Wright Edward F, Clark Elizabeth G, Paunovich Eleonore D, Hart Robert G
University of Texas Health Science Center, San Antonio, USA.
Cranio. 2006 Apr;24(2):104-11. doi: 10.1179/crn.2006.017.
The purpose of this study was to assess headache response of unselected neurology clinic chronic headache patients to TMD stabilization appliance and self-management therapies, and to identify features of patients whose headaches are more likely to improve from these therapies. Twenty chronic headache patients in a nontreatment control period were provided appliance and self-management therapies, evaluated five weeks after therapy, and those who chose to continue using their appliances were evaluated three months later. The mean pretreatment Headache Disability Inventory (HDI) score of 64.5 suggested the headaches were severe. After five weeks, the mean HDI score decreased by 17 percent (p<0.003), headache medication consumption dropped by 18 percent (p<0.0001), and headache symptoms decreased by 19 percent (p<0.002). Comparing the three months with pretreatment follow-up, the fourteen participants who chose to continue using their appliances had a mean HDI score decrease of 23 percent (p<0.003), headache medication consumption drop of 46 percent (p<0.001), and headache symptom decrease of 39 percent (p<0.001). There was no correlation between response and headache type (p=0.722). These results suggest appliance and self-management therapies can be beneficial for many severe headache patients, irrespective of the headache type (tension-type, migraine without aura, and migraine with aura).
本研究的目的是评估未经过筛选的神经内科门诊慢性头痛患者对颞下颌关节紊乱（TMD）稳定矫治器和自我管理疗法的头痛反应，并确定哪些患者的头痛更有可能通过这些疗法得到改善。20名处于非治疗对照期的慢性头痛患者接受了矫治器和自我管理疗法，在治疗5周后进行评估，那些选择继续使用矫治器的患者在3个月后再次接受评估。治疗前头痛残疾评定量表（HDI）的平均得分为64.5，表明头痛严重。5周后，HDI平均得分下降了17%（p<0.003），头痛药物消耗量下降了18%（p<0.0001），头痛症状减轻了19%（p<0.002）。将3个月后的情况与治疗前的随访结果进行比较，选择继续使用矫治器的14名参与者的HDI平均得分下降了23%（p<0.003），头痛药物消耗量下降了46%（p<0.001），头痛症状减轻了39%（p<0.001）。反应与头痛类型之间无相关性（p=0.722）。这些结果表明，矫治器和自我管理疗法对许多严重头痛患者可能有益，无论头痛类型如何（紧张型头痛、无先兆偏头痛和有先兆偏头痛）。
