头痛:洞察、理解、治疗与患者管理
Headache: insight, understanding, treatment and patient management.
作者信息
Diener H-C
机构信息
Department of Neurology and Headache Center, University Hospital Essen, Essen, Germany.
出版信息
Int J Clin Pract Suppl. 2013 Jan(178):33-6. doi: 10.1111/ijcp.12049.
Tension-type headache and migraine are the most frequent primary headaches. Diagnosis is based on the patient's history and a normal neurological examination. Most patients with these two headache entities treat headache episodes with over-the-counter analgesics or non-steroidal anti-inflammatory drugs (NSAIDs). There is good scientific evidence from randomised, placebo-controlled trials indicating that aspirin, ibuprofen, ketoprofen, diclofenac and naproxen are effective in tension-type and migraine headache. Paracetamol seems to be less effective. In patients with migraine who do not respond to analgesics or NSAIDs, triptans should be prescribed. Frequent primary headaches should not be treated with frequent intake of analgesics or triptans. In these cases, preventive therapy needs to be implemented.
紧张型头痛和偏头痛是最常见的原发性头痛。诊断基于患者的病史和正常的神经系统检查。大多数患有这两种头痛类型的患者使用非处方镇痛药或非甾体抗炎药(NSAIDs)来治疗头痛发作。随机、安慰剂对照试验提供了充分的科学证据,表明阿司匹林、布洛芬、酮洛芬、双氯芬酸和萘普生对紧张型头痛和偏头痛有效。对乙酰氨基酚似乎效果较差。对于对镇痛药或NSAIDs无反应的偏头痛患者,应开具曲坦类药物。不应频繁使用镇痛药或曲坦类药物来治疗频繁发作的原发性头痛。在这些情况下,需要实施预防性治疗。