Rapoport A, Stang P, Gutterman D L, Cady R, Markley H, Weeks R, Saiers J, Fox A W
New England Center for Headache, Stamford, CT 06902, USA.
Headache. 1996 Jan;36(1):14-9. doi: 10.1046/j.1526-4610.1996.3601014.x.
Frequent, excessive use of over-the-counter or prescription analgesics may lead to analgesic rebound headache. Little is known about the magnitude of the health problem posed by analgesic rebound headache, its epidemiology, the characteristics of analgesic rebound headache sufferers, or about physicians' approaches to treatment.
Four hundred seventy-three practitioners, who had previously expressed an interest in the treatment of headache, were mailed a questionnaire designed to capture information about the frequency and management of analgesic rebound headache and about the characteristics of analgesic rebound headache sufferers.
Completed questionnaires were returned by 174 practitioners (37%) from 40 states, the District of Columbia, and Puerto Rico. More than 40% of respondents indicated that analgesic rebound headache was present in at least 20% of their patients. On average, the physicians reported that 73% of patients with analgesic rebound headache were women. Analgesic rebound headache was most likely to occur in patients aged 31 to 40 years. No one analgesic was consistently identified as causative, although acetaminophen, butalbital + aspirin + caffeine, and aspirin were commonly used by patients. Eighty percent of respondents indicated that depression was commonly observed in analgesic rebound headache sufferers; 77% indicated that physical conditions (especially gastrointestinal symptoms) were commonly observed. A variety of therapeutic strategies, including pharmacotherapy, were used in the management of analgesic rebound headache.
Analgesic rebound headache was recognized as a distinct entity and a substantive component in more than 40% of the practices of 174 surveyed practitioners. General practitioners, who see a wide variety of patient types with a spectrum of complaints, need to be able to diagnose analgesic rebound headache by taking a good history.
频繁、过量使用非处方或处方镇痛药可能导致药物反跳性头痛。对于药物反跳性头痛所带来的健康问题的严重程度、其流行病学、药物反跳性头痛患者的特征，或医生的治疗方法，人们知之甚少。
向473名曾表示对头痛治疗感兴趣的从业者邮寄了一份问卷，旨在收集有关药物反跳性头痛的频率和管理以及药物反跳性头痛患者特征的信息。
来自40个州、哥伦比亚特区和波多黎各的174名从业者（37%）返回了完整的问卷。超过40%的受访者表示，他们至少20%的患者患有药物反跳性头痛。医生们平均报告称，73%的药物反跳性头痛患者为女性。药物反跳性头痛最常发生在31至40岁的患者中。虽然对乙酰氨基酚、布他比妥+阿司匹林+咖啡因和阿司匹林是患者常用的药物，但没有一种药物被一致认定为病因。80%的受访者表示，在药物反跳性头痛患者中普遍观察到抑郁；77%的受访者表示，普遍观察到身体状况（尤其是胃肠道症状）。在药物反跳性头痛的管理中使用了多种治疗策略，包括药物治疗。
在174名接受调查的从业者中，超过40%的从业者认为药物反跳性头痛是一种独特的病症且是一个重要组成部分。全科医生会诊治各种有不同主诉的患者类型，需要通过详细询问病史来诊断药物反跳性头痛。
