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药物过度使用性头痛：病因、临床特征和诊断

Authors
Ivan Garza, MD
Todd J Schwedt, MD, MSCI
Section Editor
Jerry W Swanson, MD, MHPE
Deputy Editor
John F Dashe, MD, PhD
Translators
范红杰, 主任医师，副教授

引言

慢性每日头痛是一种描述性术语，涵盖了数种不同的特定头痛诊断。长时间型(即，持续4小时或以上)慢性每日头痛包括慢性偏头痛、慢性紧张型头痛、连续性半侧颅痛和新发的每日持续性头痛。药物过度使用性头痛(medication overuse headache, MOH)是一种继发性头痛疾病，常使多种原发性头痛疾病的治疗变得复杂。 (参见“慢性每日头痛概述”)

本专题将总结MOH的病因、临床特征和诊断，MOH的治疗及预后将单独讨论。 (参见“药物过度使用性头痛：治疗和预后”)

背景

MOH是用来描述头痛的术语，这种头痛由规律过度使用急性或对症头痛药物超过3个月引起，每月出现15日或更多天。MOH通常在停用过度使用的药物后缓解，但不总是如此[1]。MOH也被称作镇痛药物反弹性头痛、药物诱导性头痛和药物滥用性头痛。

尽管MOH不是原发性的慢性每日头痛，但因为它常与原发性慢性每日头痛同时存在，所以需要恰当地区分。在某些病例中，MOH可能与慢性每日头痛综合征的发生和持续有关[2]。

病理生理学

现有的证据表明，所有用于急性头痛对症治疗的药物在治疗原发性头痛疾病时均可引起MOH[3,4]。导致MOH的准确机制仍不明确；然而，包括遗传易感性、中枢敏化和生物行为因素在内的多种因素似乎起一定作用。

           

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Literature review current through: 2017-07 . | This topic last updated: 2017-05-10.
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