原发性头痛障碍的诊断和预防治疗现状：中国真实世界未满足需求数据。

Status of diagnosis and preventative treatment for primary headache disorders: real-world data of unmet needs in China.

机构信息

Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.

International Headache Center, Chinese PLA General Hospital, Beijing, 100853, China.

出版信息

J Headache Pain. 2023 Sep 1;24(1):119. doi: 10.1186/s10194-023-01654-6.

DOI:10.1186/s10194-023-01654-6

PMID:37653478

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10472552/

Abstract

BACKGROUND

Headache disorders are widely prevalent and pose a considerable economic burden on individuals and society. Globally, misdiagnosis and inadequate treatment of primary headache disorders remain significant challenges, impeding the effective management of such conditions. Despite advancements in headache management over the last decade, a need for comprehensive evaluations of the status of primary headache disorders in China regarding diagnosis and preventative treatments persists.

METHODS

In the present study, we analyzed the established queries in the Survey of Fibromyalgia Comorbidity with Headache (SEARCH), focusing on previous diagnoses and preventative treatment regimens for primary headache disorders. This cross-sectional study encompassed adults diagnosed with primary headache disorders who sought treatment at 23 hospitals across China between September 2020 to May 2021.

RESULTS

The study comprised 2,868 participants who were systematically examined. Migraine and tension-type headaches (TTH) constituted a majority of the primary headache disorders, accounting for 74.1% (2,124/2,868) and 23.3% (668/2,868) of the participants, respectively. Medication overuse headache (MOH) affected 8.1% (231/2,868) of individuals with primary headache disorders. Over half of the individuals with primary headache disorders (56.6%, 1,624/2,868) remained undiagnosed. The previously correct diagnosis rates for migraine, TTH, TACs, and MOH were 27.3% (580/2,124), 8.1% (54/668), 23.2% (13/56), and 3.5% (8/231), respectively. The misdiagnosis of "Nervous headache" was found to be the most prevalent among individuals with migraine (9.9%, 211/2,124), TTH (10.0%, 67/668), trigeminal autonomic cephalalgias (TACs) (17.9%, 10/56), and other primary headache disorders (10.0%, 2/20) respectively. Only a minor proportion of individuals with migraine (16.5%, 77/468) and TTH (4.7%, 2/43) had received preventive medication before participating in the study.

CONCLUSIONS

While there has been progress made in the rate of correct diagnosis of primary headache disorders in China compared to a decade ago, the prevalence of misdiagnosis and inadequate treatment of primary headaches remains a veritable issue. As such, focused efforts are essential to augment the diagnosis and preventive treatment measures related to primary headache disorders in the future.

摘要

背景

头痛障碍广泛存在，给个人和社会带来了相当大的经济负担。在全球范围内，原发性头痛障碍的误诊和治疗不足仍然是一个重大挑战，阻碍了此类疾病的有效管理。尽管在过去十年中头痛管理取得了进展，但仍需要全面评估中国原发性头痛障碍的诊断和预防治疗现状。

方法

本研究分析了纤维肌痛共病头痛调查（SEARCH）中的既定查询，重点关注原发性头痛障碍的既往诊断和预防治疗方案。这项横断面研究纳入了 2020 年 9 月至 2021 年 5 月期间在中国 23 家医院就诊的原发性头痛障碍成年患者。

结果

该研究共纳入 2868 名经系统检查的参与者。偏头痛和紧张型头痛（TTH）占原发性头痛障碍的大多数，分别占 74.1%（2124/2868）和 23.3%（668/2868）。药物过度使用性头痛（MOH）影响了 8.1%（231/2868）的原发性头痛障碍患者。超过一半的原发性头痛障碍患者（56.6%，1624/2868）未得到诊断。偏头痛、TTH、TAC 和 MOH 的既往正确诊断率分别为 27.3%（580/2124）、8.1%（54/668）、23.2%（13/56）和 3.5%（8/231）。偏头痛（9.9%，211/2124）、TTH（10.0%，67/668）、三叉神经自主神经性头痛（TACs）（17.9%，10/56）和其他原发性头痛障碍（10.0%，2/20）中最常见的误诊是“神经性头痛”。只有少数偏头痛（16.5%，77/468）和 TTH（4.7%，2/43）患者在参加研究前接受过预防药物治疗。