Objective To assess the effectiveness of acupuncture for tension-type headache. Methods A systematic review of the relevant randomized controlled trials (RCTs) of acupuncture for tension-type headache was performed using the methods of The Cochrane Collaboration. Trials were collected from The Cochrane Library, Issue 4, 2003, MEDLINE (1966 to March 2004), CBM (1978 to August 2003), VIP (1989 to April 2003) and handsearched all related articles published in Chinese in 2003. The quality of literature was reviewed, and data were extracted by two reviewers independently. Meta-analysis was conducted using RevMan 4.2 software. Results Thirteen RCTs involving 571 patients were included, of the thirteen RCTs, six were of high methodological quality according to Jadad scale (the Jadad score≥3), and “sham acupuncture” was used as controlled intervention in eight trials. Meta-analysis indicated that no statistical difference was detected between acupuncture and sham acupuncture groups on effectiveness with RR 1.55, 95%CI 0.97 to 2.47 and P=0.07 at the end of treatment. No statistical difference was detected between acupuncture and sham acupuncture groups on visual analogue scale at the end of treatment with WMD －0.55, 95%CI －1.20 to 0.09 and P=0.09; at the end of follow-up of less than 2 months with WMD －0.22, 95%CI －0.87 to 0.42 and P= 0.50 and at the end of follow-up of more than 2 months with WMD －0.65, 95% CI －1.41 to 0.11 and P=0.09. Conclusions Comparing acupuncture with sham acupuncture and other treatments, current evidence can not evaluate whether acupuncture is significantly effective for tension-type headache, more RCTs of high methodological quality are required.
Objective To evaluate the efficacy of Yangxue Qingnao Grain for migraine. Methods We searched The Cochrane Library (Issue 3, 2007), EMBASE (1974 to June 2007), PubMed (1966 to June 2007), VIP (1989 to June 2007), CNKI (1979 to June 2007) and CBM (1978 to June 2007) to identify randomized controlled trials or quasirandomized controlled trials comparing Yangxue Qingnao Grain versus sibeline for migraine. The quality of included studies was critically assessed and data analyses were performed with The Cochrane Collaboration’s RevMan 4.2.7. Results Eight studies were included, involving 5 randomized trials and 3 quasi-randomized trials. Meta-analyses showed that the total response rate (RR=1.07, 95%CI 1.00 to 1.15, P=0.06), the duration of headache (WMD 1.33, 95%CI – 0.87 to 3.52, P=0.24), and the frequency of headache episodes (WMD 0.93, 95%CI –1.00 to 2.86, P=0.35) were similar between Yangxue Qingnao Grain and sibeline. One study reported that the changes of ACA (WMD 3.70, 95%CI –3.46 to 10.86), MCA (WMD 0.60, 95%CI –10.37 to 11.57), ICA (WMD 3.40, 95%CI –4.35 to 11.15) and DCA (WMD – 2.30, 95%CI –9.52 to 4.92) revealed by transcranial doppler sonography were also comparable between the two groups. Conclusion Yangxue Qingnao Grain is effective in the treatment of migraine, but its superiority over sibeline is not demonstrated. Due to the poor quality and small sample of the included trials, more large-scale multi-center randomized trials are needed.
【摘要】 目的 探讨颈源性头痛的特点、病因及治疗效果。 方法 2005年1月-2009年1月收治颈源性头痛患者153例，经X线平片、CT和MRI检查，病变位于上颈椎23例，下颈椎130例，其中上颈椎先天畸形11例，类风湿3例，肿瘤2例，结核3例，陈旧性骨折脱位4例，颈椎管狭窄23例，C4-5椎间盘突出35例，C5-6椎间盘突出22例，C6-7椎间盘突出6例。手术治疗129例，非手术治疗24例。随访3个月～4年，平均2.1年。 结果 手术治疗组129例中91例头痛明显好转，36例头痛部分好转，2例缓解不明显。非手术治疗组24例中11例头痛部分缓解，13例无效。 结论 上颈椎病变所致头痛主要表现为枕部疼痛，部分患者同时伴有前额及眼眶胀痛，可伴有颈部旋转活动受限。下颈椎病变所致头痛表现多样化，无明显的特点，可表现为枕颈部、头顶、额部疼痛或一侧的偏头痛，多伴肩部疼痛,部分有脊髓及神经根受压表现。颈源性头痛保守治疗效果不佳，手术治疗效果较好。【Abstract】 Objective To explore the causes, characteristics and therapeutic effeets of cervicogenic headache. Methods A total of 153 patients with cervicogenic headache from January 2005 to January 2009 were examined by X-ray, CT, and MRI. The focus was located in upper cervical vertebra in 23 cases, and in lower cervical vertebra in 130 cases. In the 153 patients, there were 11 had congenital deformity, 3 had rheumatoid, 2 had tumor, 3 had tuberculosis, 4 had fracture dislocation, 23 had cervical stenosis, 35 had C4-5 DH, 22 had C5-6 DH, and 6 had C6-7 DH. A total of 129 patients underwent operations, and 24 received expectant treatment. Results All the patients were followed up from 3 months to 4 years, averaging 2.1 years. Among 129 cases in the operation group, 91 patients’ headache disappeared completely, 36 disappeared partly, and 2 didn’t disappear. Among 24 cases in the expectant treatment group, 11 patients’ headache disappeared partly,13 didn’t disappeare. Conclusions The headache from upper cervical changing mainly appears pain in occiput; part of them combind pain in forehead or fossa orbitalis, accompanying limitation of neck rotation. Headache from lower cervical changing appears varied, having no feature, and appearing pain in cervical part, corona capitis, forehead or one lateral; many of them combind pain of shoulder, partly showing appearance from spinal cord or root compression. The efficacy of expectant treatment is bad and the efficacy of operation is good.
Objective To investigate the influencing factors of moderate to severe disability in migraine patients. Methods Patients diagnosed with migraine between September 2022 and January 2024 in the outpatient service or inpatient Department of Neurology of Baotou Central Hospital and Baotou Eighth Hospital were included. According to the scores of the Migraine Disability Assessment questionnaire, patients were divided into a group with no or mild disabilities and a group with moderate to severe disabilities. The sociodemographic, disease characteristics, and scale datas of two groups of patients were collected, and a multivariate logistic regression model was used to explore the influencing factors of moderate to severe disability in migraine patients. Results A total of 116 patients were included. Among them, there were 49 cases in the group with no or mild disabilities, and 67 cases in the group with moderate to severe disabilities. There were statistically significant differences in gender, duration of headache, severity of headache, number of headache days per month, drug overuse, the scores of Generalized Anxiety Disorder-7 scale, the scores of Patient Health Questionnaire-9 scale, the scores of Pittsburgh Sleep Quality Index scale, the scores of Headache Impact Test scale, the scores of Montreal Cognitive Assessment scale, and the scores of 36-item Short-Form Health Survey questionnaires between the two groups (P<0.05). There was no statistically significant difference in other sociodemographic information and disease characteristics between the two groups of patients (P>0.05). The results of multivariate logistic regression analysis showed that the number of headache days per month, the scores of Generalized Anxiety Disorder-7 scale, the scores of Headache Impact Test scale, and the scores of 36-item Short-Form Health Survey questionnaire were independent influencing factors for moderate to severe disability in migraine patients (P<0.05). Conclusions Headache duration, anxiety disorders and health-related quality of life are influencing factors for moderate to severe disability in migraine patients. Early screening and intervention of influencing factors for migraine patients should be emphasized.
ObjectiveTo explore the personalistic characteristics of patients with migraine and medication-overuse headache (MOH), and to provide scientific evidence for mental treatment of these patients. MethodsThe subjects were divided into three groups:migraine group, MOH group, and health group.Patients with migraine or MOH, admitted to the Deyang People's Hospital from March 2012 to March 2014, were selected in this study.In addition, healthy volunteers were selected as controls at the same time.Data were collected through the Minnesota multiphasic personality inventory computer testing software, and differences of personalistic characteristics were compared among patients with migraine, MOH and controls. ResultsPatients with migraine and MOH had mental problems and the occurrence rate of psychological problems of MOH patients was significantly higher than that of migraine patients (χ2=6.055, P=0.014).Migraine patients showed higher scores of hypochondriasis, depression, hysteria, psychasthenia, hypomania than controls (P < 0.01).Compared with migraine patients, the scales of hypochondriasis, depression, hysteria, paranoia, schizophrenia were higher in MOH patients (P < 0.01). ConclusionsPatients with migraine and MOH have personalistic and psychological problems.Early screening of personalistic characteristics and mental interventions may improve the clinical outcome of patients with migraine or MOH.