University of Pittsburg, Pittsburgh, PA, USA.
Med Clin North Am. 2021 Jan;105(1):39-53. doi: 10.1016/j.mcna.2020.09.005.
Headaches are common in primary care. The diagnosis is made by a careful history and physical examination. Imaging is generally not warranted. Several general principles underlie the acute treatment of headache: early initiation of therapy and adequate dosing at first dose. Careful attention to avoiding too frequent administration of acute therapy is important to avoid medication overuse headaches. Opioids should always be avoided. Preventive treatment is indicated for frequent headaches. Successful treatment entails low-dose medication with careful titration and monitoring of headache frequency. Behavioral strategies are important and should be part of any comprehensive headache management plan.
头痛在基层医疗中很常见。诊断需要通过仔细的病史询问和体格检查。一般不进行影像学检查。急性头痛治疗有几个基本原则：早期开始治疗和首剂足量。谨慎注意避免过于频繁使用急性治疗非常重要，以避免药物过度使用性头痛。应始终避免使用阿片类药物。对于频繁头痛，需要进行预防性治疗。成功的治疗需要低剂量药物，并谨慎滴定和监测头痛频率。行为策略很重要，应成为任何全面头痛管理计划的一部分。
