Rollnik J D, Tanneberger O, Schubert M, Schneider U, Dengler R
Department of Neurology and Clinical Neurophysiology, Medical School of Hannover, Germany.
Headache. 2000 Apr;40(4):300-5. doi: 10.1046/j.1526-4610.2000.00044.x.
To determine whether injections of botulinum toxin could be of therapeutic value in the treatment of tension-type headache.
Botulinum toxin A is very effective at reducing muscle tenderness and pain in many diseases. Increased muscle tension may contribute to tension-type headache.
We performed a double-blind, placebo-controlled study with 21 patients fulfilling the International Headache Society criteria for tension-type headache. Participants were randomly assigned to treatment (pericranial injection of 10 x 20 mouse units botulinum toxin A) or placebo (injection of isotonic saline in the same manner).
After 4, 8, and 12 weeks, no significant differences between placebo and treatment could be observed (with respect to visual analog scale, frequency and duration of headache attacks, consumption of analgesics, pressure pain threshold, total tenderness score, and quality-of-life parameters).
The findings of our study strongly support the hypothesis that peripheral mechanisms, such as increased muscle tenderness, only play a minor role in the pathogenesis of tension-type headache.
确定注射肉毒杆菌毒素对紧张型头痛的治疗是否具有价值。
A型肉毒杆菌毒素在减轻许多疾病的肌肉压痛和疼痛方面非常有效。肌肉紧张加剧可能导致紧张型头痛。
我们对21例符合国际头痛协会紧张型头痛标准的患者进行了一项双盲、安慰剂对照研究。参与者被随机分配接受治疗（颅骨周围注射10×20小鼠单位A型肉毒杆菌毒素）或安慰剂（以相同方式注射等渗盐水）。
在4周、8周和12周后，未观察到安慰剂组和治疗组之间有显著差异（在视觉模拟量表、头痛发作频率和持续时间、镇痛药消耗量、压痛阈值、总压痛评分和生活质量参数方面）。
我们的研究结果有力地支持了这样一种假设，即诸如肌肉压痛增加等外周机制在紧张型头痛的发病机制中仅起次要作用。
