■药物过度使用性头痛(MOH)是一种继发性头痛障碍,可导致明显的残疾和生活质量下降。MOH的可用治疗选择有限,许多只对一部分个体有效。虽然现有证据有限,针灸可能是MOH的有效治疗选择。
■一名45岁的中国妇女于2022年4月11日前往三明市中西医结合医院医疗针灸科就诊。三十五年前,她有偶发性偏头痛。频率随着时间的推移而增加,然而,在过去的10年里,她每天都头痛。这些头痛的特点是患者头部左侧每天持续阵痛,伴有畏光,恐惧症,颈部僵硬度,头晕,和疲劳。没有止痛药,患者在视觉模拟量表上将头痛强度评为10分之9(0=无痛,10=无法忍受的疼痛),据报道,头痛持续了7天或更长时间。用止痛药,头痛的强度降低(10个中的5个),但坚持。患者每天服用1-3.5复方氨基比林非那西丁片,持续5年以上。标准的保守疗法(患者教育,停药,和行为干预)对于MOH未能改善她的症状。在她来访之前,患者头痛,每月30天进行短期用药.每月头痛强度总分为90分。患者的偏头痛特异性生活质量问卷(MSQ)评分为33分,她的汉密尔顿抑郁量表(HAMD)得分为24分,她的汉密尔顿焦虑量表(HAMA)得分为20分。
■经过24周的48次针灸治疗,患者完全停止短期镇痛药使用,每月头痛天数和头痛强度评分均减少96.67%(分别从30至1和90至3),没有不良影响。与基线相比,MSQ,HAMD,HAMA得分提高了45、17和16分,分别。12个月时,患者病情保持稳定,MOH未复发。
■在当前文献和本案的背景下,当其他治疗失败时,电针有望长期缓解MOH慢性偏头痛。
UNASSIGNED: Medication overuse headache (MOH) is a secondary headache disorder that leads to pronounced disability and decreased quality of life. Available therapeutic options for MOH are limited, and many are only effective in a subset of individuals. Although the existing evidence is limited, acupuncture may be an effective treatment option for MOH.
UNASSIGNED: A 45-year-old Chinese woman presented to the Medical Acupuncture Department of Sanming Integrated Traditional Chinese and Western Medicine Hospital on April 11, 2022. Thirty-five years ago, she had episodic migraines. The frequency increased over time, however, and for the past 10 years she has had daily headaches. These headaches were characterized by daily persistent throbbing pain on the left side of the patient\'s head, accompanied by photophobia, phonophobia, neck stiffness, dizziness, and fatigue. Without painkillers, the patient rated her headache intensity as 9 out of 10 on a visual analog scale (0 = no pain, 10 = intolerable pain), and reported that the headaches lasted for up to 7 days or more. With painkillers, the headaches had a reduced intensity (5 of 10), but persisted. The patient had taken 1-3.5 compound aminopyrine phenacetin tablets daily for more than 5 years. Standard conservative therapy (patient education, medication withdrawal, and behavioral intervention) for MOH had failed to improve her symptoms. Before her visit, the patient had headache and engaged in short-term medication use on 30 days per month. The total monthly headache intensity score was 90. The patient\'s Migraine-Specific Quality of Life Questionnaire (MSQ) score was 33 points, her Hamilton Depression Scale (HAMD) score was 24 points, and her Hamilton Anxiety Scale (HAMA) score was 20 points.
UNASSIGNED: After 48 acupuncture sessions over 24 weeks, the patient completely discontinued short-term analgesic use and the monthly number of headache days and headache intensity score were both reduced by 96.67 % (from 30 to 1 and 90 to 3, respectively), with no adverse effect. Compared with baseline, the MSQ, HAMD, and HAMA scores improved by 45, 17, and 16 points, respectively. At 12 months, the patient\'s condition remained stable and her MOH had not relapsed.
UNASSIGNED: In the context of the current literature and the present
case, electroacupuncture shows promise for the long-term relief of chronic migraine with MOH when other treatments fail.