Observation of therapeutic effect of cervicogenic headache treated by acupuncture plus Tuina therapy

目的：观察电针配合推拿治疗颈源性头痛的疗效。方法；将200例颈源性头痛患者随机分为电针配合推拿组（针推组，n=100）、电针组（n=50）和推拿组（n=50），分别应用电针颈部夹脊穴、风池穴、阿是穴、患侧率谷、翳风、头维和外关穴和推拿治疗。结果：针推组有效率为100％；电针组总有效率为90．oH；推拿组总有效率为88．0％，差异有显著性意义（P〈0．05）。结论：电针结合推拿是治疗颈源性头痛的有效方法。     

Locus of control moderates the relationship between headache pain and depression

The aim of the current study was to triangulate qualitative and quantitative data in order to examine in greater detail the relationship between self-reported headache pain severity, depression and coping styles. Psychosocial scales, headache characteristic scales and in-depth interviews were administered to 71 adults with the diagnosis of primary headache. Regression analyses with the scales showed that greater self-reported headache pain severity was associated with higher levels of depression. A high internal locus of control weakened the relationship between the headache severity and depression variables. The qualitative data supported the relationship between pain severity and internal locus of control and, in addition, revealed that perceived efficacy of pharmacologic intervention might be a related factor. The results suggested that stronger coping skills might reduce depression among headache sufferers.     

Headache and ischemic stroke

Migraine is a common neurological condition affecting yearly 1%–10% of all men and 3%–20% of all women. Focal neurological symptoms (auras), most commonly visual and sensory, occur in 4% of migraine attacks. Migraine with and without aura seems to be associated with an increased stroke risk. Migraine with aura may mimic transient ischemic attacks and may induce stroke (migrainous stroke). Headache is also a common symptom during ischemic stroke In this review, we present the evidence about each of these circumstances to better understand the relationship between headache, especially migraine, and ischemic stroke. Received: 27 September 2001 / Accepted in revised form: 27 December 2001     

Clinical presentation of cerebral aneurysms

Presentation of a cerebral aneurysm can be incidental, discovered at imaging obtained for unrelated causes, can occur in the occasion of imaging obtained for symptoms possibly or likely related to the presence of an unruptured aneurysm, or can occur with signs and symptoms at the time of aneurismal rupture.     

头痛粉所致药物滥用性头痛1例

在中国头痛粉是最便宜的止痛药,尤其针对偏头痛,效果甚好。但是,由于头痛粉的滥用,常常导致药物滥用性头痛,头痛粉的剂量逐渐增加,药物治疗效果差。本研究举例分析头痛粉所致药物滥用性头痛的个案,同时总结药物滥用性头痛的定义、流行病学、产生药物滥用性头痛的危险因素以及药物滥用性头痛的治疗。     

Whites and African-Americans in headache specialty clinics respond equally well to treatment

This study sought to determine if Whites and African-Americans respond similarly to headache treatment administered in 'real-world' headache specialty treatment clinics. Using a naturalistic, longitudinal design, 284 patients receiving treatment for headache disorders completed 30-day daily diaries that assessed headache frequency and severity at pretreatment and 6-month follow-up and also provided data on their headache disability and quality of life at pretreatment and 1-, 2- and 6-month follow-up. Controlling for socioeconomic status and psychiatric comorbidity, hierarchical linear models found that African-Americans and Whites reported significant reductions in headache frequency and disability and improvements in life quality over the 6-month treatment period. African-Americans, unlike Whites, also reported significant decreases in headache severity. Nevertheless, Africans-Americans had significantly more frequent and disabling headaches and lower quality of life after treatment relative to Whites. Although Whites and African Americans responded favourably to headache treatments, more efficacious treatments are needed given the elevated level of headache frequency that remained in both racial groups following treatment.     

Opiate-induced persistent pronociceptive trigeminal neural adaptations: potential relevance to opiate-induced medication overuse headache

Medication overuse headache (MOH) is a challenging, debilitating disorder that develops from the frequent use of medications taken for the treatment of migraine headache pain. MOH affects an estimated 3–5% of the general population. The mechanisms underlying the development of MOH remain unknown. Opiates are one of the major classes of medications used for the treatment of migraine at least in some countries, including the USA. Although the effects of repeated opiate use for headache are unknown, it is possible that opiate use may contribute to increased frequency and occurrence of such headaches. Recent preclinical studies exploring the neuroadaptive changes following sustained exposure to morphine may give some insights into possible causes of MOH. Peripherally, these changes include increased expression of calcitonin gene-related peptide (CGRP) in trigeminal primary afferent neurons. Centrally, they include increased excitatory neurotransmission at the level of the dorsal horn and nucleus caudalis. Critically, these neuroadaptive changes persist for long periods of time and the evoked release of CGRP is enhanced following morphine pretreatment. Stimuli known to elicit migraine, such as nitric oxide donors or stress, produce hyperalgesia in morphine- but not in saline-pretreated rats even long after the discontinuation of the opiate. CGRP plays a prominent role in initiating vasodilation of the intracranial blood vessels and subsequent headache. Furthermore, studies have demonstrated increased excitability of the nociceptive pathway in migraine sufferers, and CGRP receptor antagonists have been shown to be efficacious in migraine pain. Thus, such persistent neuroadaptive changes may be relevant to the processes that promote MOH.     

孤立性蝶窦病变31例临床分析

目的探讨孤立性蝶窦病变的诊断与治疗,以提高其诊治水平。方法回顾分析孤立性蝶窦病变患者31例的临床资料。结果31例患者临床症状无特征性,以头痛和眼部症状多见。一次性确诊5例,其他被误诊、漏诊。全部病例经CT或MRI确诊,并经鼻内镜手术及病理检查证实。全部病例行鼻内镜下蝶窦开放术,症状完全缓解26例,改善4例,无效1例。全部病例随访1年以上,4例分别于术后3、4、6及7个月症状复发,经鼻内镜下清理后缓解。超过一年以上者无复发病例。结论孤立性蝶窦病变易被漏诊、误诊,CT或MRI是确诊的标准。早诊断,早治疗非常重要,鼻内窥镜手术是首选安全、有效的治疗方法。     

河车路颈针治疗椎-基底动脉供血不足患者84例疗效观察

目的观察河车路颈针疗法治疗椎-基底动脉供血不足的临床疗效。方法选择128例椎-基底动脉供血不足患者,随机分为两组,治疗组84例,对照组44例。治疗组接受河车路颈针疗法治疗,对照组接受传统针刺治疗。观察治疗前后临床症状及经颅多普勒超声检测基底动脉、左椎动脉、右椎动脉平均血流速度的变化情况。结果治疗两个疗程后,治疗组不仅在改善头痛、眩晕等临床症状方面,而且在提高椎-基底动脉平均血流速度方面优于对照组。结论河车路颈针对椎-基底动脉供血不足具有肯定的疗效。     

TREATING 100 CASES OF HEADACHE BY MAINLY NEEDLING FENGCHI AND TAICHONG

This article introduces the writers' experience in treating 100 cases of headache bymainly needling Fengchi (GB 20) and Taichong (LR 3). It is considered in TCM that headache ismostly caused by pathogenic wind, and there is a saying of "no wind, no headache". The combinationof the two points can expel both endogenous and exogenous wind. So we treat headache mainly withneedling Fengchi and Taichong. The result is good, especially for cluster headache and psychicheadache.'