Clinical effect of "head-nine-needle" therapy on tension headache / 针刺研究

OBJECTIVE: To observe the effect of the "head-nine-needle" therapy on tension headache. METHODS: A total of 150 patients with tension headache were divided into a head-nine-needle therapy group, a western medicine control group and an acupuncture control group according to the random number table, 50 cases in each one. In the head-nine-needle therapy group, the head-nine-needle therapy was adopted. In the western medicine control group, epiperisone hydrochloride tablets were prescribed for oral administration, 50 mg, three times a day as well as fluoguili hydrochloride capsules, 5 mg, once a day, taking orally before sleep. In the acupuncture control group, the routine acupuncture technique was used at Baihui (GV20), Taiyang (EX-HN5), Fengchi (GB20) and Ashi (extra), etc. The clinical effect was observed in each group. The scores of visual analogy scale (VAS) for headache severity and the scores of headache duration were assessed before and after treatment in the patients of each group. RESULTS: In comparison of the total effective rate among the groups, there was no significant difference between the head-nine-needle therapy group (48/50，96.0%) and the acupuncture control group (47/50，94.0%). The total effective rate of either of the two groups was higher than that of the western medicine control group (40/50，80.0%，P0.05). After 3 weeks and 4 weeks of treatment, the scores in the two acupuncture groups were all better than those in the western medicine control group (P<0.05). CONCLUSION: The "head-nine-needle" therapy achieves the obviously advantages in the alleviation of headache degree as compared with the simple western medicine and its effect is similar to the common acupuncture therapy in the patients with tension headache.

Clinical Observation of Plum-blossom Needling Combined with Deanxit for Treatment of Depression or Anxiety in Chronic Tension Headache Patients / 广州中医药大学学报

Objective To observe the clinical efficacy of plum-blossom needling combined with Deanxit for the treatment of depression or anxiety in chronic tension headache patients. Methods Sixty chronic tension headache patients with depression and/or anxiety were randomized into treatment group and control group , 30 cases in each group. The treatment group was treated by plum-blossom needling combined with oral use of Deanxit , and the control group was treated only by oral use of Deanxit. After treatment for 4 weeks , the scores of headache symptom, Hamilton Depressive Scale (HAMD), and Hamilton Anxiety Scale (HAMA) of the two groups were observed. Results After treatment , the scores of headache symptom , HAMA and HAMD in all patients were decreased (P < 0 . 05 compared with those before treatment), and the decrease in the treatment group was obviously superior to that in the control group, the difference being significant between the two groups (P <0.05). Conclusion Plum-blossom needling combined with Deanxit shows better effect than Deanxit for the treatment of depression or anxiety in chronic tension headache patients.

A TOPIC REVIEW: IS MANUAL THERAPY EFFECTIVE IN THE MANAGEMENT OF TENSION TYPE HEADACHES IN PRIMARY CARE?

Headaches are one of the commonest neurological disorders with a global lifetime prevalence of 66 percent (1), and 82.7 percent in Singapore (2). Tension type headache (TTH) is the commonest primary headache with a lifetime prevalence of 30-78 percent globally (1). TTH is related to muscular factors (17) thus treatment directed toward muscular factors such as manual therapy can be considered (18). This review is aimed at evaluating the use of manual therapy for TTH.

A Topic Review: Is Manual Therapy Effective In The Management Of Tension Type Headaches In Primary Care?

@#Headaches are one of the commonest neurological disorders with a global lifetime prevalence of 66 percent (1), and 82.7 percent in Singapore (2). Tension type headache (TTH) is the commonest primary headache with a lifetime prevalence of 30-78 percent globally (1). TTH is related to muscular factors (17) thus treatment directed toward muscular factors such as manual therapy can be considered (18). This review is aimed at evaluating the use of manual therapy for TTH.

Clinical Efficacy and Effects on Hemorheology of Acupuncture Therapy Combined with Gabapentin in the Treatment of Patients with Tension Headache / 中国药师

Objective:To investigate the clinical efficacy and effects on hemorheology of acupuncture therapy combined with gaba-pentin in the treatment of patients with tension headache. Methods:Totally 92 cases of patients with tension headache were randomly divided into the observation group (n=46) and the control group (n=46) according to the random number table. The control group was given gabapentin, while the observation group was treated with acupuncture therapy on the basis of treatment in the control group. The treatment course was 4 weeks. The clinical efficacy, changes of the headache indices, VAS score and hemorheology levels before and after the treatments in the two groups were compared, and the incidence of adverse reactions was observed as well. Results:The to-tal effective rate of the observation group (93. 48%) was significantly higher than that of the control group (73. 91%, P<0. 05). Af-ter the treatment, the headache indices in both groups significantly decreased (P<0. 05), and the decrease in the observation group was more significant than that in the control group (P<0. 05). The VAS scores in both groups significantly decreased after the treat-ment (P<0. 05), and the decrease in the observation group was more significant than that in the control group (P<0. 05). The plas-ma viscosity, hematocrit and platelet aggregation rate in both groups significantly decreased after the treatment (P<0. 05), and the decrease in the observation group was more notable than that in the control group (P<0. 05). No severe adverse reactions were shown in both groups during the treatment course. Conclusion: Acupuncture therapy combined with gabapentin in the treatment of patients with tension headache shows striking effects, which can improve hemorheology with promising safety and deserves further studies.

Cefalea primaria y cervicalgia en el Hospital San Francisco de Quito / Primary headaches and neck pain in the San Francisco de Quito Hospital

Introducción: las cefaleas en conjunto son la primera causa de consulta ambulatoria neurológica. De todos los tipos de cefalea, tanto primarias como secundarias a otro proceso, el 90% de los pacientes que presentan este trastorno, padecen migraña y/o cefalea tensional. Muchos pacientes con cefalea primaria manifiestan presentar dolor en la región cervical. El objetivo del presente trabajo es conocer la epidemiología de cefalea primaria en pacientes atendidos en el Hospital San Francisco de Quito (HSFQ) y valorar la prevalencia de cervicalgia en este grupo de pacientes y la relación de este síntoma con rectificación de la lordosis fisiológica. Materiales y métodos: se realizó un estudio observacional en donde se analizaron los expedientes clínicos de 356 pacientes con cefalea tensional o migraña según los criterios de la "International Headache Society" valorados en la consulta externa de Neurología entre el 01 de marzo y el 31 de diciembre de 2013. Resultados: en la muestra se observó que un 71% y 29% de pacientes padecen cefalea tensional y migraña respectivamente, con un predominio de mujeres en relación a los hombres en ambos casos. La migraña es más prevalente que la cefalea tensional en la pubertad y afecta principalmente al grupo de edad comprendido entre los 25 y los 40 años. La cefalea tensional presenta un pico de prevalencia entre los 35 y 59 años de edad. 269 pacientes equivalente al 76% de los casos presentaron cervicalgia concomitantemente, con la cefalea sin encontrarse una diferencia significativa entre la presencia de este síntoma y cefalea tensional o migraña. Los pacientes que presentaban un dolor cervical entre moderado y grave medido por escala análoga visual, tenían en su mayoría una rectificación de la lordosis cervical valorada mediante el método de Gore. Conclusiones: la prevalencia de cervicalgia en pacientes con cefalea primaria en el presente estudio está en torno al 76%. No existe una diferencia estadísticamente significativa en relación a la presencia de cervicalgia entre personas con cefalea tensional o migraña. El presente estudio nos permite conocer cuál es la epidemiología de las cefaleas primarias en una muestra de población ecuatoriana y es un punto de partida para futuros estudios con el fin de demostrar una asociación entre cervicalgia y cefaleas primarias.

Introduction: headaches are the leading cause of neurological consultations. From all types of both primary and secondary, 90 % of patients with this disorder showed migraine and / or tension headache. Many patients with primary headache complained about pain in the cervical region. The objective of this study is to determine the epidemiology of primary headache in patients seen at the San Francisco of Quito Hospital and assess the prevalence of neck pain in this group of patients and the relationship of this symptom with rectifcation of physiological lordosis. Materials and methods: an observational study was performed, where medical records of 356 patients with tension headache or migraine according to the criteria of the International Society Headache seen at the outpatient Neurology between march 1 and december 31, 2013 was conducted. Results: it was observed that 71 % and 29% of patients suffer from tension headache and migraine respectively, with a predominance of women in relation to men in both cases. Migraine is more prevalent than tension headache at puberty and affects mainly the group aged between 25 and 40 years. Tension headache has peak prevalence between 35 and 59 years old. 269 patients equivalent to 76% of cases had neck pain along with tension headache without fnding a signifcant difference between the presence of this symptom and tension headaches or migraine. Most of the patients, who had a cervical pain from moderate to severe measured by visual analog scale had also a correction of cervical lordosis assessed by the method of Gore. Conclusions: the prevalence of neck pain in patients with primary headache in the present study is around 76%. There is no statistically signifcant difference in relation to the presence of neck pain among people with tension headache or migraine. This study allows us to know the epidemiology of primary headache disorders in a sample of Ecuadorian population and it is a starting point for future studies to demonstrate a connection between cervical pain and primary headaches.

Frequência das cefaleias primárias na comunidade e em centros de cuidados especializados / Frequency of primary headaches in the community and in specialized care centers

JUSTIFICATIVA E OBJETIVOS: A comparação entre as características da cefaleia encontradas na população geral e em centros de cuidados terciários pode elucidar fatores associados à procura de consulta médica e obstáculos ao atendimento. O objetivo deste estudo foi contrastar os achados demográficos e a frequência de migrânea e de cefaleia do tipo tensional (CTT) na população geral e em um centro de atendimento especializado. MÉTODO: Todos os habitantes de uma pequena cidade foram entrevistados quanto à presença de cefaleia. Em uma região, escolhida por sorteio, os moradores que responderam positivamente foram avaliados por uma equipe de neurologistas especialistas em cefaleia. Esses profissionais também avaliaram uma casuística de pacientes atendidos consecutivamente em um centro especializado. Os diagnósticos seguiram os critérios da Classificação Internacional das Cefaleias-2004. RESULTADOS: Foram entrevistados 1.605 moradores em toda cidade e 258 na região da amostra. Destes, os 76 que tinham cefaleia passaram por avaliação neurológica, bem como 289 pacientes do centro especializado. As mulheres representaram a maioria, tanto na comunidade quanto no ambulatório. Na população, a frequência de CTT foi de 77,6% e a de migrânea de 61,8%, havendo sobreposição diagnóstica em boa parcela dos casos. Já no ambulatório a vasta maioria dos pacientes tinham migrânea (79,8%), enquanto apenas 20,4% tinham CTT, sendo a associação diagnóstica bem menos comum. CONCLUSÃO: A CTT é mais comum na comunidade e a migrânea em centros especializados. Conhecer os contrastes destas cefaleias primárias nestes dois cenários pode auxiliar o planejamento de ações preventivas e utilização dos recursos assistenciais.

BACKGROUND AND OBJECTIVES: The comparison of headache features in general population and in tertiary care centers may explain factors associated to the search for medical assistance and the obstacles to such assistance. This study aimed at comparing demographic findings and the frequency of migraine and tension headache (THA) in general population and in a specialized care center. METHOD: All inhabitants of a small village were interviewed about the presence of headache. In one randomly selected region, people who answered positively were evaluated by a team of neurologists specialized in headache. They have also evaluated a number of patients consecutively treated by a specialized center. Diagnoses have followed International Headaches Classification criteria (2004). RESULTS: Participated in this study 1605 inhabitants of the whole village and 258 inhabitants of the region selected as sample. From these, 76 people reporting headache went through a neurological evaluation, as well as 289 patients of the specialized center. THA was the most common headache among general population (77.6%), followed by migraine (61.8%) with diagnostic overlapping in a good percentage of cases. In the outpatient setting the vast majority of patients had migraine (79.8%), while only 20.4% had THA, being the diagnostic association far less common. CONCLUSION: THA is more common in the community and migraine prevails in specialized centers. Understanding the contrasts of both primary headaches within these two scenarios may help the planning of preventive actions and the use of health care resources.

A Clinic Trial of Venlafaxine Oblatum in Treating 20 Cases of Chronic Tension Headache / 医学研究杂志

Objective To evaluate the therapeutic effect and safety of Venlafaxine oblatum in treating chronic tension headache.Methods A clinic study using randomized double-blind double-simulation parallel controlled trial and take Naproxen tablets as contrast control.The experimental group(venlafaxine group) was given venlafaxine oblatum 25 mg bid and the control group(naproxen group) naproxen tablets 200 mg bid.Results Both the experimental group and the control group had 20 patients and all of them completed the treatment trial.After 14 days treating,the experimental group got 30% clinic control rate and the control group reached 15% clinic control rate respectively;the clinic total effective rate of the experimental group and control group was 65.00%and 40.00%respectively,clinic benefit rate 90.00%and 85.00%,living quality improvement rate 35.00%and 25.00%,and the adverse effect rate was 30.00%and 30.00%.The difference between two groups had not statistically significant.Conclusions The effect and safety of Venlafaxine for treating chronic tension headache was at least as well as Naproxen Tablets.

Analysis of Psychological and Cognitive State of Patients with Tension Headache / 中国康复理论与实践

@#ObjectiveTo explore the possible pathogeny of tension headache(TH) as well as some emotional and cognitive function impediment.Methods53 cases with tension headache were given coronal CT or MRI examination and cervix X-ray examination.Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS) and Mini-Mental State Examination(MMSE) were used to assess their emotion and cognition.ResultsThere were 14 cases of magnitude mental events induced anxiety and/or depression,23 cases of work tensions induced anxiety,14 cases of work tensions induced depression,and 12 cases of lightly cognitive impediment.ConclusionTension headache patients usually related with continued convulsion of cervical muscle induced by hard work and life.Most of them represent more or less emotional impediment,part of them represent lightly cognitive impediment.

Comparison of Effectiveness of Stellate Ganglion Block between Chronic Tension Headache and Chronic Migraine Patients / 대한마취과학회지

BACKGROUND: The treatment for chronic headache is not simple because of the complexity of its cause and etiology. A stellate ganglion block (SGB) is normally used to treat chronic headache. This study compared the effectiveness of SGB in treating tension headache and migraine patients by evaluating its effect on pain alleviation and improving the quality of life after an 8 week treatment duration. METHODS: Forty-six patients, who experienced headache for more than 4 hours a day and more than 15 days a month and were diagnosed with chronic headache, were enrolled in this study. The patients were classified into two groups, the migraine group (MG, n = 26) and the tension headache group (TG, n = 20). The patients were treated with SGB only and the degree of pain was evaluated after 4 and 8 weeks of treatment, and 4 weeks after the end of treatment. The treatment was applied twice a week during 8 weeks. The effects of these treatments in the two groups were analyzed using Visual Analogue Scale (VAS) pain scores and Brief Pain Inventory (BPI). RESULTS: The VAS and BPI after 8 weeks of treatment showed significant differences compared with those of MG and TG before treatment, and there were no differences between the two groups. The VAS and BPI of the two groups, 4 weeks after the end of treatment, showed statistically significant improvement compared with those before treatment. CONCLUSIONS: The above results suggested that SGB might be an useful modality for the alleviating the pain and improving the quality of life in TG and MG patients.

A Study on Headache in an Island Area of Korea

BACKGROUND: Headache is one of the most common disorders, and shows ethnic or geographic diversities. Moreover, the prevalence and epidemiologic characteristics of headache, especially in people living in an island area, is lacking. Therefore, we investigated the prevalence and subtypes of headache in an island area of Korea. METHODS: We collected the demographic and clinical data of all residents living in the survey island area. A neurologist interviewed 352 respondents in a face-to-face method. The specific headache diagnosis was based on the diagnostic criteria of the International Headache Society. RESULTS: The survey island area represented a typical aging society like that of a rural area in Korea. Tension-type headache was the most common type. The prevalence of migraine, tension-type headache, and other headache were 4.0%, 7.1%, and 1.7%, respectively. Migraine with aura occupied 1.7% and migraine without aura occupied 2.3%. Episodic tension-type headache occupied 6.5% and chronic tension-type headache occupied 0.6%. Migraine showed a peak prevalence below the third decade of age and tension-type headache showed a peak prevalence above the sixth decade. CONCLUSIONS: This study showed a characteristic pattern of the prevalence of headache in an island area of Korea. We thought this low prevalence of headache might be due to not only subject age but also social-environmental factors. This study may be helpful in understanding headaches and can provide some basic information for future studies.