Hering R, Steiner T J
Princess Margaret Migraine Clinic, Charing Cross Hospital, London, UK.
Lancet. 1991 Jun 15;337(8755):1442-3. doi: 10.1016/0140-6736(91)93129-w.
46 migraineurs with secondary chronic daily headache were treated for medication abuse as outpatients by abrupt withdrawal of the offending drugs. The patients were supported with adequate explanation of the disorder, regular follow-up, amitriptyline (10 mg at night), and naproxen (500 mg) for relief of headache symptoms. By 6 months of follow-up 37 patients had relief from chronic headaches, and analgesic intake had become intermittent and appropriate to the original occasional migraine episodes. 6 had substantially reduced analgesic intake, but headache severity was unchanged; 2 had not managed to reduce intake and headache was unchanged; and 1 patient withdrew after the first visit.
46例继发性慢性每日头痛的偏头痛患者作为门诊病人接受了药物滥用治疗，即突然停用致病药物。向患者充分解释病情，定期随访，并给予阿米替林（每晚10毫克）和萘普生（500毫克）以缓解头痛症状。随访6个月时，37例患者的慢性头痛得到缓解，镇痛药物的服用变为间歇性，且与最初偶尔发作的偏头痛发作情况相符。6例患者的镇痛药物摄入量大幅减少，但头痛严重程度未变；2例患者未能减少药物摄入量，头痛情况也未改变；1例患者在首次就诊后退出。
