Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
J Clin Neurol. 2012 Sep;8(3):198-203. doi: 10.3988/jcn.2012.8.3.198. Epub 2012 Sep 27.
Chronic migraine (CM) has a significant impact on daily activities, and analgesic overuse is a major contributing factor to migraine transformation. Limited information is available on the functional consequences of CM stemming from analgesic overuse. This study evaluated the impact of the frequency of analgesic medication use on headache-related disability and clinical features in patients with CM.
PATIENTS WITH CM WERE ENROLLED CONSECUTIVELY AND CLASSIFIED INTO TWO GROUPS ACCORDING TO THEIR FREQUENCY OF MEDICATION USE: <15 days/month (CM-ML, n=52) and ≥15 days/month (CM-MH, n=68). All patients completed a structured questionnaire concerning the clinical features of their migraine, a validated version of the Migraine Disability Assessment questionnaire (MIDAS), and the Headache Impact Test-6 (HIT-6).
The pain intensity, as measured by a visual analog scale, was greater in the CM-MH group than in the CM-ML group (8.5±0.2 vs. 7.7±0.3, mean±SD; p<0.05). In the disability domain, the MIDAS scores were significantly higher for CM-MH patients than for CM-ML patients (47.6±4.8 vs. 26.8±4.5, p<0.01). The impact from migraine, as measured by the HIT-6, was greater for CM-MH patients than for CM-ML patients (65.6±1.0 vs. 62.1±1.0, p<0.05).
Our results indicate that the headache pain intensity and disability are greater in patients with CM who use medication frequently.
慢性偏头痛(CM)对日常活动有重大影响,而镇痛药滥用是偏头痛转化的主要因素。关于镇痛药滥用引起的 CM 的功能后果,信息有限。本研究评估了镇痛药使用频率对 CM 患者头痛相关残疾和临床特征的影响。
连续纳入 CM 患者,并根据用药频率将其分为两组:<15 天/月(CM-ML,n=52)和≥15 天/月(CM-MH,n=68)。所有患者均完成了关于偏头痛临床特征、经过验证的偏头痛残疾评估问卷(MIDAS)和头痛影响测试-6(HIT-6)的结构化问卷。
CM-MH 组的疼痛强度(用视觉模拟评分法测量)大于 CM-ML 组(8.5±0.2 对 7.7±0.3,平均值±标准差;p<0.05)。在残疾领域,CM-MH 患者的 MIDAS 评分明显高于 CM-ML 患者(47.6±4.8 对 26.8±4.5,p<0.01)。CM-MH 患者的偏头痛影响(用 HIT-6 测量)大于 CM-ML 患者(65.6±1.0 对 62.1±1.0,p<0.05)。
我们的结果表明,经常使用药物的 CM 患者头痛强度和残疾程度更大。