慢性偏头痛的病理生理机制研究现状及针刺潜在作用机制探讨

Pathophysiological Mechanism of Chronic Migraine and Potential Mechanisms of Acupuncture

慢性偏头痛通常由偏头痛进展而来,每月头痛超过15 d,高发焦虑抑郁等慢性共病,致残性更甚,严重损害了患者的生命质量。近年来慢性偏头痛发病率逐年上升,然而其慢性化进展的病理生理机制仍不清晰,给临床预防性治疗及进一步机制研究带来了阻碍,探讨慢性偏头痛进展的潜在病理生理机制可能对临床治疗产生积极指导作用。现从非典型疼痛处理、中枢致敏、皮质高兴奋性和大脑可塑性改变方面对慢性偏头痛的进展机制进行综述,并对针刺干预慢性偏头痛的潜在机制进行探讨,以期为预防性治疗慢性偏头痛,以及防止偏头痛慢性化进程提供借鉴与参考。

Chronic migraine usually progresses from migraine, which is manifested by more than 15 days of headache per month and a high incidence of chronic comorbidities such as anxiety and depression.Chronic migraine has high disability, which seriously damages the quality of life of patients.Recently, the incidence rate of chronic migraine is gradually increasing, but its pathophysiological mechanism is still unclear, which hinders the research on clinical prophylactic treatment and further mechanisms.The research on the underlying pathophysiological mechanism of chronic migraine may play a positive guiding role in clinical treatment.This paper reviewed the progress mechanism of chronic migraine from the aspects of atypical pain management, central sensitization, cortical euphoria, and brain plasticity, and discussed the potential mechanisms of acupuncture in the treatment of chronic migraine, hoping to provide references for the prophylactic treatment of chronic migraine and the prevention of the chronic progress of migraine.