紧张型头痛的临床特征、治疗效果与国际诊断标准测试  

CLINICAL CHARACTERISTICS, EFFECT OF TREATMENTS AND CLINICAL TEST OF DIAGNOSTIC CRITERIA IN ICHD-3β FOR TENSION-TYPE HEADACHE

作　　者：孔雪莹[1] 陈津津[1] 姜花花 李琴[2] 吕玉花 黄园媛 吴瑾[5] 张莉莉 唐明山[3] 蒋晓静 陈莉芬[8] 陈敏 周志强[10] 熊联强 刘静 周红梅 王若丹 薛维[14] 卢干珍 周冀英[1] KONG Xue-Ying;CHEN Jin-Jin;JIANG Hua-Hua;LI Qin;LV Yu-Hua;HUANG Yuan-Yuan;WU Jin;ZHANG Li-Li;TANG Ming-Shan;JIANG Xiao-Jing;CHEN Li-Fen;CHEN Min;ZHOU Zhi-Qiang;XIONG Lian-Qiang;LIU Jing;ZHOU Hong-Mei;WANG Ruo-Dan;XUE Wei;LU Gan-Zhen;ZHOU Ji-Ying(Department of Neurology,The First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China;Department of Neurology,The Third People's Hospital of Chongqing,Chongqing,400014,China;Department of Neurology,Nanchuan People's Hospital of Chongqing Medical University,Chongqing,408499,China;Department of Neurology,People's Hospital of Qijiang District,Chongqing,401420,China;Department of Neurology,Xinqiao Hospital,Third Military Medical University,Chongqing,400037,China;Department of Neurology,Chongqing Sanxia Central Hospital,Chongqing,404000,China;Department of Neurology,People's Hospital of Bishan County,Chongqing,402760,China;Department of Neurology,Zhongshan Hospital of Chongqing,Chongqing,400013,China;Department of Neurology,Banan People’s Hospital of Chongqing,Chongqing,401320,China;Department of Neurology,South-West Hospital,Third Military Medical University,Chongqing,400038,China;Department of Neurology,The Ninth People's Hospital of Chongqing,Chongqing,400700,China;Department of Neurology,The Third Affiliated Hospital of Third Military Medical University,Chongqing,400042,China;Department of Neurology,The people's Hospital of Yongchuan District,Chongqing,402160,China;Department of Neurology,The Second Affiliated Hospital of Chongqing Medical University,Chongqing,400010,China;Department of Neurology,The First People's Hospital of Jiangbei District,Chongqing,400020,China)

机构地区：[1]重庆医科大学附属第一医院神经内科,重庆400016 [2]重庆市中山医院神经内科,重庆400013 [3]重庆市巴南区人民医院神经内科,重庆401320 [4]陆军军医大学西南医院神经内科,重庆400038 [5]重庆市第九人民医院神经内科,重庆400700 [6]陆军军医大学大坪医院神经内科,重庆400042 [7]重庆永川区人民医院神经内科,重庆402160 [8]重庆医科大学附属第二医院神经内科,重庆400010 [9]重庆市江北区第一人民医院神经内科,重庆400020 [10]重庆市第三人民医院神经内科,重庆400014 [11]南川区人民医院神经内科,重庆408499 [12]綦江区人民医院神经内科,重庆401420 [13]陆军军医大学新桥医院神经内科,重庆400037 [14]重庆三峡中心医院神经内科,重庆404000 [15]重庆璧山人民医院神经内科,重庆402760

出　　处：《中国疼痛医学杂志》2018年第9期666-670,共5页Chinese Journal of Pain Medicine

摘　　要：目的:旨在研究国人紧张型头痛(tension-type headache,TTH)的临床特征、治疗效果,并对ICHD-3β诊断标准进行测试。方法:2014年3月到2015年12月,在重庆15家医院的神经内科门诊纳入150例TTH病人,收集其人口统计学、头痛特征等临床数据。通过电话或者复诊的方式进行随访。结果:研究共纳入150例TTH病人。与发作性紧张型头痛(episodic tension-type headache,ETTH)相比,慢性紧张型头痛(chronic tension-type headache,CTTH)病人年龄更大,女性更多,教育程度更低,且存在药物过度使用。所有TTH病人均表现为轻中度头痛。98.0%表现为非搏动性头痛,99.3%病人表现为日常活动不会加重头痛。阿米替林联合养血清脑颗粒治疗的病人中,64.9%取得了明显的改善。结论:在神经科门诊筛查TTH病人,非搏动性头痛和日常活动不加重头痛可能是很重要的两点。中成药为TTH的治疗提供了一种新思路。Objective:The aim of the present study was to explore the clinical features,diagnosis and treatment of tension-type headache(TTH)based on ICHD-3 beta.Methods:Clinical features and demographic characteristics were prospectively collected from 150 patients,who were diagnosed with tension-type headache(TTH)at 15 participating hospitals in Chongqing from March 2014 to December 2015.Moreover,the follow-up was conducted through direct interview or semi-structured telephone interview after starting treatment.Results:A total of 150 patients were diagnosed with TTH based on ICHD-3β.Compared to patients with episodic tension-type headache(ETTH),the patients with chronic tension-type headache(CTTH)were more likely to be less-educated elder female,who often overuse analgesics.All patients with TTH showed mild or moderate headache.Most patients(98.0%)manifested non-pulsating headache,and the headache was not aggravated by routine physical activity in 99.3%of the patients.64.9%of the patients with TTH showed significant clinical remission to the treatment of amitriptyline combined with Yangxue Qingnao Granule.Conclusion:Non-pulsating headache and the headache that is not aggravated by routine physical activity may be the two important features to screen patients with complaint of headache in neurologic clinics.Chinese patent medicine may provide a new method for TTH treatment.

关 键 词：紧张型头痛 临床特征 诊断标准 治疗 

分 类 号：R741[医药卫生—神经病学与精神病学]