不同发作频率偏头痛病人头痛特征及伴随症状差异分析

ANALYSIS OF CHARACTERISTICS OF HEADACHE AND ACCOMPANYING SYMPTOMS IN MIGRAINE PATIENTS STRATIFIED BY ATTACK FREQUENCY

目的:分析不同发作频率偏头痛病人头痛特征及伴随症状的差异。方法:收集334例偏头痛病人,按照每月头痛天数分为偶发组(Infrequent episodic migraine,IEM,每月头痛天数≤2天)、频发组(Frequent episodic migraine,FEM,每月头痛天数3~14天)及慢性组(Chronic Migraine,CM,头痛≥15天/月,持续大于3个月,至少8天/月符合偏头痛特征)3个亚组,采集临床资料,并比较其头痛特点及伴随症状。结果:IEM与FEM组间头痛特征及伴随症状均无明显统计学差异(P>0.05);与IEM及FEM组相比,CM组搏动性头痛、活动后加重的病人比例明显减少(P<0.05);伴随症状中恶心、呕吐及畏声的比例无明显差异(P>0.05),畏光、畏嗅、异常疼痛比例明显增加(P<0.05);生活质量评分,IEM与FEM相比,抑郁、睡眠障碍评分无明显统计学差异(P>0.05),焦虑及头痛致残性评分存在差异(P<0.05),CM组与IEM及FEM组相比,所有生活质量相关评分均显著增高(均为P<0.01)。结论:FEM与IEM相比头痛症状及伴随症状差异不显著;CM与IEM及FEM相比,头痛症状较不典型,情感障碍、睡眠障碍及头痛致残性更严重,畏光、畏嗅及异常疼痛更常见。

Objective： This study was to compare the characteristics of headache and accompanying symptoms during headache attack in migraine patients stratified by attack frequency. Methods： Total 334 migraine patients were collected and divided into three subgroups by attack frequency： Infrequent episodic migraine group （IEM, Headache attackfrequency were less than 2 days per month）, Frequent episodic migraine group （FEM, Headache attackfrequencywere 3-14 days per month） and chronic migraine group （CM, Headache attackfrequency were 15 or more days per month formore than 3 months, which have the features of migraine headache for at least 8 days per month）. The clinic data were collected, and the characteristics of headache and accompanying symptoms were compared. Results： There were no significant differences in headache symptoms and accompanying symptoms between IEM group and EM group （P 〉 0.05）. Compared with IEM and FEM group, the proportion of patients with pulsatile quality and aggravation by daily activitieswas decreased in CM group （P 〈 0.05）; and there was no significant difference in nausea, vomiting and phonophobia between CM and EM groups （P 〉 0.05）; the rates of photophobia, olfactory and allodynia were in creasedsignificantlyin CM group （P 〈 0.05）; there was no significant difference indepression and sleep disorder scores between IEM group and FEM group （P 〉 0.05）, but the difference in anxiety and headache disability was marked between CM group and EM group. Compared with FEM group and IEM group, all the scores of quality of life were significantly increased in CM group （P 〈 0.01 for all）. Conclusions： There was no significant difference in headache symptoms and accompanying symptoms between FEM and IEM; Compared with IEM and FEMgroups, Headache symptoms are less typical in CM group, but anxiety, depression, sleep disorder and disability were more serious, and photophobia, osmophobia and abnormal pain are more common.