【摘要】 目的:观察药物过量性头痛(medication overuse headache, MOH)的临床特点及疗效评估。方法:纳入符合诊断标准的MOH病人,采用程序化戒药治疗结合相对个体化治疗,完成1年随访。采用头痛日记、视觉模拟评分法(visual analogue scale, VAS)记录治疗前及随访期间每月头痛天数、镇痛药物使用的天数及头痛程度,对合并情绪障碍者评估治疗前后焦虑、抑郁程度。结果:19例入组病人仅1例简单型,余为复杂型。在随访期间每月头痛天数、镇痛药物使用天数及头痛程度与治疗前相比,均有明显降低(P <0.01)。治疗第6、12个月总有效率分别为64.70%、68.75%。伴随的焦虑、抑郁程度于治疗第6个月较基线明显降低(P <0.05),第12个月较基线降低但无统计学意义。有与无情绪障碍共病MOH病人相比,随访第6、12个月疗效相当,但前者治疗前每天服用镇痛药剂量更多(P <0.05)。结论:MOH病人多伴有情绪障碍,且为复杂型。建议程序化戒药治疗基础上采用个体化的治疗方案。更多还原

【Abstract】 Objective: To analyze the clinical characteristics and therapeutic effect of medication overuse headache(MOH). Methods: MOH patients were screened according to the diagnostic criteria. The structured detoxi?cation treatment was adopted, and the individualized treatment was used to part of the patients. The MOH patients were followed up for one year. The days of acute headache per month, the days of taking analgesics per month, and the headache intensity were recorded before treatment and during follow-up period by using the headache diary and visual analogue scale(VAS). The levels of anxiety and depression of those patients with emotional disorder were evaluated before and during follow-up period. Results: Among 19 cases of MOH patients enrolled in the treatment study, only one case is simple type, the others are complicated type. During the follow-up period, the MOH patients’ headache frequency and the days of taking analgesics and the headache intensity compared with that of the baseline, were signi?cantly reduced(P < 0.01). The total effective rates were 64.70% and 68.75% at the 6 th month and 12 th month, respectively. At the 6 th month the patients’ anxiety and depression levels were signi?cantly lower than that of the baseline(P < 0.05). At the 12 th month the patients’ anxiety and depression levels were lower than that of the baseline too, but the difference was not statistically signi?cant. There was no signi?cant difference found in the treatment ef?cacy between patients with emotional disorder and patients without at 6 th and 12 th month follow-up. The MOH patients with emotional disorders took more analgesics everyday compared with the patients with no emotional disorders before treatment(P < 0.05). Conclusion: Most of the MOH patients are complicated type and often accompanied by emotional disorders. Based on the structured detoxi?cation treatment, the individualized treatment program is recommended.更多还原