鼻源性头痛的研究动态分析

doi:10.6040/j.issn.1673-3770.0.2019.557

山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (4): 130-133.doi: 10.6040/j.issn.1673-3770.0.2019.557

鼻源性头痛的研究动态分析

周芳茗¹,谢艳²,刘洋²蒋路云²

周芳茗¹, 谢艳², 刘洋² 综述蒋路云² 审校1. 成都中医药大学, 四川成都 610075;
2. 成都中医药大学附属医院耳鼻咽喉科, 四川成都 610075

收稿日期:2019-11-04 出版日期:2020-07-20 发布日期:2020-08-28
作者简介:周芳茗. E-mail:18408203992@163.com
基金资助:
国家自然科学基金(81774131,81603492);四川省科技厅科技支撑计划(2016FZ0094);四川省科技厅科技重点研发项目(2018SZ0400)

Dynamic analysis of rhinogenic headacheZHOU Fangming¹, XIE Yan², LIU Yang² Overview JIANG Luyun²〓Guidance 1. Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, China 2. Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, ChinaAbstract:

Key words: Rhinogenic headache;
Diagnosis;
Mechanism;
Treatment;
Prognosis疼痛是机体对伤害性刺激产生的最基础和灵敏的生理反应, 头痛作为最常见的疼痛类型, 既是独立的病种也是其他疾病的兼症。近年来流行病学调查显示, 我国头痛发病率可高达50%, 且发病趋势越加年轻化^［1］。鼻源性头痛也是“头痛”重要的疾病分支, 过往长期作为鼻-鼻窦炎的兼症存在, 并未引起耳鼻喉科从业者的重视。随着内窥镜与影像技术的发展, 研究者们发现鼻源性头痛是独立于鼻-鼻窦炎之外的实体性疾病, 并且与鼻腔的解剖变异相关, 通过鼻内镜手术重建鼻内结构可以实现良好的治疗效果^［2］。该概念一经提出, 立即引起了业界的广泛关注, 成为鼻科疾病的研究热点。时至今日, 关于该病的具体分类、作用机制、诊断标准、治疗方法等均有相关文献报道, 但结果缺乏系统性、完整性。因此我们将从鼻源性头痛的发展历史、机制、诊断、鉴别、治疗等方面对近20年相关文献进行汇总、梳理, 报道如下。

Received:2019-11-04 Online:2020-07-20 Published:2020-08-28

摘要/Abstract

摘要： 鼻源性头痛是指因鼻-鼻窦炎或鼻腔解剖结构异常所导致的头痛。诊断方面鼻源性头痛目前已有明确的分类以及疼痛分级标准。其作用机制现在较为认可的是三叉神经刺激以及感觉神经肽P物质的作用。治疗上以功能性鼻内镜手术(FESS)为首选治疗方法,手术过程中着重恢复鼻腔的正常解剖结构。经过多项临床研究表明采用FESS治疗鼻源性头痛总体有效率可达90%,治愈率为78%,效果显著。同时,报道指出通过术后内镜下检查、换药可有效减少并发症的发生,保证治疗的安全性。

关键词: 鼻源性头痛, 诊断, 机制, 治疗, 预后

Abstract: Rhinogenic headache is caused by rhinosinusitis or abnormal nasal anatomy. Currently, there are clear classifications and pain grading standards to diagnose the same. Further, its mechanism of action is now understood to involve trigeminal nerve stimulation and sensory neuropeptide substance P. Functional endoscopic surgery(FESS)is prioritized as a treatment modality. During surgery, it is imperative to restore the normal anatomy of the nasal cavity. Several clinical studies have reported that FESS was significantly effective in treating rhinogenic headache, with an overall effective rate of 90% and cure rate of 78%. Additionally, one report indicates that postoperative endoscopic examination and dressing change can effectively reduce the occurrence of complications and ensure safety of the treatment.

Key words: Rhinogenic headache, Diagnosis, Mechanism, Treatment, Prognosis

中图分类号:

R765

周芳茗,谢艳,刘洋蒋路云. 鼻源性头痛的研究动态分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 130-133.

Rhinogenic headache is caused by rhinosinusitis or abnormal nasal anatomy. Currently, there are clear classifications and pain grading standards to diagnose the same. Further, its mechanism of action is now understood to involve trigeminal nerve stimulation and sensory neuropeptide substance P. Functional endoscopic surgery(FESS)is prioritized as a treatment modality. During surgery, it is imperative to restore the normal anatomy of the nasal cavity. Several clinical studies have reported that FESS was significantly effective in treating rhinogenic headache, with an overall effective rate of 90% and cure rate of 78%. Additionally, one report indicates that postoperative endoscopic examination and dressing change can effectively reduce the occurrence of complications and ensure safety of the treatment.. Dynamic analysis of rhinogenic headacheZHOU Fangming¹, XIE Yan², LIU Yang² Overview JIANG Luyun²〓Guidance 1. Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, China 2. Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, ChinaAbstract:[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 130-133.

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