慢性偏头痛和药物过度使用头痛患者的疼痛应对
Thomas C van den Hoek1, Judith A Pijpers1, Erik W van Zwet2
1Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands.
Brain and behavior
|August 12, 2025
概括
慢性偏头痛 (CM) 患者的疼痛应对能力比偶发性偏头痛 (EM) 患者差. 在CM患者中,高疼痛灾难性预测了对行为戒断治疗的更好的反应.
科学领域:
- 神经学 神经学
- 心理学 心理学 心理学
- 疼痛管理 疼痛管理
背景情况:
- 慢性偏头痛 (CM) 是导致残疾的重要原因,通常与药物过度使用头痛 (MOH) 有关.
- 心理因素,包括应对疼痛的策略,可能会影响偏头痛的慢性化和药物过量使用.
- 识别那些将受益于CM和MOH行为治疗的患者是具有挑战性的.
研究的目的:
- 为了比较CM和MOH患者的疼痛应对机制,与患有偶发性偏头痛 (EM) 和无头痛的对照人群相比.
- 确定CM患者的基线疼痛应对是否可以预测戒断治疗的成功.
主要方法:
- 该研究包括65个CM,34个EM和49个非头痛对照.
- 疼痛接受 (AAQ-II-P),疼痛灾难化 (PCS) 和头痛特定控制位置 (HSLC) 通过验证的问卷进行了评估.
- 患有CM和MOH的患者在临床试验中接受了行为疗法.
主要成果:
- 与EM患者和健康对照患者相比,CM患者的疼痛接受度明显降低,疼痛灾难性程度更高.
- 与EM患者相比,CM患者更有可能将头痛归因于巧合.
- 在CM患者中,更高的疼痛灾难性得分与治疗后偏头痛日数的更大减少有关.
结论:
- 患有慢性偏头痛的人与患有偶发性偏头痛的人和健康人相比,表现出较差的疼痛应对能力.
- 在慢性偏头痛患者中,疼痛升级成为灾难,是行为戒断治疗中积极结果的预测因素.
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