偏头痛与躯体症状障碍共病现象  

Comorbidity of migraine and somatic symptom disorder

作　　者：尚成镇 孔凡斌[1] 吴林[1] 陈春富[2] SHANG Chengzhen;KONG Fanbin;WU Lin;CHEN Chunfu(Second Ward,Department of Neurology,People's Hospital of Rizhao,Rizhao,Shandong 276800,China;Department of Neurology,Shandong Provincial Hospital,Jinan,Shandong 250021,China)

机构地区：[1]日照市人民医院神经内科二病区,山东日照276800 [2]山东省立医院神经内科,山东济南250021

出　　处：《国际神经病学神经外科学杂志》2023年第4期95-100,共6页Journal of International Neurology and Neurosurgery

摘　　要：临床工作中可发现部分偏头痛与躯体症状障碍存在共病现象。两者在严重程度上相互影响。可能的共病机制涉及中枢敏化、大脑功能连接异常、5-羟色胺能系统功能障碍等。偏头痛共病躯体症状障碍患者常见的躯体症状有疲劳、失眠、恶心或消化不良、肢体疼痛、头晕、背痛和胸痛等。共病现象需要与偏头痛的非头痛症状、合并躯体症状的紧张性头痛、新发每日持续头痛相鉴别。治疗上可应用阿米替林、文拉法辛等抗抑郁药物以及认知行为疗法和正念疗法。The comorbidity of migraine and somatic symptom disorder is common in clinical practice,with severity influenced by each other.The possible comorbidity mechanisms involve central sensitization,abnormal brain functional connectivity,and dysfunction of the 5-hydroxytryptamine system.The common somatic symptoms of patients with migraine with somatic symptom disorder include fatigue,sleep difficulty,nausea or indigestion,extremity pain,dizziness,back pain,and chest pain.The comorbidity should be distinguished from non-headache symptoms of migraine as well as tension-type headache and new daily persistent headache with somatic symptoms.Migraine with somatic symptom disorder can be treated with antidepressants such as amitriptyline and venlafaxine,cognitive behavior therapy,and mindfulness-based therapy.

关 键 词：偏头痛 躯体症状障碍 共病 机制 治疗 

分 类 号：R747.2[医药卫生—神经病学与精神病学]