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英国国家卫生与临床优化研究所近期发布的头痛治疗指南指出，过度服用止痛片是头痛久治不愈的源头，甚至会加重病情，患者应该停止对止痛片的依赖。世界卫生组织的数据显示，因过度服用药物导致的头痛患者占所有头痛患者的5%。华威医学院教授马丁?安德伍德表示，用止痛片在解决头痛问题可能会陷入一个恶性循环，头痛越厉害，服用的止痛片越多，结果导致头痛更加严重。至于止痛片为何会对头痛患者有如此影响，目前尚无从得知。不过，英国国立神经内外科医院一位神经科医生表示，头痛患者每月服用止痛片达到10至15天时通常会出现上述恶性循环情况。在头痛治疗指南中，医学专家们建议头痛患者停止服用止痛片，提前进行预防性治疗，并建议用针灸来治疗头痛。另外，专家们还建议患者不要为了“确信没有长脑瘤”而做脑部扫描检查。他们表示，脑瘤通常会伴有行为类变化等其他症状。 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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