五招对付偏头痛

原文配图 ©

原文|Maria Cohut from medicalnewstoday

乱译|中外物語

图片|原文网站或各路

今日关键词| 偏头痛 （migraine）

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某次，有个朋友跟我说，她生不如死，因为深受偏头痛折磨——夜黑风高，神鬼无助。她问我治疗偏头痛的方子，我当时很不负责任地说：没有。不料“偶遇”这篇文章，索性舶来“赎罪”。阁下一介草民，不幸得了困扰阿瞒一生的“枭雄病”——偏头痛；更不幸者，华佗医术未能流传人间，出自神医之手可根治头风病的方子自然也就不可得也。岂料洋人也深受此病折磨，所以总结出对付偏头痛的五个“偏方”，至于管不管用，我不得而知；在此舶来，供常受偏头痛困扰的“平民枭雄”参考一番。这是废话，正文在后。

Five ways to cope with migraine

五招对付偏头痛——信不信由你，试不试由你

Migraines are not just your average headaches. They can be debilitating, come unexpectedly, and be accompanied by a varied range of upsetting effects, such as extreme nausea, cognitive impairment, and eyesight disturbances. We have investigated the best ways of dealing with them.

偏头痛可不是普通意义上的头痛，可一旦像不速之客一样找上“头”来，那是相当闹人——极度恶心，认知缺损，头昏眼花——全都随着偏头痛不期而至。偏头痛是个顽疾，但也有法子对付它。比如，本文作者就提供了五招对付偏头痛的“偏方”，管不管用且不说，等偏头痛不期而至，不妨一试，兴许有所帮助。

Migraines are severe headache attacks that can last for between 4 and 72 hours. They are often accompanied by severe nausea and vomiting, acute sensitivity to light and sounds, and, in some cases, by temporary cognitive impairment and allodynia, which is when normal touch is felt as painful. Individuals can start experiencing migraines from childhood, and their prevalence increases well into adulthood, until age 35 to 39. Migraines are up to three times more common in women than they are in men, and the attacks also last longer in women.

偏头痛严重时能持续4-72小时，常伴随着剧烈的恶心和呕吐，对光线和声音“过敏”——看啥看不清，听啥听不真，某些患者可能还会出现短暂的认知缺损，甚至出现浑身像针扎一样疼痛的症状，轻轻一碰，痛到不行。有些人在小时候就经历过偏头痛的折磨，想必那样的童年一点也不快乐吧；可气的是，童年经受过偏头痛的折磨，并不意味着长大成人后就不再患偏头痛。偏头痛会像个阴魂不散的幽灵，从一个人的童年一直“追随”到成年，年近不惑还有可能遭受它的困扰和折磨。女性偏头痛的发病率是男性的三倍——要不怎么说做个好女人难呢，就连遭受偏头痛的折磨都要比男人“占便宜”——而且发作后持续时间也更长。

Multiple studies link chronic migraine with a decreased quality of life and disrupted activity levels. What, then, are the options of prevention and treatment available to people who face migraines? Here is a list of the five most cited approaches.

针对慢性偏头痛的研究很多，结论是跟患者生活质量的下降和活动状态有关。如何预防和治疗偏头痛？在此不妨支几小招——管不管用，试了就懂。

NSAIDs, such as the widely available OTC drug ibuprofen, are the most common port of call for handling migraine attacks.

1. Prescription and over-the-counter drugs

1. 处方和非处方药物

A range of over-the-counter (OTC) and prescription drugs are used to manage migraines. These include:

要问药效哪家强？治疗偏头痛的药物也分处方和非处方，常见的有：

Nonsteroidal anti-inflammatory drugs (NSAIDs). These are common OTC drugs and include aspirin (acetylsalicylic acid), ibuprofen, diclofenac, and naproxen. They are by far the most widely used type of medication in the case of migraines, partly because they are readily available and inexpensive, but also because they are effective in both mild and moderate attacks.

非甾体抗炎药。这类非处方药物最常见，主要起到镇痛作用，像阿司匹林（更洋气的名字叫乙酰水杨酸），布洛芬，双氯芬酸，萘普生，等等。这些药物价格亲民，也比较容易买到，而且药性温和，毒副作用小，所以是偏头痛患者的首选药物。

Triptans. These are serotonin receptor agonists, which, as their name suggests, selectively activate serotonin receptors. Low levels of serotonin are sometimes believed to be one of the causes behind migraine attacks. Triptans are occasionally prescribed to regulate that imbalance, but they are not effective in all cases.

曲坦类药物。这类药物常常以“血清吸收显效药”的身份出现，药如其名，作用主要是为了调节血清素标准。血清素（医学名称叫5-羟色胺）过低被认为是诱发偏头痛的一个重要病因。曲坦类药物是常见处方药，可用来调节血清素不平衡症状，但也因人而异，不是对所有偏头痛症状都管用。

Ergotamine. This is a chemical that can provide immediate pain relief. The drug is usually prescribed only to people who experience migraines infrequently, or whose attacks go on for a long time. Ergotamine is a vasoconstrictor, meaning that it causes blood vessels to become narrower. As such, it can have unpleasant cardiovascular side effects, so it is not recommended to people who experience migraines often.

麦角胺。这是一种处方药，镇痛效果立竿见影，但一般只对偶患偏头痛的患者，或长期遭受偏头痛折磨的患者才开此药。这种药虽然药效很好，但副作用也很大，它的药效几乎可以说是一种“血管收缩剂”，能让血管收缩变窄，特别对心血管的副作用很大，因此不建议常患偏头痛的患者服用。

Antiemetics. Since severe nausea and vomiting affect most people who experience migraines, antiemetic agents, or drugs that counter the sensation of nausea, are often prescribed.

止吐药。多数偏头痛引发严重的恶心和呕吐，因此止吐药也是必备的处方药——医生开了止吐药，不要以为是想多赚点钱——治病抓药，没法讨价还价。

Specialists advise that medication taken to relieve migraine "should be taken as early as possible after the onset of an attack" to maximize effectiveness. Preventive drugs are also sometimes prescribed to people who experience migraines, though these are generally symptomatic and are better adapted to coexisting conditions, rather than to migraine itself. These may include, on a case-by case basis, antihypertensives (which are drugs that target high blood pressure), anticonvulsants (which is medication normally used in the treatment of epilepsy), and antidepressants. However, most of these treatments can also produce adverse effects, so they tend to have a poor adherence rate.

“砖家”建议，一旦发现有偏头痛征兆，哪怕只疼一下，也要赶紧服用止痛药物——治病于未发或始发之际，效果当然最好。有些医生开的处方药不单单是针对偏头痛的，同时也针对偏头痛并发症，还要考虑到患者的身体状况，还会开一些像降压药物（比如有高血压的患者）、抗痉挛药物（比如像癫痫患者）和抗抑郁药。是药三分毒，西药毒更大。有些药物治好了偏头痛，可能会引发其他毛病，患者也因此对药物产生依赖——治病有风险，吃药需谨慎。

Certain dietary supplements, such as vitamin B-2, are sometimes said to ease the painfulness of migraines.

2. Dietary supplements

2. 营养保健品

Supplements are often used for migraine prevention, especially since they are more easily available and do not have as many side effects as traditional medication.

保健品通常起到预防偏头痛的作用，而且不像传统药物那样有太多副作用，因此算得上是不错的选择。

Some of the supplements that have been found to help with migraines are:

在此列举一些对预防偏头痛有效的保健品：

Coenzyme Q10. It seems that coenzyme Q10, when taken alongside other preventive medication, is effective in reducing both the severity and the frequency of migraine attacks.

辅酶Q10。辅酶Q10和其他预防性药物同服效果更好，对减轻或减缓病症和发病频率都能起到一定的作用。

Riboflavin, or vitamin B-2. Recent research suggests that this dietary supplement can act as a neuroprotective agent, safeguarding brain function and structure, and it can be effective in reducing the painfulness of migraine headaches.

核黄素，或叫维他命B-2。新近研究发现补充维生素B-2的作用类似于服用神经保护剂，不但不会吃坏脑子，反倒对大脑功能和结构起到保护作用，因此对缓解偏头痛才有效果。

Magnesium. This is a mineral that plays a key role in many processes that take place in the body, including metabolism and the regulation of blood pressure. Some studies suggest that various kinds of magnesium supplementation are beneficial in reducing migraine intensity and frequency, though not all researchers agree.

镁。镁元素的重要性一两句话说不清楚，但它对新陈代谢和调节血压起到至关重要的作用。研究发现含有镁元素的营养品对缓解偏头痛和降低病发率有很好的效果，但部分“砖家”对这一结论表示不屑——总有人喜欢唱反调，这才能使科学进步嘛。

Melatonin. This is a hormone that regulates states of sleep and wakefulness in animals, and guards against oxidative stress - which is a process that can lead to cell damage and death - in plants. Some research suggests that it can be effective in migraine prevention and can be more beneficial than other preventive drugs as it has fewer side effects.

褪黑素（洋气的名字叫N-乙酰-5-甲氧基色胺，一般人记不住！）。这是一种能调节动物睡眠状态的激素，同时还能预防氧化应激——这一作用在植物界特别“刺激”，可致使植物细胞损坏和死亡。当然啦，又是个别“砖家”认为，褪黑素对预防偏头痛有效果，更重要的是没有药物那么大的副作用。

Butterbur. This refers to extracts from the root of the butterbur plant (Petasites hybridus), which is common in Europe and some parts of North America and Asia. A number of studies suggest that butterbur is effective in preventing migraine, but some specialists urge that this dietary supplement should be treated with caution.

蜂斗菜（也叫款冬，学名Petasites hybridus）——这也是一味中药，主治咽喉肿痛，痈肿疔毒，毒蛇咬伤，跌打损伤。这种植物在欧洲、北美和亚洲部分地区很常见，但这里所指的是从蜂斗菜根部萃取出来的成分。有研究称它对预防偏头痛起一定作用，但也有“砖家”表示，用蜂斗菜萃取物治疗偏头痛，最好还是谨慎一些——砖家互掐，必有隐情。

3. 'Neuromodulation' therapy

3. “神经调节”疗法

"Neuromodulation" therapy works by stimulating the brain or spinal chord to promote or suppress various functions of the central nervous system. Sometimes, the stimuli are delivered using implanted devices. This kind of therapy is more often used to treat chronic illnesses that inflict severe pain or seizures.

“神经调节”疗法的原理是通过刺激大脑或脊髓来促进或抑制中枢神经系统的多种功能。这一疗法有时需要一些辅助设备。“神经调节”疗法通常用来治疗引发强烈疼痛或经常发作的慢性症状。

Two types of neuromodulation therapy are now approved by the United States Food and Drug Administration (FDA). Single-pulse transcranial magnetic stimulation (sTMS) involves stimulating the brain through magnetic impulses generated by a device placed over the person's head. The FDA have approved sTMS in the treatment of acute migraine.

目前，有两类神经调节疗法通过了美国食品药品监管局的审批。一种叫单脉冲经颅磁刺激疗法（sTMS），治疗设备磁信号可以无衰减地透过颅骨而刺激到大脑神经，是一种无痛、无创的绿色治疗方法。美国食品药品监管局批准这一疗法可用于治疗急性或重度偏头痛。

Transcutaneous supraorbital nerve stimulation (t-SNS) acts in a similar way, with a device placed on the forehead generating magnetic impulses that stimulate the supraorbital nerve, which allows the impulses to travel through the forehead to the scalp, eyes, and sinus. The FDA have approved t-SNS as a preventive treatment for migraine.

另一种叫经皮肤眶上神经刺激疗法（t-SNS），原理跟单脉冲经颅磁刺激疗法相似，也是通过设备产生的磁信号刺激眶上神经，经由额头到头皮、眼睛和静脉窦，实现治疗效果。美国食药监管局批准该疗法用于偏头痛的预防性治疗。

Some studies suggest that practicing meditation can decrease the frequency of attacks and improve individuals' resilience to pain.

4. Meditation

4. 冥想（那谁不是写了本《沉思录》么，估计一辈子没得过偏头痛吧）

Meditation is increasingly explored as a way of relieving stress and pain, as Medical News Today have reported. Research suggests that meditation - spiritual meditation, in particular - can improve tolerance to pain in the case of migraines.

医学相关报道称冥想正以锐不可当之势走进千家万户，对释放压力和减缓疼痛的效果非常显著。“砖家”建议，冥想——特别是精神冥想——对缓解诸如偏头痛一类的症状，效果尤其显著。

The study worked with participants who were dealing with migraine in their day-to-day lives. They were randomly assigned to practice one of four meditation types or relaxation techniques: spiritual meditation, internally focused secular meditation, externally focused secular meditation, or progressive muscle relaxation. It was found that the people involved in spiritual meditation experienced migraine attacks less frequently and had a strengthened pain tolerance threshold.

这可不是空穴来风，而是在日积月累的观察研究的基础上得出的结论。研究人员对四类冥想——精神冥想，内修俗念冥想，外修俗念冥想，渐进式肌肉放松法——进行了对照研究，结果发现精神冥想的“止痛”效果最为显著。（这四种冥想名称译法不够准确，希望这方面的“砖家”不吝赐教！）

5. Acupuncture

5. 针灸

MNT have also previously reported on studies that suggested that acupuncture could be an effective alternative treatment for chronic pain. A recent article published in JAMA found that acupuncture could reduce both the frequency and intensity of migraines without aura, which are migraines not accompanied by visual disturbances or temporary cognitive impairment. This seems to support previous research with similar findings, which recommended acupuncture as a first port of call for people dealing with migraine who want to explore nonpharmaceutical approaches.

针灸本来是博大精深的中医疗法，对慢性疼痛的治疗非常有效，因此上美国医学协会杂志不得不撰文表示认同，但也并不跟风地进行了一些研究，结论是针灸对降低和缓解没有预兆的偏头痛的频率及强度效果显著。这貌似是对之前一项类似研究做了个补充“说明”，对那些不想用药物治疗偏头痛的患者而言，针灸疗法简直就是“福音”。

Do you experience migraines frequently? If so, how do they affect your lifestyle, and what are some approaches you take to cope with them? Do you follow traditional or nontraditional therapy to treat or prevent attacks? Let us know what your coping strategies are, and if there are any therapies you would like to know more about.

有偏头痛经历或常受偏头痛困扰和折磨的朋友，可以谈谈自己的病史和看法，也可以分享治疗手段和心得——高手在民间，兴许还有比这篇文章的作者所列疗法更好者，不妨分享出来——救人一命，胜造七级浮屠。

结语：华佗好心好意要劈开曹阿瞒头颅为其取出风痫以根治头风，不料阿瞒认定华佗不轨，必是以此为借口，治病是虚，杀他为实，佗有替寿亭侯报仇的嫌疑——阿瞒头风病以外，还有疑心病——神医不死，岂有此理。操杀佗，历史冤案；更冤者，佗之医术未能流传于世。得亏针灸，弥补了这一遗憾。操之头风病，到底是不是偏头痛？外行不知。在此舶来这篇文章，仅供参考，不当之处，敬请指正；文中所列疗法是否管用，拿来者不负责任。

这不是结束，只是个开始。