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[慢性偏头痛患者的疼痛灾难化思维与药物过度使用]

[Pain catastrophizing and medication overuse in patients with chronic migraine].

作者信息

Barral E, Buonanotte F

机构信息

Hospital Nacional de Clínicas. Universidad de Córdoba, Córdoba, Argentina.

出版信息

Rev Neurol. 2020 Apr 16;70(8):282-286. doi: 10.33588/rn.7008.2020034.

Abstract

INTRODUCTION

Migraine is a frequent and debilitating primary headache. Pain catastrophizing is a negative set activated in response to anticipated or actual pain. The anticipatory fear of pain, one of its characteristics, has been associated with a greater prescription and use of analgesics.

AIM

To explore the pain catastrophizing in relation to analgesic overuse and the headache impact on quality of life in patients with chronic migraine.

PATIENTS AND METHODS

An observational cross-sectional analytical study was performed. Patients older than 18 years with chronic migraine were included, who were given anonymously the Pain Catastrophizing Scale and the Head Impact Test-6.

RESULTS

When comparing the incidence of analgesic overuse among patients with clinical pain catastrophizing levels and those without pain catastrophizing, the probability of analgesic overuse was 16 times higher in the first group (odds ratio = 16.06; 95% CI = 5.91-43.61; p < 0.0001). When comparing the presence of a severe migraine impact in patients with and without pain catastrophizing, the probability of a severe migraine impact is approximately eight times greater in the first group (odds ratio = 8.27; 95% CI = 3.19-21.42; p < 0.0001).

CONCLUSION

Clinical levels of pain catastrophizing in patients with chronic migraine might be associated with a higher incidence of analgesic overuse and a greater headache impact on quality of life.

摘要

引言

偏头痛是一种常见且使人衰弱的原发性头痛。疼痛灾难化是一种在预期或实际疼痛时被激活的消极思维模式。其特征之一——对疼痛的预期恐惧,与更多的镇痛药处方和使用有关。

目的

探讨慢性偏头痛患者的疼痛灾难化与镇痛药过度使用以及头痛对生活质量的影响之间的关系。

患者与方法

进行了一项观察性横断面分析研究。纳入年龄大于18岁的慢性偏头痛患者,他们被匿名给予疼痛灾难化量表和头痛影响测试-6。

结果

比较有临床疼痛灾难化水平的患者和无疼痛灾难化的患者中镇痛药过度使用的发生率时,第一组中镇痛药过度使用的概率高出16倍(优势比 = 16.06;95%置信区间 = 5.91 - 43.61;p < 0.0001)。比较有和无疼痛灾难化的患者中存在严重偏头痛影响的情况时,第一组中出现严重偏头痛影响的概率大约高出8倍(优势比 = 8.27;95%置信区间 = 3.19 - 21.42;p < 0.0001)。

结论

慢性偏头痛患者的临床疼痛灾难化水平可能与更高的镇痛药过度使用发生率以及头痛对生活质量的更大影响有关。

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