对急性药物的不满意反应不会影响药物的过度使用 儿科慢性偏头痛中头痛的发展
Ilaria Frattale1, Michela Ada Noris Ferilli2, Fabiana Ursitti2
1Child Neurology and Psychiatry Unit, Department of Wellbeing of Mental and Neurological, Dental and Sensory Organ Health, Policlinico Tor Vergata Foundation Hospital, Rome, Italy.
The journal of headache and pain
|April 22, 2024
概括
在儿科慢性偏头痛中,对急性治疗的反应不佳是常见的,但不能防止药物过度使用头痛 (MOH). 预防性治疗可以改善慢性偏头痛儿童的急性治疗反应.
科学领域:
- 神经学 神经学
- 儿科 儿科 儿科
- 临床药理学 临床药理学
背景情况:
- 慢性偏头痛 (CM) 显著影响儿科生活质量,影响2-4%的儿童.
- 与成年人不同,患有CM的儿童很少患上药物过量使用头痛 (MOH),可能是由于急性药物使用减少而引起的.
- 本研究研究了儿科CM的急性治疗应答率及其与MOH,预防性治疗和精神病并发症的关系.
研究的目的:
- 确定儿科慢性偏头痛中急性疗法不响应的频率.
- 为了比较药物过度使用头痛 (MOH) 的患病率,对急性治疗的反应者和不反应者之间.
- 评估预防治疗对急性治疗反应的影响,并检查精神病相关疾病的作用.
主要方法:
- 使用ICHD3标准诊断的慢性偏头痛的儿科患者 (18岁以下) 的临床数据的回顾性分析.
- 在基线和预防治疗3个月后评估急性药物反应.
- 收集人口统计数据,偏头痛发病年龄,CM疗程持续时间,以及父母关于神经精神病并发症的报告.
主要成果:
- 评估了70名患有CM的儿科患者; 73%的患者没有对急性治疗 (白醇,NSAID,三药) 产生反应.
- 药物过度使用头痛 (MOH) 患病率总体为27.1%,响应者 (22%) 和不响应者 (29%) 之间没有显著差异.
- 预防性治疗改善了65.4%以前没有反应的患者的急性治疗反应,并且在69%的响应者中有效. 在68.6%的患者中,精神病并发症存在,但没有影响治疗反应.
结论:
- 在儿科慢性偏头痛中,对急性治疗的低最佳反应不能防止药物过度使用头痛 (MOH).
- 药物预防治疗显著提高了儿童慢性偏头痛患者对急性药物的反应能力.
- 同时的精神病并发症不会影响儿童慢性偏头痛急性或预防性治疗的反应.
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