH.3.The increased sensibility of central nervous system is involved in the occurrence of CTTH.