药物过量性头痛的临床分析

Clinical characteristics of medication overuse headache

目的 探讨药物过量性头痛（MOH）患者的不同病因及临床特征,加强该病的临床重视程度及患者用药安全意识. 方法 总结分析自2011年8月至2012年3月在吉林大学第二医院神经内科头痛门诊诊治的88例MOH患者人口学特点、头痛特点、伴发症状及致残情况. 结果 MOH患者平均年龄为（47.0±10.5）岁,约80％为女性,98％为中重度头痛,头痛部位在全头和颞顶部的为39％,头痛性质为跳痛、胀痛的各占51％和42％;近70％伴发睡眠障碍,近50％平日情绪烦躁,近20％伴有情绪低落;63.15％和73.68％ MOH患者的偏头痛残疾程度评估问卷、头痛影响测试评分显示致残程度为重度.过量服用的药物种类包括非甾体类抗炎药与咖啡因的复合止痛剂、中成药、单组份的非甾体类抗炎药,其中非甾体类抗炎药与咖啡因的复合止痛剂占86％. 结论 MOH好发于中老年女性慢性偏头痛患者,程度较重,易伴发精神、睡眠障碍,严重影响生活.

Objective To investigate the clinical features of medication overuse headache （MOH） to provide data for the diagnosis and treatment of MOH.Methods Eighty-eight patients with MOH,admitted to our hospital from August 2011 to March 2012,were chosen in our study; the demographic characteristics,headache characteristics,concomitant symptoms and disability of these patients were analyzed statistically.Results MOH patients （aged 47.0±17.5 years and 80% being women） had the following characteristics：moderate to severe pain （98%）,throbbing or distending pain （51% and 42%,respectively）,locating in full head or temporal top,sleep disorders （70%）,emotional irritability （50%） and depression （20%）.Migraine Disability Assessment Questionnaire showed that about 63.15% patients had severe degree of disability and Headache Impact Test （HIT-6） indicated about 73.68% patients.The over-used medication was combination analgesic,including non-steroid anti-inflammatory drug and caffeine in 76 patients （86%）,Chinese patent drug in 10 patients （12%） and non-steroid anti-inflammatory drug in 2 patients （2%）.Conclusion Most MOH patients are old women with chronic migraine,whose typical characteristics of headache are moderate to severe throbbing or distending pain in full head or temporal top,often accompanied with depression,dysphoria and sleeplessness,which affects life deeply.