Holroyd K A, Nash J M, Pingel J D, Cordingley G E, Jerome A
Department of Psychology, Ohio University, Athens 45701.
J Consult Clin Psychol. 1991 Jun;59(3):387-93. doi: 10.1037//0022-006x.59.3.387.
Forty-one recurrent tension headache sufferers were randomly assigned to either cognitive-behavioral therapy (administered in a primarily home-based treatment protocol) or to amitriptyline therapy (with dosage individualized at 25, 50, or 75 mg/day). Cognitive-behavioral therapy and amitriptyline each yielded clinically significant improvements in headache activity, both when improvement was assessed with patient daily recordings (56% and 27% reduction in headache index, respectively), and when improvement was assessed with neurologist ratings of clinical improvement (94% and 69% of patients rated at least moderately improved, respectively). In instances where differences in treatment effectiveness were observed (headache index, somatic complaints, perceptions of control of headache activity), cognitive-behavioral therapy yielded somewhat more positive outcomes than did amitriptyline. Neither treatment, however, eliminated headache problems.
41名复发性紧张性头痛患者被随机分配到认知行为疗法组（主要采用家庭治疗方案）或阿米替林疗法组（剂量个体化，分别为25、50或75毫克/天）。当通过患者每日记录评估改善情况时（头痛指数分别降低56%和27%），以及当通过神经科医生对临床改善的评分评估改善情况时（分别有94%和69%的患者被评为至少有中度改善），认知行为疗法和阿米替林疗法在头痛活动方面均产生了具有临床意义的改善。在观察到治疗效果存在差异的情况下（头痛指数、躯体不适、对头痛活动控制的认知），认知行为疗法产生的积极结果比阿米替林疗法略多。然而，两种治疗方法都未能消除头痛问题。
