偏头痛伴发枕大神经痛的临床意义  

CLINICAL SIGNIFICANCE OF MIGRAINE ACCOMPANYING GREATER OCCIPITAL NERVE PAIN

作　　者：雷革胜[1] 宿长军[1] 苗建亭[1] 林宏[1] 李柱一[1] 

机构地区：[1]第四军医大学唐都医院神经内科,西安710038

出　　处：《中国疼痛医学杂志》2012年第7期407-409,共3页Chinese Journal of Pain Medicine

摘　　要：目的：观察偏头痛伴发枕大神经痛的临床意义。方法：对1998~2010年我院神经内科专科门诊382例偏头痛患者按照性别、发作类型、病程进行亚组分型,分别统计伴发枕大神经痛的发生率。将偏头痛患者按治疗方式分为封闭＋药物组（发作性偏头痛30例、慢性偏头痛50例）和药物组（发作性偏头痛20例、慢性偏头痛50例）,比较枕大神经封闭对总疗效影响。结果：男性、女性偏头痛并发枕大神经痛比例分别为36%和37%;先兆性和无先兆性偏头痛合并枕大神经痛比例分别为42%和36%;发作性和慢性偏头痛合并枕大神经痛比例分别为25%和56%（P〈0.001）。发作性偏头痛总疗效86%,慢性偏头痛总疗效71%（P〈0.05）;慢性偏头痛亚组中,封闭＋药物组有效率84%,药物组有效率58%（P〈0.05）。结论：偏头痛并发枕大神经痛与否与其病程有关,枕大神经痛可能是偏头痛慢性化临床指标之一。合并治疗枕大神经痛可有效提高偏头痛的治愈率。Objective： To observe the clinical significance of migraine accompanying greater occipital nerve pain. Method： 382 migrainuers from our neurology clinic service from 1998 to 2010 were divided into two groups according to their gender, attack type and course： blocking plus drugs group and simply drugs groups. Occurrence rates of greater occipital nerve pain were calculated correspondingly. The influence of blocking greater occipital nerve on curative effect was compared according to different therapy as both blocking plus drugs and simply drugs. Results： The occurrence ratio of migraine accompanying greater occipital nerve pain were： 36% in male, 37% in female; 42% with aura, 36% without aura; and 25% in episodic, 56% in chronic （P 〈 0.001）. The total curative effect was 86% in episodic migraine, 71% in chronic migraine （P 〈 0.05）. In the subgroup of chronic migraine, the curative effect was 84% in blocking plus drugs, 58% in simply drugs （P 〈 0.05）. Conclusion： The course of migraine was related to whether or not accompanying with greater occipital nerve pain. Greater occipital nerve pain may be one of clinical indicators of migraine chronication. Administration to greater occipital nerve pain may help to cure migraine.

关 键 词：偏头痛 枕大神经痛 慢性化 

分 类 号：R747.2[医药卫生—神经病学与精神病学]