中国偏头痛诊断治疗指南2011

do:i10.3969/.jissn.1006-9852.2011.02.001##(按姓氏汉语拼音顺序排列)李舜伟李焰生刘若卓乔向阳万琪杨晓苏于生元v于挺敏邹静()()()()()()()()1.2.()1.2.3.4.5.CTMRI()()1.v:,100853Emai:[e-mail]#65#ChineseJournalofPainMedicine2011,17,(2)2.3.4.()()()()()()()()()()()()1.(1)(2)2.(1)(2)(3)Gepant3.()()()1.2.3.4.()()()()1.B2.3.4.5.NSAIDs6.()()()1.(1)(2)2.3.4.()()()()()()#66#ChineseJournalofPainMedicine2011,17,(2),,3.3%~32.6%,0.7%~16.1%,4%,,,40,1/2,1/3(WHO)2001(YearsLivedwithDisability,YLD),20,,,,(transientischemicattack,TIA),,,,MRI,,,,,,2006/0,,,:;;;(InternationalHeadacheSo-ciety,IHS);;30,:(1);,;(2);(3),;(4),,,,,,IHS1988,1990,19881990,/0(TheGradingofRecommendationsAssessmen,tDevelopmentandEvaluation,GRADE)4:Ñ():;Ò():;Ó():,;Ô():2:A():,;,B():,;,,,,,,#67#ChineseJournalofPainMedicine2011,17,(2),(),,,(),,,/0,,/0,,,5~30,60()60%,,40%,,,,,,,2/3,,,(allodynia)()4~72,(1)2004,IHS/0(ICHD-Ò),:,,,6,(2)()()1()/2ICHD-II1.11.21.2.11.2.21.2.31.2.41.2.51.2.61.31.3.11.3.21.3.31.41.51.5.11.5.21.5.31.5.41.5.51.61.6.11.6.21.6.3#68#ChineseJournalofPainMedicine2011,17,(2),,65.2%,ICHD-II,,,(1)1(),,,,(1),,,,,;;,,(),(),,,,,,,(),,/0,:(1)();(2)();(3);(4)50;(5);(6);(7),,()1.(3)3A.B-D5B.()4~72C.21.2.3.4.()D.11.()2.E.2.:,2#69#ChineseJournalofPainMedicine2011,17,(2)4B-D,1,(4),(5),(6),,,(7),(8)(),,(9),2:604A.B-D2B.1,:1.,()()()2.,()()()3.C.21.()2.1\5,(),\53.5~60D.60,B-DE.5A.2B~DB.,:1.,()/()2.,()/()3.C.2:1./2.\5/\53.\5[60D.60B-DE.6A.2B~DB.,,:1.,()/()2.,()/()C.2:1./2.\5/\53.\5[60D.60E.D.60B-DE.7A.2B~DB.,:1.,()/()2.,()/()3.C.2:1./2.\5/\53.\5[60D.60B-DE.8A.2B~CB.,:#70#ChineseJournalofPainMedicine2011,17,(2)1.,()/()2.,()/()3.C.2:1.\5/\52.\5[243.601.1B-DD.A-EE.9A.2B~DB.2,:1.2.3.4.5.6.7.8.9.C.1:1.\5/\52.\5[60D.601.1B-DE.,,(),1.:,50,,C-2.:15%,0.2%~9%,,:,3.::4.:,CT,5.CTMRI:CTMRI18764CTMRI,1.2%/0,0.9%,0.4%11,/00.2%3383,MRI7(2.1%),,MRI,,MRICT,MRICT,CTMRI:CT,MRI()DSA,CTMRI#71#ChineseJournalofPainMedicine2011,17,(2)(),12,(10),,10,,184~7215~180,,///(),,ICHD-II1.::;,;;;20%,,,30:(1):,,,(2):,1~72,-,:;/0;-,2,(3):,,,2.:,,4~5,(1):,32,,1?2,-2+3,(2):,1?2,-2+3,32,,,3.:ICHD-Ò,,315,2006(11),ICHD-Ò#72#ChineseJournalofPainMedicine2011,17,(2)11A.3(/)\15B.5C.3\8C1/C2,1.a-d(a)(b)(c)(d)()ab(a)()(b)2.C1,D.,4.:72,(12)12A.,B.1.722.C.,,,,,:(VisualAnalogueScale,VAS)(NumericRatingScale)(MigraineDisabilityAssessmentQuestionnaire,MI-DAS)(HeadacheImpactTes,tHIT)-6(HIT-6)IDMigraine()(VAS),10cm,/0(0)/0(10)()(2),,2,,111010,10100()MIDAS3(2)5,,4,()HITHIT-6HIT,,,5HIT,,,HIT-6HIT(3),6#73#ChineseJournalofPainMedicine2011,17,(2)6HIT,,HITHITHIT-6,()IDMigraine(4),()(1);(2),;(3),(),,;,;,()()()(),,(),():;,;;():2;2,(VAS50%);,32;24,MIDASHIT-6()1.::¹(NSAIDs,),;º;»(1):,,,(ASA)300~1000mg,200~800mg,250~1000mg,50~100mg,1000mg,200mg,(B),ASA,,20~40mg25~50mg(13)(acetylsalicylicacid,ASA)::1300~1000mg,,1300~600mg1000mg252%(I),50mg,0.30.5g,150~250ml,(),,0.9g(0.5g)0.5g(0.28g),0.9~1.8g2,43.7%,6mg,24,,,,,,;,,#74#ChineseJournalofPainMedicine2011,17,(2),,(ibuprofen):(I):1200~800mg,200mg400mg,2,,400mg,250mg,,,24ASA(naproxen)::250~1000mg1250mg275mg,(I),50mg,50mg,ASA,,ASA(diclofenac):,,,(I)100mg,,150mg,10,3088%,2100mgASA(paracetamol):1000mg15mg/kg(I),ASA,,ASA,,ASA(medicationoverusehead-ache,MOH),,15,10616Kg625Kg10ASA,13(mg)300~1000IA::,200~800IAASA250~1000IAASA250~100IIA1000IIA250200~25050IAASA(2):,,(14),,,MOH,,,,,(III)#75#ChineseJournalofPainMedicine2011,17,(2)14(mg)I10~202010,II10,,I20~30102.(1)(triptan):5-1B/1D,,,,,24(15%~40%),,,,,:(),100mg6mg,10,280%ASA1000mg,20mg,50mg100mg,,50mg100mg2550mg,100mg50mgASA1000mg,100mgASA900mg10mg:2.5mg5mg,,40~60,,35mg62.5mgASA900mg10mg,5mg,12.5mg,212.5mg40mg50mg,2.5mg;210mg5mg,250mg100mg:5mg10mg10mg,,2,,10mg100mg,:2.5mg,,4,50mg100mg,,66.25mg12.5mg,40~60,6.25mg12.5mg12.5mg,10mg100mg,100mg,allodynia20mg40mg,40mg80mg,,80mg,(2):,(2mg200mg1mg100mg)ASA,2,,MOH,,(15)(3)(CGRP):CGRP(gepant),gepant#76#ChineseJournalofPainMedicine2011,17,(2)2()telcagepant(MK-0974),300mg210mg5mg,15(mg)25,50,100(,)25()1020()6()IAAAA:,,,,,,,,,,,,,,,:Raynaud18652.5,5(,,)IA2.5()IA5,10(,)IA12.5()IA20,40()IA2.5()IAIIB::RaynaudTelcagepant(MK-0974)300()IB3.-(Ò):ASA,,,(),cAMP,cAMP,,,,MOH()(16)()2:¹,NSAIDs,º,,,NSAIDs(thedisabilityinstrategiesofcare,DISC),2,,,,,,;,,,MOH,NSAIDs15/,NSAIDs10/#77#ChineseJournalofPainMedicine2011,17,(2)16(mg)NSAID1000;1000A,200~800A,500~1000A,50~100A1000A++250+200-250+50AASA:,;10001000B1000B200B,2550100,;25;1020;6A:TIA12MAO(2)100mg2.55,;2.55A2.5A;10,A;,5mg12.5A2040A40mg,80mg2.5A2B:12TIA2B10~20;20;10B:1420~30B:10,()1.:,,,,,(50~100mg10mg),,#78#ChineseJournalofPainMedicine2011,17,(2),,2.:,()2~24,-ASA,,15%~40%3.:(10mg/kg)(15mg/kg)(16kg)(625kg)ASA1211,5~20mg(10mg),,ASANSAIDs,4.:,,,(1g),NSAID,,,()()(),,,,:¹();º2;»;¼,;½36~8;¾72;¿()():BNSAID1.B:B,BB,,B,B2.:,5mg~10mg,,,,,3.:(600mg),()(25~100mg),MOH,4.:,4#79#ChineseJournalofPainMedicine2011,17,(2),10mg~150mg,,()1(SSRI)3,1,25.NSAIDs:ASA200~300mgASAASA,31000mg,2,6.:,(400mg)Q10,1,1(Petasiteshybridus)2,75mg(Tanacetumparthen-ium),,,,,,(6),4~6,,1,,A,7,1AA,-(50mg/d)-1()(17)(),,,,,,,,,4~8,50%6,,,,;,,,#80#ChineseJournalofPainMedicine2011,17,(2)17(mg)B50~20040~2405~10AAB:;(1%):;5~10A:;:500~1800A25~100A