Center for Sleep Evaluation, Elliot Hospital, One Elliot Way, Manchester, NH 03103, USA.
Expert Rev Neurother. 2002 Sep;2(5):749-60. doi: 10.1586/14737175.2.5.749.
Behavioral treatments have become widely accepted interventions for migraine and tension-type headache. Ample empirical evidence supports the effectiveness of interventions, such as relaxation training, biofeedback and cognitive-behavioral (i.e., stress-management) treatments. Such interventions may be utilized alone or in combination with the more widely used pharmacological treatments for headache. Behavioral approaches are often the treatments of choice for patients who have contraindications to or who are refractory to traditional pharmacologic interventions. Recent research has attempted to increase the availability of behavioral treatments to patients through more cost-effective forms of treatment administration. Ample empirical evidence now indicates that these efficient interventions are just as effective as more time-intensive, individually administered clinic-based treatments. Important future directions for behavioral headache treatments include: integration into the primary care setting, developing algorithms for matching behavioral and pharmacologic treatments to patient characteristics for maximum effectiveness, behavioral skills training to enhance outcomes with pharmacologic interventions and reduce complications (e.g., rebound migraine), as well as identifying and treating comorbid conditions that undermine treatment.
行为治疗已被广泛接受为偏头痛和紧张型头痛的干预措施。大量的实证证据支持干预措施的有效性，如放松训练、生物反馈和认知行为（即压力管理）治疗。这些干预措施可以单独使用，也可以与更广泛使用的头痛药物治疗联合使用。对于有药物治疗禁忌或对传统药物干预有抗药性的患者，行为方法通常是首选治疗方法。最近的研究试图通过更具成本效益的治疗管理形式，为患者提供更多的行为治疗方法。现在有大量的实证证据表明，这些高效的干预措施与时间密集、个体化的诊所治疗一样有效。行为性头痛治疗的重要未来方向包括：将其纳入初级保健环境、为患者的行为和药物治疗匹配制定算法，以达到最佳效果、行为技能培训以提高药物干预的效果并减少并发症（例如，偏头痛反弹），以及确定和治疗破坏治疗效果的合并症。
