Rapoport Alan M
The New England Center for Headache, Stamford, CT 06902, USA.
J Headache Pain. 2006 Oct;7(5):355-9. doi: 10.1007/s10194-006-0327-x. Epub 2006 Oct 27.
Effective acute treatment of headache begins with making an accurate diagnosis and ruling out secondary causes of headache. Once a primary headache is diagnosed, it is important to choose the right combination of behavioural therapy and acute care (abortive and symptomatic) therapy for each patient. Some patients may need preventive medication on a daily basis. If patients overuse acute medications and develop medication overuse headache (previously called analgesic rebound headache), they often seek medical attention due to the chronicity and/or intensity of their pain and resultant disability. For acute care of migraine, physicians should choose a triptan they know and expect to work. They should prescribe the dose and route of administration that will provide the most rapid and complete response to all the associated symptoms of migraine, in addition to the pain. The effectiveness of the 7 available triptans in early, double-blind, controlled trials is more similar than different. How and when to give them will be discussed. Treatment of cluster headache will be presented briefly.
头痛的有效急性治疗始于准确诊断并排除头痛的继发原因。一旦诊断为原发性头痛，为每位患者选择正确的行为疗法和急性护理（中止发作和对症）疗法的组合非常重要。一些患者可能需要每日服用预防性药物。如果患者过度使用急性药物并发展为药物过量使用性头痛（以前称为止痛剂反弹性头痛），他们往往会因疼痛的慢性化和/或强度以及由此导致的残疾而寻求医疗关注。对于偏头痛的急性护理，医生应选择他们了解且预期有效的曲坦类药物。除疼痛外，他们应开具能对偏头痛所有相关症状提供最快速和完全缓解的剂量及给药途径。在早期双盲对照试验中，7种可用曲坦类药物的有效性差异不大。将讨论如何以及何时给予这些药物。将简要介绍丛集性头痛的治疗。
