Headache Unit & University Centre for Adaptive Disorders and Headache, University of Pavia, Pavia, Italy.
Cephalalgia. 2010 Mar;30(3):329-36. doi: 10.1111/j.1468-2982.2009.01934.x. Epub 2010 Feb 15.
To investigate factors influencing prognosis in medication-overuse headache (MOH), we conducted a 12-month follow-up of patients with probable MOH. We recruited 215 patients consecutively admitted to our headache centre for an inpatient detoxification treatment. We analysed likely predictor factors for headache resolution (sex, age, primary headache, psychiatric comorbidity, type and timing of overuse). Mann-Whitney U-test and chi-squared test were used. One year after withdrawal, we had complete data on 172 patients (80%): 38 of these patients (22%) had relapsed into overuse and 134 (78%) had not. The negative prognostic factors for relapse were: intake of more than 30 doses/month (P = 0.004), smoking (P = 0.012), alcohol consumption (P = 0.037), non-confirmation of MOH diagnosis 2 months after detoxification (P = 0.000), and return to overused drug(s) (P = 0.000). The 1-year relapse rate was 22%. The existence of sub-groups of MOH patients with such risk factors could influence treatment strategies.
为了探究影响药物过度使用性头痛（MOH）预后的因素，我们对可能患有 MOH 的患者进行了为期 12 个月的随访。我们连续招募了 215 名因住院解毒治疗而被送入头痛中心的患者。我们分析了头痛缓解的可能预测因素（性别、年龄、原发性头痛、精神共病、滥用的类型和时间）。使用了曼-惠特尼 U 检验和卡方检验。停药 1 年后，我们获得了 172 名患者（80%）的完整数据：其中 38 名患者（22%）复发过度使用，134 名患者（78%）未复发。复发的负性预测因素为：每月摄入超过 30 剂（P = 0.004）、吸烟（P = 0.012）、饮酒（P = 0.037）、解毒后 2 个月未确认 MOH 诊断（P = 0.000）以及恢复使用过度药物（P = 0.000）。1 年复发率为 22%。这些存在风险因素的 MOH 患者亚组的存在可能会影响治疗策略。
