在患有慢性偏头痛和药物过度使用头痛的患者中,神经阻塞是否能提高情绪和功能活动?
Ahmet Basari1, Gökhan Pek2, Ibrahim Asik3
1Department of Algology, Kayseri City Hospital, Kayseri, Turkey.
概括
在标准药物中添加大椎神经 (GON) 和上椎神经 (SON) 块,在慢性偏头痛和药物过度使用的头痛患者中改善了疼痛和功能. 结合的GON和SON块提供了更快的缓解,从第二周开始显示出显著的益处.
科学领域:
- 神经学 神经学
- 疼痛管理 疼痛管理
- 头痛 疾病 头痛 疾病
背景情况:
- 慢性偏头痛 (CM) 和药物过度使用头痛 (MOH) 带来了重大治疗挑战.
- 这些情况通常与情绪障碍和功能障碍有关.
- 标准的预防性药物治疗是必不可少的,但可以从辅助干预中获益.
研究的目的:
- 为了评估增加大尾神经 (GON) 和脑上神经 (SON) 阻塞在标准药物预防中的有效性.
- 评估接受神经阻塞的CM或MOH患者的情绪和功能改善.
- 为了比较不同治疗策略的结果:单独使用药物,使用GON块的药物,以及使用联合GON和SON块的药物.
主要方法:
- 对147名被诊断患有CM或MOH的患者进行了回顾性分析.
- 根据治疗方法,患者被分为三组:单独药物治疗,使用GON阻断剂的药物治疗或使用GON和SON阻断剂组合的药物治疗.
- 使用视觉模拟量表 (VAS),偏头痛残疾评估量表 (MIDAS) 和贝克抑郁量表 (BDI) 评分来评估疼痛和功能.
主要成果:
- 结合的GON和SON阻断从第2周开始显著降低了VAS得分 (p = 0.021).
- 在所有组中,MIDAS得分都显著改善,GON + SON组合组块组中最明显的减少 (p < 0.01).
- 随着时间的推移,BDI得分显著下降 (p < 0.01),但没有观察到情绪的特定治疗优势.
结论:
- 辅助的GON和SON阻断剂增强了CM和MOH患者的疼痛减轻和功能.
- 综合神经阻塞提供更快和显著的好处,特别是从第二周开始减轻疼痛.
- 虽然情绪得分有所改善,但需要进一步的研究来确认治疗对情绪的特定影响;建议在未来进行多中心随机对照试验.
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