Laube Justin G, Salles Araujo Thais, Taw Lawrence B
UCLA Center for East-West Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
Division of General Internal Medicine and Health Service Research, Department of Medicine, University of California, Los Angeles, Los Angeles, California.
Glob Adv Health Med. 2020 Feb 13;9:2164956120905817. doi: 10.1177/2164956120905817. eCollection 2020.
Chronic daily headache is a group of headache syndromes including most commonly chronic migraine and chronic tension-type headache, which often overlap, are complicated by medication overuse and are disabling, costly, and variable responsive to western pharmacotherapeutic interventions. There is growing research and awareness of integrative health approaches and therapies to address patients with chronic headache, yet limited examples of how to deliver this approach. This article reviews a commonly seen challenging case of a patient with overlapping chronic migraine and chronic tension-type headache complicated by medication overuse managed with an integrative east-west medicine intervention. This included person-centered biopsychosocial history taking, traditional Chinese medicine informed acupuncture, trigger point injections, and contributing factors modifications. A narrative review of the literature is presented to demonstrate an evidence-informed rationale for incorporating nonpharmacologic approaches to effectively help reduce the symptom burden of this patient population.
慢性每日头痛是一组头痛综合征,最常见的包括慢性偏头痛和慢性紧张型头痛,它们常常相互重叠,因药物过度使用而复杂化,会导致残疾、花费高昂且对西方药物治疗干预的反应多变。针对慢性头痛患者的综合健康方法和疗法的研究及认知日益增加,但关于如何实施这种方法的实例却很有限。本文回顾了一个常见的具有挑战性的病例,该患者同时患有慢性偏头痛和慢性紧张型头痛且相互重叠,并伴有药物过度使用,采用中西医结合干预进行治疗。这包括以患者为中心的生物心理社会病史采集、基于中医理论的针灸、触发点注射以及对促成因素的调整。本文还进行了文献综述,以证明采用非药物方法有效帮助减轻该患者群体症状负担的循证依据。