Nicolodi M, Sicuteri F
Internal Medicine Department, Florence University, Italy.
Drugs Exp Clin Res. 1999;25(2-3):147-53.
According to popular belief, alcoholic beverages are to be avoided in the case of headache, a term which includes migraine, the most common type of headache. An imbalance between pain transmission and inhibition has been suggested and partly proved to be the mechanism of migraine. This means that peripherally acting substances following wine intake are unlikely to trigger migraine attacks. We hypothesized that factors other than the mere consumption of alcohol can trigger migraine attacks. In an attempt to corroborate this assumption, we carried out a 14-month study in 307 volunteers. All the volunteers had no health problems apart from suffering from migraine without aura. During the entire study period, patients had to complete a diary/questionnaire every time they consumed alcohol. The questionnaires included items regarding the quantity (measured in dl) and the type of alcohol they consumed as well as information about their lifestyle. The volunteers also had to complete a pain diary. It was observed that spirits and sparkling wines were significantly (p > 0.0001) more frequently related to migraine attacks than other alcoholic beverages. Nonetheless, there was no statistical relationship between the consumption of alcohol and migraine attacks. On the other hand, a positive relationship was established between stressful events and the onset of migraine attacks. As an overall result, it was observed that low amounts of alcohol (i.e., 1 dl of 4-14% alcohol/vol. and 0.4 dl of 35-42% alcohol/vol.) did not induce a significant increase in the frequency of migraine attacks. Moreover, it emerged that alcoholic beverage intake during stress periods was related to a significantly higher frequency of migraine attacks (p > 0.0001 for spirits and sparkling wines, p > 0.009 for red wine and p > 0.006 and p > 0.004 for white wine and beer, respectively). Routine blood tests revealed that the subjects who prefer red wine showed a lower level (p > 0.05) of total cholesterol, independently of sex or age. Due to the small sample size (197 vs. 96 tested subjects), this last observation can not be regarded as conclusive.
根据普遍看法，在头痛（包括最常见的头痛类型偏头痛）的情况下应避免饮用酒精饮料。有人提出并部分证明了疼痛传递与抑制之间的失衡是偏头痛的发病机制。这意味着饮酒后作用于外周的物质不太可能引发偏头痛发作。我们推测除了单纯饮酒之外的其他因素也可能引发偏头痛发作。为了证实这一假设，我们对307名志愿者进行了为期14个月的研究。所有志愿者除了患有无先兆偏头痛外没有其他健康问题。在整个研究期间，患者每次饮酒都必须填写日记/问卷。问卷包括饮酒量（以分升为单位）、饮酒类型以及他们生活方式的相关信息。志愿者还必须填写疼痛日记。结果发现，与其他酒精饮料相比，烈酒和起泡酒与偏头痛发作的关联更为显著（p>0.0001）。然而，饮酒量与偏头痛发作之间没有统计学关联。另一方面，压力事件与偏头痛发作的起始之间建立了正相关关系。总体结果显示，少量饮酒（即4%-14%酒精度/体积的1分升酒和35%-42%酒精度/体积的0.4分升酒）并未导致偏头痛发作频率显著增加。此外，还发现压力期间饮酒与偏头痛发作频率显著更高相关（烈酒和起泡酒p>0.0001，红酒p>0.009，白葡萄酒和啤酒分别为p>0.006和p>0.004）。常规血液检测显示，偏爱红酒的受试者总胆固醇水平较低（p>0.05），与性别或年龄无关。由于样本量较小（197名受试者接受检测，96名受试者接受检测），最后这一观察结果不能被视为结论性的。
