性活动相关原发性头痛6例临床分析

Clinical analysis in 6 cases of primary headache associated with sexual activity

目的：分析和探讨与性活动相关的原发性头痛的临床特点,并对其诊断和治疗加以总结,以期为提高与性活动相关的原发性头痛的认识,改善临床治疗效果。方法：入选2011年6月至2014年1月于本院就诊的与性活动相关的原发性头痛患者6例作为研究观察对象,针对其临床表现进行分析,同时总结其诊断和治疗相关结果。结果：入选6例患者中5例患者进行预防性治疗,3例应用普萘洛尔20mg,日3次口服治疗,2例有效,1例无效;2例应用尼莫地平30mg,日3次口服治疗,均有效;剩余1例未进行预防性治疗;6例患者中4例应用吲哚美辛25~50mg进行先期治疗,其中3例有效,1例无效后应用布洛芬0.1g起效;2例应用舒马普坦0.1g进行先期治疗,均有效。6例患者均随访时间12个月。患者疼痛情况均有明显改善,差异具有显著性,P〈0.05。结论：与性活动相关的原发性头痛属于临床罕见病例,临床应提高对疾病的认识,预防性治疗可以选用普萘洛尔、尼莫地平,而先期治疗可以采用吲哚美辛、布洛芬等药物。

Objectives：To study the clinical features of primary headache associated with sexual activity（ PHASA） and summarize its diagnosis and treatment so as to increase the awareness of PHASA and improve the clinical treatment effect.Methods：6 patients with PHASA treated in our hospital from June 2011 to January 2014 were selected.The clinical features,diagnosis and treatment outcomes were analyzed and summarized.Results：For5 patients receiving prophylactic treatment,3 cases received Propranolol（ 20mg）,3 times a day;2 cases were valid and 1 case was invalid.2 cases received Nimodipine（ 30mg） 3 times a day;2 cases were valid.1 case did not adopt prophylactic treatment.4 cases received preoperative treatment of Indomethacin（ 25-50mg）;3 cases were valid;1 case was invalid,who then received Ibuprofen（ 0.1g） and was valid.2 cases adopted preoperative treatment of Sumatriptan（ 0.1g） and were both valid.After 12 months＇ follow-up visits,the pain was significantly improved（ P 〈0.05）.Conclusions：PHASA is rarely seen in clinical practices and the awareness of PHASA shall be increased.The prophylactic treatment can choose Propranolol,Nimodipine and preoperative treatment can choose Indomethacin,Ibuprofen,etc.