偏头痛社区你的偏头痛程度处于哪个区间？
2023年8月31日·223 阅读
<p data-first-child="" data-pid="q1L_aubH" style="margin-top: 0px; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">偏头痛按照国际上正式ICHD-3标准，根据每个月发作天数的多少，以15天作为分水岭，分为发作性偏头痛和慢性偏头痛两种。</p><p data-pid="0XPpHrTb" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">15天的分水岭一过，处理难度增加，一般医生会改变策略，不再采用保守的策略，改为更激进的方式和用药原则。</p><h2 style="font-stretch: inherit; font-size: 1.2em; line-height: 1.5; font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: calc(2.33333em) 0px calc(1.16667em); clear: left; font-synthesis: style; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); text-wrap: wrap;">但是近年来，有些欧美的医生开始采用三分法，即在两者中间增加了高频发作性偏头痛，把这个阶段作为一个主要控制区间。</h2><p><figure data-size="normal" style="margin: 1.4em 0px; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;"><img src="/uploads/ueditor/20230831/64f04bca08296.png" data-caption="" data-size="normal" data-rawwidth="960" data-rawheight="1280" data-original-token="v2-6f8ba4a6aa5beb1cb54a9546e7950320" class="origin_image zh-lightbox-thumb lazy" width="960" data-original="https://pic3.zhimg.com/v2-f1315c33043535145513652ebf40abaa_r.jpg" data-actualsrc="https://pic3.zhimg.com/v2-f1315c33043535145513652ebf40abaa_b.jpg" height="1280" data-lazy-status="ok" style="display: block; margin: 0px auto; max-width: 100%; height: auto; cursor: zoom-in; animation: 0.5s ease-in 0s 1 normal none running animation-1yvu044;"/></figure></p><p data-pid="yTRcjewd" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">为什么增加这个区间呢？因为如果你已经处于这个区间，你必须打起十二分精神来管理你的偏头痛！一旦进入慢性偏头痛，随着不得不用更多频次的止痛药，会出现药物过量性头痛，此时会形成“乒乓球效应”。</p><p data-pid="jbArSVCF" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;"><span style="font-synthesis-weight: none; font-synthesis-style: auto; font-synthesis-small-caps: none; font-weight: 600;"><em>记住：偏头痛如果不加控制管理，是会不断发展的，无论是诱因还是外在表现。所以不能破罐子破摔。</em></span></p><h2 style="font-stretch: inherit; font-size: 1.2em; line-height: 1.5; font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: calc(2.33333em) 0px calc(1.16667em); clear: left; font-synthesis: style; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); text-wrap: wrap;">那么三个区间的偏头痛应该如何处理呢？</h2><h3 style="font-stretch: inherit; font-size: 1.1em; line-height: 1.5; font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: calc(1.90909em) 0px calc(1.27273em); clear: left; font-synthesis: style; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); text-wrap: wrap;">1、发作性偏头痛。</h3><p data-pid="dl-f3UDC" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">保守原则，建议通过<span style="font-synthesis-weight: none; font-synthesis-style: auto; font-synthesis-small-caps: none; font-weight: 600;">经常性</span>的锻炼身体，外加注意饮食的平衡性，在偶尔发作时服用紧急止痛药，即可以控制偏头痛。</p><p data-pid="WmxS4daw" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">如果能采用物理方式止痛，尽量采用物理方式，只有在物理方式失败后，才建议及时采取药物控制。</p><h3 style="font-stretch: inherit; font-size: 1.1em; line-height: 1.5; font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: calc(1.90909em) 0px calc(1.27273em); clear: left; font-synthesis: style; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); text-wrap: wrap;">2、高频发作性偏头痛。</h3><p data-pid="6fQmpJYX" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">这时必须经<span style="font-synthesis-weight: none; font-synthesis-style: auto; font-synthesis-small-caps: none; font-weight: 600;">规律性</span>锻炼，应该剔除明显的饮食诱因。发作时要及时服用止痛药，物理方式作为辅助性手段。</p><p data-pid="0xtVqCbQ" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">这个偏头痛发作频次之下，患者已经暴露在药物过量的风险中，所以建议采用“三药轮换”的方式，避免或延缓出现药物过量的情况。</p><p data-pid="mTEOnJxc" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">患者应该严格自己的生活方式，记录偏头痛日记，对自己的偏头痛进行动态控制。因为此时的偏头痛，已经开始出现性质的变化，比如从单纯的先兆型偏头痛转化为前庭性偏头痛等。</p><h3 style="font-stretch: inherit; font-size: 1.1em; line-height: 1.5; font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: calc(1.90909em) 0px calc(1.27273em); clear: left; font-synthesis: style; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); text-wrap: wrap;">3、慢性偏头痛。</h3><p data-pid="3PEIoy36" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">这时患者已经处于非常艰难的处境，已经说不清是单次偏头痛在持续发作，还是多次偏头痛“一波示平，一波又起”，生活与情绪均会受到很大的影响。</p><p data-pid="Vg1sTeEl" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">这时医生一般会建议采取星状神经阻滞、A型肉毒杆菌等手术方式进行控制，以求患者中断止痛药的连续服用。</p><p data-pid="Z3lo52XY" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">患者不仅面临因为药物用量和频次的增加困境，还面临多种药物失效以致无药可用的困境，（许多患者不得不采用麻醉性药物。）</p><p data-pid="6ppkJ4xg" style="margin-top: 1.4em; margin-bottom: 1.4em; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; text-wrap: wrap;">好消息是，现在CGRP拮抗类药物的上市，给了患者和医生一个新的选择，可以在anti-CGRP药物的控制之下（一般一次用药可以控制一个月，也有隔天服以用的，其副作用和耐药风险很低），重新建立生活和治疗方式，而不是再“用药”还是“硬抗”之间进行选择。</p><h2 style="font-stretch: inherit; font-size: 1.2em; line-height: 1.5; font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Microsoft YaHei", "Source Han Sans SC", "Noto Sans CJK SC", "WenQuanYi Micro Hei", sans-serif; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: calc(2.33333em) 0px calc(1.16667em); clear: left; font-synthesis: style; caret-color: rgb(18, 18, 18); color: rgb(18, 18, 18); text-wrap: wrap;">所以，无论你处于哪个区间，千万不要灰心，办法总是有的。</h2><p><br/></p>