Heinze A, Heinze-Kuhn K, Göbel H
Neurologisch-verhaltensmedizinische Schmerzklinik Kiel, Heikendorfer Weg 9-27, 24149, Kiel.
Schmerz. 2010 Feb;24(1):73-9; quiz 80. doi: 10.1007/s00482-009-0858-6.
With the introduction of the highly effective triptans in the treatment of acute migraine attacks, the significance of migraine prevention temporarily lost ground in the awareness of doctors and, even more so, patients. This was unjustified, as the increasing numbers of patients with triptan-overuse headache clearly demonstrated. Recent years have seen this trend reversed with a resurgence of migraine prevention. In daily practice the first question is whether migraine prevention is indeed indicated for the patient. If answered affirmatively, the next step is the intricate selection of the most promising agent for the patient. Treatment guidelines regularly updated by the relevant medical societies provide a general overview of the agents principally available according to the principles of evidence-based medicine. Yet, low compliance rates suggest that in practice implementation of these guidelines may have to be tailored to the patient in question. The treatment algorithm presented here tries to bridge the gulf between general treatment guidelines and the actual needs of the patient. From this, feasible clinical pathways are derived for individualized treatment.
随着高效曲坦类药物被引入急性偏头痛发作的治疗，偏头痛预防的重要性在医生甚至患者的认知中暂时失宠。这是不合理的，因为曲坦类药物过度使用性头痛患者数量的增加清楚地表明了这一点。近年来，这种趋势发生了逆转，偏头痛预防再度兴起。在日常实践中，首要问题是偏头痛预防是否确实适用于该患者。如果答案是肯定的，下一步就是为患者精心挑选最有前景的药物。相关医学学会定期更新的治疗指南根据循证医学原则对主要可用药物提供了总体概述。然而，低依从率表明，在实践中，这些指南的实施可能必须根据相关患者进行调整。此处呈现的治疗算法试图弥合一般治疗指南与患者实际需求之间的差距。由此得出针对个体化治疗的可行临床路径。
