女性紧张性头痛及经期偏头痛影响因素的比较

Comparison of the influence factors of female tension-type headache and menstrual migraine

目的：比较女性紧张性头痛（ TTH）及经期偏头痛（ MM）的影响因素。方法收集104例女性TTH患者（TTH组）及91例MM患者（MM组）的临床资料。采用视觉模拟评分法（VAS）和头痛影响测评量表-6（HIT-6）对其头痛程度、生活质量进行评估，并采用汉密尔顿焦虑（HAMA）、抑郁量表（HAMD）对患者情绪障碍进行测定。结果 TTH组与经期相关19例，累积发病率18．3％；MM组与经期相关59例，累积发病率64．8％。与TTH组比较，MM组发病年龄显著降低，病程、家族史，焦虑、抑郁、重度疼痛、HIT-6（Ⅳ级）、共病的比率，以及HAMA、HAMD评分均显著升高（P＜0.05～0．01），而文化程度、吸烟、饮酒、职业差异无统计学意义（均P＞0.05）。无先兆的月经相关性偏头痛（ MRM）、无先兆的单纯月经性偏头痛（ PMM）及非月经性无先兆偏头痛患者发病年龄、家族史、VAS及HIT-6评分差异有统计学意义（P＜0.05～0．01）。结论与女性TTH比较，MM发病年龄更轻、病程更长，也更易合并焦虑、抑郁。在不同类型MM中，PMM发病年龄更早，有家族史的比率更高；而MRM的重度疼痛率及HIT-6评分最高。

Objective To compared the influence factors of female tension-type headache （ TTH ） and menstrual migraine （ MM） .Methods Clinical data of 104 female patients with TTH （ TTH group） and 91 patients with MM （MM group） were collected.The headache degree and the quality of life were evaluated by visual analogue scale （VAS） and headache impact test-6 （HIT-6）.Emotional disorders were measured by Hamilton anxiety scale （ HAMA） and Hamilton depression scale （ HAMD） .Results There were 19 cases of menstrual related headache in TTH group, cumulative incidence rate was 18.3%.There were 59 cases of menstrual related headache in MM group , and cumulative incidence rate was 64.8%.Compared with TTH group , age in MM group was significantly decreased , and course of disease, family history, anxiety, depression, severe pain, HIT-6 （ IV） lever, comorbidity rate, HAMA, HAMD score in MM group were significantly increased （P〈0.05 -0.01）, but there was no significant correlation in the level of education, smoking, drinking, and occupation （all P〉0.05）.Among menstrually related migraine without aura（MRM）, pure menstrual migraine without aura （PMM） and non-menstrual migraine without aura patients, significant differences were found in the onset age , family history, VAS and HIT-6 score （P〈0.05-0.01）.Conclusions Compared with female TTH, MM patients have a lower age of onset , longer course of disease , and a higher rate of anxiety and depression .Among different types of MM , the onset age is younger in PMM , with a higher rate of positive family history .The rate of severe pain and the score of HIT-6 are higher in MRM .