女性紧张性头痛及经期偏头痛影响因素的比较

目的比较女性紧张性头痛(TTH)及经期偏头痛(MM)的影响因素。方法收集104例女性TTH患者(TTH组)及91例MM患者(MM组)的临床资料。采用视觉模拟评分法(VAS)和头痛影响测评量表-6(HIT-6)对其头痛程度、生活质量进行评估,并采用汉密尔顿焦虑(HAMA)、抑郁量表(HAMD)对患者情绪障碍进行测定。结果 TTH组与经期相关19例,累积发病率18.3%;MM组与经期相关59例,累积发病率64.8%。与TTH组比较,MM组发病年龄显著降低,病程、家族史,焦虑、抑郁、重度疼痛、HIT-6(Ⅳ级)、共病的比率,以及HAMA、HAMD评分均显著升高(P0.05~0.01),而文化程度、吸烟、饮酒、职业差异无统计学意义(均P0.05)。无先兆的月经相关性偏头痛(MRM)、无先兆的单纯月经性偏头痛(PMM)及非月经性无先兆偏头痛患者发病年龄、家族史、VAS及HIT-6评分差异有统计学意义(P0.05~0.01)。结论与女性TTH比较,MM发病年龄更轻、病程更长,也更易合并焦虑、抑郁。在不同类型MM中,PMM发病年龄更早,有家族史的比率更高;而MRM的重度疼痛率及HIT-6评分最高。

Comparison of the influence factors of female tension-type headache and menstrual migraine

Objective To compared the influence factors of female tension-type headache ( TTH ) and menstrual migraine ( MM) .Methods Clinical data of 104 female patients with TTH ( TTH group) and 91 patients with MM (MM group) were collected.The headache degree and the quality of life were evaluated by visual analogue scale (VAS) and headache impact test-6 (HIT-6).Emotional disorders were measured by Hamilton anxiety scale ( HAMA) and Hamilton depression scale ( HAMD) .Results There were 19 cases of menstrual related headache in TTH group, cumulative incidence rate was 18.3%.There were 59 cases of menstrual related headache in MM group , and cumulative incidence rate was 64.8%.Compared with TTH group , age in MM group was significantly decreased , and course of disease, family history, anxiety, depression, severe pain, HIT-6 ( IV) lever, comorbidity rate, HAMA, HAMD score in MM group were significantly increased (P<0.05 -0.01), but there was no significant correlation in the level of education, smoking, drinking, and occupation (all P>0.05).Among menstrually related migraine without aura(MRM), pure menstrual migraine without aura (PMM) and non-menstrual migraine without aura patients, significant differences were found in the onset age , family history, VAS and HIT-6 score (P<0.05-0.01).Conclusions Compared with female TTH, MM patients have a lower age of onset , longer course of disease , and a higher rate of anxiety and depression .Among different types of MM , the onset age is younger in PMM , with a higher rate of positive family history .The rate of severe pain and the score of HIT-6 are higher in MRM .