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英國(guó)國(guó)家衛(wèi)生與臨床優(yōu)化研究所近期發(fā)布的頭痛治療指南指出，過(guò)度服用止痛片是頭痛久治不愈的源頭，甚至?xí)又夭∏椋颊邞?yīng)該停止對(duì)止痛片的依賴(lài)。世界衛(wèi)生組織的數(shù)據(jù)顯示，因過(guò)度服用藥物導(dǎo)致的頭痛患者占所有頭痛患者的5%。華威醫(yī)學(xué)院教授馬丁?安德伍德表示，用止痛片在解決頭痛問(wèn)題可能會(huì)陷入一個(gè)惡性循環(huán)，頭痛越厲害，服用的止痛片越多，結(jié)果導(dǎo)致頭痛更加嚴(yán)重。至于止痛片為何會(huì)對(duì)頭痛患者有如此影響，目前尚無(wú)從得知。不過(guò)，英國(guó)國(guó)立神經(jīng)內(nèi)外科醫(yī)院一位神經(jīng)科醫(yī)生表示，頭痛患者每月服用止痛片達(dá)到10至15天時(shí)通常會(huì)出現(xiàn)上述惡性循環(huán)情況。在頭痛治療指南中，醫(yī)學(xué)專(zhuān)家們建議頭痛患者停止服用止痛片，提前進(jìn)行預(yù)防性治療，并建議用針灸來(lái)治療頭痛。另外，專(zhuān)家們還建議患者不要為了“確信沒(méi)有長(zhǎng)腦瘤”而做腦部掃描檢查。他們表示，腦瘤通常會(huì)伴有行為類(lèi)變化等其他癥狀。
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Up to a million people in the UK have "completely preventable" severe headaches caused by taking too many painkillers, doctors said. |
Up to a million people in the UK have "completely preventable" severe headaches caused by taking too many painkillers, doctors said.
They said some were trapped in a "vicious cycle" of taking pain relief, which then caused even more headaches.
The warning came as part of the National Institute for Health and Clinical Excellence's (NICE) first guidelines for treating headaches.
"Medication overuse headaches" feel the same as other common headaches or migraines.
There is no definitive UK data on the incidence of the condition, but studies in other countries suggest 1-2% of people are affected, while the World Health Organization says figures closer to 5% have been reported.
While painkillers would be many people's instant response, they could be making sufferers feel even worse.
Prof Martin Underwood, from Warwick Medical School, who led the panel, said: "This can end up getting into a vicious cycle where your headache gets worse, so you take more painkillers, so your headache gets worse and this just becomes worse and worse and worse.
"It is such an easy thing to prevent."
Exactly how painkillers have this effect on the brain is unknown.
Most of the people affected are thought to have started with either everyday, tension-type headaches or migraines. The headaches then became worse as they treated themselves at home.
Manjit Matharu, a consultant neurologist at the National Hospital for Neurology and Neurosurgery, said there was a tipping point at 10 to 15 days of using pain relief each month when the drugs became the issue.
He said: "This is a huge problem in the population. The figures in terms of the number of people who have medication overuse headache are one in 50, so that is approximately a million people who have headaches on a daily or near daily basis because they're using painkillers."
People with a family history of tension-type headaches or migraine may also be genetically more vulnerable to medication overuse headaches. They could be susceptible when taking pain relief even if it is not for headaches.
The new guidelines for doctors in England and Wales advise telling sufferers to immediately stop taking all pain relief. However, this will lead to about a month of agony as patients contend with regular headaches without pain relief, until symptoms eventually improve.
The panel said other options for controlling any underlying headaches, such as preventative treatments, could be considered.
The guidelines also include a recommendation for acupuncture in patients susceptible to migraine and tension headaches.
"We would expect that to lead to more people getting acupuncture, but given there is good evidence to show this is effective for the prevention of both tension-type and migraine-type headaches then that is a good thing because people are getting access to an effective treatment," Underwood said.
Doctors have also been asked not to refer patients for brain scans "solely for reassurance" that they do not have a brain tumor. The panel said a tumor would come with other symptoms such as a change in behavior or epilepsy.
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(Agencies)
（中國(guó)日?qǐng)?bào)網(wǎng)英語(yǔ)點(diǎn)津 Helen ）
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