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[德累斯顿儿童和青少年头痛项目DreKiP的性别特异性结果]

[Gender-specific results of the Dresden children and adolescents headache program DreKiP].

作者信息

Zaranek Laura, Sobe Hanna, Richter Matthias, Hübler Anke, Berner Reinhard, von der Hagen Maja, Koch Thea, Sabatowski Rainer, Klimova Anna, Goßrau Gudrun

机构信息

Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland.

UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.

出版信息

Schmerz. 2024 Apr;38(2):107-117. doi: 10.1007/s00482-023-00756-z. Epub 2023 Sep 22.

Abstract

BACKGROUND

Girls and women are more frequently affected by headache than boys and men. The influence of gender on the effectiveness of headache therapies has so far been hardly investigated. We examined gender differences in the outpatient multimodal Dresden Child and Adolescent Headache Program DreKiP.

METHODS

We treated 140 patients with primary headache in a 15-hour structured group program. At baseline (T0) and six (T1) and twelve months (T2) after the end of the program, data on headache-related limitation of daily activities (PedMIDAS) as well as headache frequency, intensity, and pain-related disability (P-PDI) were collected. Retrospectively, these data were analyzed separately for girls and boys.

RESULTS

For 91 patients (9-19 years, median = 15; 71.4 % female) data were available for at least two measurement time points. Girls showed significantly higher headache frequency than boys at all time points (median headache days/last three months at T0: ♀ 43, ♂ 20; T1: ♀ 32, ♂ 12; T2: ♀ 28, ♂ 9) as well as numerically higher headache-related limitation of daily life. There were significant effects over time with a decrease in headache frequency (F (2.88) = 5.862; p = 0.004) and improvement in daily functioning (F (2.92) = 5.340; p = 0.006). There was no gender-specific treatment response.

DISCUSSION

The DreKiP therapy shows effects in girls and boys with primary headache. Higher headache frequencies and everyday life restrictions in girls may have hormonal but also psychosocial causes and should be addressed in educational measures.

摘要

背景

女孩和女性比男孩和男性更容易患头痛。到目前为止,性别对头痛治疗效果的影响几乎没有得到研究。我们在德累斯顿儿童和青少年头痛门诊多模式项目DreKiP中研究了性别差异。

方法

我们在一个为期15小时的结构化小组项目中治疗了140例原发性头痛患者。在基线(T0)以及项目结束后的6个月(T1)和12个月(T2),收集了与头痛相关的日常活动受限情况(儿童偏头痛残疾评估量表)以及头痛频率、强度和疼痛相关残疾情况(疼痛-疼痛残疾指数)的数据。回顾性地对这些数据分别针对女孩和男孩进行了分析。

结果

91例患者(9 - 19岁,中位数 = 15;71.4%为女性)的数据可用于至少两个测量时间点。女孩在所有时间点的头痛频率均显著高于男孩(T0时最后三个月的头痛天数中位数:♀43,♂20;T1:♀32,♂12;T2:♀28,♂9),并且在日常生活中与头痛相关的受限程度在数值上也更高。随着时间推移有显著效果,头痛频率降低(F(2.8,8) = 5.862;p = 0.004),日常功能得到改善(F(2.9,2) = 5.340;p = 0.006)。没有性别特异性的治疗反应。

讨论

DreKiP疗法对患有原发性头痛的女孩和男孩均有效果。女孩较高的头痛频率和日常生活限制可能有激素方面的原因,但也有社会心理方面的原因,应在教育措施中加以解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e40/10959813/a4401331eea1/482_2023_756_Fig1_HTML.jpg

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