原发性头痛与抑郁焦虑障碍共病的临床研究

THE CLINICAL RESEARCH OF PRIMARY HEADACHE COMORBID WITH DEPRESSION/ANXIETY DISORDERS

目的:分析原发性头痛与抑郁焦虑障碍共病的临床特点及疗效评估。方法:纳入符合标准的105例门诊原发性头痛患者,分为共病组和非共病组,予以药物治疗并完成8周随访。分别于治疗前及治疗后4周、8周应用SF-12健康调查问卷及HIT-6量表评估患者生活质量,并记录头痛持续时间、频率、疼痛程度。结果:抑郁焦虑障碍在高、低频率头痛发作组中的OR值为3.277,95%置信区间(1.48,7.27)。治疗前共病组的精神健康部分评分(MCS-12)较非共病组低(P<0.01),HIT-6评分比非共病组高(P<0.01);治疗后两组的生活质量和临床症状都较前明显改善(P<0.01),且治疗后2周共病组的头痛发作频率下降较非共病组慢(P<0.05)。结论:原发性头痛患者其头痛频率的增加与抑郁焦虑障碍共病密切相关。合并有抑郁焦虑使头痛患者生活质量差,症状缓解慢,治疗疗程长。

Objective：To analyze the clinical characteristics and therapeutic effect of the primary headache comorbid with depression and anxiety disorders.Methods：In outpatient clinic,105 cases of primary headache patients were selected and met the inclusion criteria,and were divided into comorbid group and non-comorbid group.All patients received corresponding treatment and 8 weeks follow-up.The Health-related quality of life was measured using Headache Impact Test-6（HIT-6）and the 12-item Short-Form Health Survey（SF-12）which contained a mental health component score（MCS-12） and a physical health component score（PCS-12）;the duration,frequency and degree of headache were recorded before treatment,4th week and 8th week after treatment.Results： The Odds Ratio（OR） for the headache anxiety disorder in the high and low headache frequency groups was 3.277,95 percent of confidence interal（1.48,7.27）.Before treatment,there were lower MCS-12 scores（P0.01） and higher HIT-6 scores（P0.01） in the comorbid group than those of non-comorbid group.After treatment,the quality of life and clinical symptoms were significantly improved in both groups（P0.01）,but the frequency of headache attacks in comorbid group decreased slowly than non-comorbid group two weeks after treatment.Conclusion： The frequency of headache episodes is closely correlated with depression / anxiety disorders in primary headache patients.Standard treatment can reduce the frequency,intensity and duration of headache,and improve the life quality of headache patients.But in the headache patients comorbid with depression / anxiety disorders the life quality become worse,clinical symptoms improve slowly and a longer courses of treatment is needed.