抗焦虑抑郁治疗在原发性头痛患者中的应用观察

目的 探索原发性头痛与焦虑抑郁的关系;抗焦虑抑郁药物在原发性头痛治疗中疗效的评价.方法 在门诊及病房工作中收集原发性头痛患者,以区组随机法随机分为黛力新组(黛力新、西比灵)和对照组(西比灵),分别于治疗初作焦虑抑郁评分及头痛程度的评定,然后于治疗后2周、4周复查焦虑抑郁评分及头痛的评分.结果 (1)原发性头痛患者的焦虑抑郁评分,参差不齐,也即焦虑、抑郁的严重程度不一,以轻中度为多.主要与发生焦虑抑郁的时距有关;(2)原发性头痛经抗焦虑抑郁治疗后,其头痛的发作频率、程度皆见明显改善,服药2周即显有效.4周时疗效已非常明显;(3)抗焦虑、抑郁药物对焦虑、抑郁改善程度明显.结论 头痛的发生可能与既往焦虑、抑郁有关;经抗焦虑、抑郁治疗能使原发性头痛治疗更加有效.

The application of anti-anxiety and anti-depression therapy in the primary headache and the curative effects of deanxit

Objective To explore the association of primary headache with anxiety and depression; to evaluate the effects of Deanxit on primary headache. Methods Primary headache patients were collected from the outpatient and inpatient department of neurology and randomly divided into deanxit group （treated with Deanxit, Flunarizine）and control （treated with flunarizine）. All of them were assessed in HAD （hospital anxiety and depression scales）for affective disorder and in NRS（numerical rating scale） for the degree of headache before and 2 and 4 weeks after the therapy. Results The score of anxiety or depression were variable in the primary headache patients, mainly showing mildness or moderate （deanxit.. 21.41±7.29,control 20.69±6.87, P〉 0.05）, and decreased significantly in the deanxit group after 2 and 4 weeks treatment （14.41±6.33, 9.13±5.64 respectively）and in control group（ 2weeks 17.38± 6.43, 4 weeks 11.96±6.23; 2weeks P 〈 0.05, 4weeks P 〈0.05 ）. The severity of headache reveals the similar changes（ Deanxit： 0week 6.00±1.70, 2weeks 3.76±1.48, 4weeks 2.35±1.35; Control： 0week 5.67±1.57, 2weeks 4.58± 1.78, 4weeks 3.58!1.53; 0 week P 〉 0.05, 2weeks P〈 0.05, 4weeks P 〈 0.01）. Conclusions The primary headache may be associated with anxiety or depression. Therapeutic effect of antidepressant of deanxit is better than routine treatment.