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| 摘要 目的 探讨紧张性头痛患者的可能病因及某些情感和认知功能障碍。方法 对53例紧张性头痛患者的临床资料进行分组分析、整理、归类，全部病例进行头颅CT或MRI检查以及颈部X线检查，用焦虑、抑郁自评量表(SAS、SDS)、简易智能量表(MMSE)进行情感和认知评估。结果 颈椎病42例(79.24%)，其他11例(20.76%)，重大精神事件所致焦虑和(或)抑郁14例(26.41%)，工作紧张所致焦虑23例(43.41%)，抑郁14例(26.41%)，轻度认知障碍14例(26.41%)。结论 紧张性头痛患者多半与紧张的工作与生活环境导致头颈部肌肉的持续痉挛有关，大部分患者都存在不同程度的心理障碍，部分有轻度认知障碍，男女无明显差异(P>0.05)。建议应给予患者适当的康复治疗。 关键词 紧张性头痛 病因 认知障碍 Analysis of pathogeny and cognitive impediment of tension headache.GU Jianxiong,QU Jianping,YANG Biao(Department of convalescance of Affiliated Hospital Guangdong Medical College Guangdong Zhanjiang 524001 Chi-na) Abstracte Objective Probe the possible pathogeny of tension headache as well as some emotion and cognitive function impediment.Method After grouping,analyzing,arranging,classifying the clinic data of 53 cases of patients of tension headache,all patients were given coronal CT or MRI examination and cervix X-ray examination,use Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS),and Mini-Mental State Examination (MMSE) to asses emot-ion and cognition.Result 42 cases of cervical spondylosis (79.24%),11 cases of others (20.76%);14 cases of anxiety and(or) depression induced by magnitude mental events (26.41%),23 cases of anxiety induced by work tensions (43.41%),14 cases of depression induced by work tensions (26.41%);14 cases of lightly cognitive impediment (26.41%).Conclusion Tension headache patients usually related with intensive work and life condition which indu-ced continued convulsion of cervical muscle,most patients have moor less psychology impediment,part of them have lightly cognitive impediment,there is no significant difference between male and female patients.We suggest proper c-onvalescence treatment should give to patients. Key words Tension headache;Pathogeny;Cognitive impediment 紧张性头痛是一种常见的慢性头痛，病因尚未完全明确。患者常因头痛而产生一些不良的情绪,如焦虑或抑郁，从而影响工作及睡眠。本文旨在分析其病因,探讨其精神、心理状况及认知功能，从而为其治疗提供一些临床依据。 1 资料与方法 1.1 临床资料 本组53例患者均为我科今年4月至今年4月门诊及住院病人，其中男22例，女31例；平均年龄男34.8±10.3岁，女32.5±10.5岁；平均病程男10.2±9.5年，女11.1±10.3年；均符合紧张性头痛的诊断标准［1］。有关临床资料见表1。 表1 男女患者临床资料比较
1.3 统计学处理 所有数据均由SPSS 10.0统计软件处理，计数资料采用χ2检验，计量资料采用t检验。 表2 男女临床检查及评估结果比较
2.1 病因及伴随疾病 53例患者中,有重大精神刺激14例(占26.41%),工作及学习紧张28例(占53.84%),不明原因11例(占20.76%),头颅MRI及CT检查均为正常，颈椎X线或CT检查提示颈椎轻度异常(颈椎增生或颈椎生理曲度变直)42例(占79.24%)，肌筋膜炎8例(占15.09%)，轻度头颅外伤(头皮裂伤)3例(占5.67%)，伴有睡眠障碍35例(占66.04%)。男女差异不显著(P>0.05)。 |
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