Bartelink M L, van de Lisdonk E, van den Hoogen H, Wollersheim H, van Weel C
Department of Family Medicine, University of Nijmegen, The Netherlands.
Fam Med. 1993 May;25(5):331-6.
The objective of this study was to determine the prevalence of migraine headache in a family practice patient population. In addition, this study evaluated the simultaneous presence of Raynaud's phenomenon (RP) and migraine and examined the influence of sex hormonal status on migraine symptoms.
Data from the Continuous Morbidity Registration Project (CMR) of Nijmegen, the Netherlands, were used to identify all patients in the registration who had migraine headache and a comparison group of patients with nonvasospastic tension headache. Questionnaires were used to verify the diagnosis and to determine signs and symptoms of both headaches.
There was an average annual prevalence of migraine headache of four per 1,000 men and 16 per 1,000 women. Eighty-five percent of patients diagnosed by family physicians as having migraine were found to fulfill the International Classification of Health Problems in Primary Care (ICHPPC) criteria for migraine headache. Migraine differed from tension headache with regard to the duration of the attacks, concomitant photo- and phonophobia, provoking factors, and the need to use analgesic medications. RP was present in 15% of the migraine group and in 16% of the tension headache group and occurred almost exclusively in women. The headaches were worse during and before menstruation in both groups and improved during pregnancy and menopause in the migraine group to greater extent than in the tension headache group.
The use of the ICHPPC criteria for migraine headache is reliable in morbidity surveys in family practice. Although there was an overlap, migraine differed in various aspects from tension headache. Digital vasospasm and the influence of female hormonal changes were present in both headache groups.
本研究的目的是确定家庭医疗患者群体中偏头痛的患病率。此外，本研究评估了雷诺现象（RP）与偏头痛的同时存在情况，并研究了性激素状态对偏头痛症状的影响。
使用荷兰奈梅亨连续发病登记项目（CMR）的数据，识别登记中所有患有偏头痛的患者以及一组非血管痉挛性紧张性头痛患者作为对照组。通过问卷调查来核实诊断并确定两种头痛的体征和症状。
偏头痛的年平均患病率为每1000名男性中有4例，每1000名女性中有16例。家庭医生诊断为偏头痛的患者中，85%被发现符合初级保健中健康问题国际分类（ICHPPC）的偏头痛头痛标准。偏头痛在发作持续时间、伴随的畏光和畏声、诱发因素以及使用止痛药物的必要性方面与紧张性头痛不同。RP在偏头痛组中的发生率为15%，在紧张性头痛组中的发生率为16%，且几乎仅发生在女性中。两组头痛在月经期间及之前都会加重，而偏头痛组在怀孕期间和绝经期间的改善程度比紧张性头痛组更大。
在家庭医疗发病率调查中，使用ICHPPC偏头痛头痛标准是可靠的。尽管存在重叠，但偏头痛在多个方面与紧张性头痛不同。两种头痛组中均存在手指血管痉挛以及女性激素变化的影响。
