Trachtenbarg D E
Department of Family Practice, University of Illinois College of Medicine at Peoria.
Postgrad Med. 1994 May 1;95(6):44-6, 49-52, 55-6.
Almost half of headaches that are treated in a primary care practice are of the tension type. The diagnosis is made primarily on the basis of a history of bilateral mild or moderate headache with a pressing or tightening quality, often located in the hatband region and sometimes extending down the back of the neck. Laboratory tests and imaging studies are indicated only for selected patients to rule out other causes. A stepwise approach to treatment, starting with reduction of precipitating factors and use of over-the-counter analgesic medications, is often helpful. Prophylaxis should be considered if tension headaches occur more than twice a week or last more than 2 days. A tricyclic antidepressant is the drug of choice for prophylaxis.
在初级保健机构接受治疗的头痛患者中，近一半属于紧张型头痛。诊断主要基于双侧轻度或中度头痛的病史，疼痛性质为压迫性或紧箍样，通常位于帽带区域，有时可延伸至颈部后方。仅对部分患者进行实验室检查和影像学研究以排除其他病因。采用逐步治疗方法，首先减少诱发因素并使用非处方止痛药物，通常会有所帮助。如果紧张型头痛每周发作超过两次或持续超过两天，则应考虑预防治疗。三环类抗抑郁药是预防治疗的首选药物。
