Kim H S, Chung S C, Kim Y K, Lee S W
Department of Oral Medicine and Oral Diagnosis, Seoul National University, College of Dentistry, Korea.
J Orofac Pain. 1995 Fall;9(4):357-64.
Pain-pressure thresholds of the head and neck region of 31 female patients (aged 13 to 50 years; mean, 28.4 +/- 9.6 years) suffering from episodic tension-type headache and 32 female control subjects (aged 15 to 46 years; mean, 26.6 +/- 8.6 years) were recorded with an electronic algometer by the same blinded observer. The multivariate analysis of variance revealed that the algometer values obtained from different age groups of patients and control subjects were statistically different, but the values for the right-side muscles were not statistically different from the corresponding values for the left-side muscles. The pain-pressure thresholds of the patient group were lower than those of the control group for the superior sternocleidomastoid muscles, middle sternocleidomastoid muscles, and trapezius insertion muscles (P < .01) but were not statistically different for the anterior temporal, middle temporal, posterior temporal, deep masseter, anterior masseter, inferior masseter, medial pterygoid, posterior digastric, splenius capitis, and upper trapezius muscles (P > .01). The results may indicate that pain-pressure thresholds of the head and neck region should be considered in the diagnosis of episodic tension-type headache. The results may also propose that the increased pain sensitivity of the head and, especially, the neck region, may be included in the pathogenetic mechanism in episodic tension-type headache.
由同一位不知情的观察者使用电子痛觉计记录了31名发作性紧张型头痛女性患者(年龄13至50岁;平均28.4±9.6岁)和32名女性对照者(年龄15至46岁;平均26.6±8.6岁)头颈部区域的痛压阈值。多因素方差分析显示,从不同年龄组的患者和对照者获得的痛觉计数值在统计学上存在差异,但右侧肌肉的值与左侧肌肉的相应值在统计学上无差异。患者组在胸锁乳突肌上部、胸锁乳突肌中部和斜方肌附着处肌肉的痛压阈值低于对照组(P<0.01),但在颞前肌、颞中肌、颞后肌、咬肌深层、咬肌浅层、咬肌下部、翼内肌、二腹肌后腹、头夹肌和斜方肌上部肌肉中,差异无统计学意义(P>0.01)。结果可能表明,在发作性紧张型头痛的诊断中应考虑头颈部区域的痛压阈值。结果还可能提示,头部尤其是颈部区域痛觉敏感性增加,可能参与了发作性紧张型头痛的发病机制。