㈿-7 AF

㈿−7	患者の健康寿命の阻害、 QOLの阻害はどの程度か

1) Solomon, G. D.,Skobieranda, F. G.,Gragg, L. A. Does quality of life 　 differ among headache diagnoses? Analysis using the medical 　 outcomes study instrument . Headache 1994, 34(3): 143-7
論文抄録	BACKGROUND: To analyze the differences in quality of life associated with headache diagnoses using the Medical Outcomes Study Short Form Health Survey (SF-20). METHODS: A patient interview survey using the SF-20 Short Form Health Survey was conducted in a headache clinic within a multi-specialty group practice. All six health components of the SF-20 were included in the study. Headache diagnoses were made using IHS criteria. RESULTS: 208 consecutive headache patients were studied. Patients with cluster headache had a significantly higher (worse) pain score (P < 0.018) and higher percentage of patients with poor health due to pain (P < 0.005) than patients with migraine headache. There were fewer cluster patients with poor health associated with physical functioning than tension-type (P < 0.020) or mixed headache (P < 0.022) patients. Poor health associated with social functioning was greater for cluster (P < 0.011) and tension-type headache (P < 0.015) than for migraine. There was a significantly higher percentage of tension-type headache patients with poor health associated with mental health (P < 0.002) than patients with migraine. CONCLUSIONS: The SF-20 is a reliable and valid measure of quality of life for patients with different headache diagnoses. Distinct headache diagnoses are marked by unique patterns of impairment and quality of life.
文献 PubMed−ID	8200787
エビデンスレベル	IIb
文献タイトル (日本語)	頭痛の種類による QOLの相違があるか． medical outcomes study instrumentを用いての検討
目的	群発頭痛患者の健康寿命の阻害はどの程度か
研究デザイン	よくデザインされた準実験的研究
研究施設	USA, Ohio, The Cleveland Clinic Foundation
研究期間	1992年1月31日から3月4日
対象患者	Cleveland Clinicの頭痛センターを上記の期間に訪れた頭痛患者208名（片頭痛79名，緊張型頭痛41名，群発頭痛13名，混合型49名）
主要評価項目とそれに用いた統計学的手法	SF-20 Short Form Health Survey Chi-Square test
結果	群発頭痛患者では片頭痛に比して．疼痛スコアが有意に高く，疼痛のため健康が損なわれ，社会的機能も低下していた．
結論	群発頭痛患者では生活上の機能障害が明らかである．
コメント	群発頭痛患者での社会生活上の機能障害を明らかにした．
作成者	荒木信夫

2) Manzoni, G. C. Cluster headache and lifestyle: remarks on a population 　 of 374 male patients . Cephalalgia, 1999 19(2): 88-94
論文抄録	To investigate the relation between cluster headache (CH) and lifestyle, some lifestyle factors were considered in a population of 374 CH male patients consecutively referred to the same headache center, including 306 with episodic CH, 22 with chronic CH unremitting from onset, 20 with chronic CH evolved from episodic, and 26 with CH periodicity undetermined CH patients had jobs involving greater responsibilities and were more frequently self-employed than controls. In addition, their past medical histories often reported head injury, either with loss of consciousness (13.4%) or without loss of consciousness (23.5% of cases). As regards nonessential consumption habits, both cigarette-smoking and coffee and alcohol intake were more frequently reported in CH patients than in the general population, with a higher prevalence in chronic CH as opposed to episodic CH sufferers. In particular, smokers accounted for 78.9% of episodic CH patients and 87.8% of chronic CH patients--12.9% of episodic CH patients and 19.6% of chronic CH patients smoked over 30 cigarettes a day. Alcohol abuse was reported in 16.2% of episodic and 26.8% of chronic CH patients, while coffee abuse was reported in 6.9% of episodic and in 36.6% of chronic CH patients. Rather than pointing to a single lifestyle factor directly implicated in CH onset, my review suggests a common trend among CH patients to overindulge in certain living habits.
文献 PubMed−ID	10214533
エビデンスレベル	IIb
文献タイトル (日本語)	群発頭痛とライフスタイル： 374例の男性患者における検討
目的	群発頭痛患者におけるライフスタイルの検討
研究デザイン	よくデザインされた準実験的研究
研究施設	イタリアのパルマ， Headache Center, University of Parma
研究期間	未記入
対象患者	男性の群発頭痛患者 374例
介入	イタリアの 1971年から1991年のCentral Institute of Statisticsのデータと比較
主要評価項目とそれに用いた統計学的手法	喫煙歴，アルコール歴などの検討 Student's t-test
結果	群発頭痛患者では喫煙歴やアルコール歴が有意に高かった．
結論	男性の群発頭痛患者では，一般人口に比して喫煙歴やアルコール歴が有意に高かった．
コメント	群発頭痛患者では喫煙歴やアルコール歴が多く，ライフスタイル上の問題も指摘された．
備考	KEY WORDS Adolescent Adult Aged Alcohol Drinking Caffeine/administration & dosage Child Cluster Headache/physiopathology Human Life Style Male Middle Aged Smoking Social Class
作成者	荒木信夫

3) Ertsey, C.,Manhalter, N.,Bozsik, G.,Afra, J.,Jelencsik, I. Health-related 　 and condition-specific quality of life in episodic cluster headache . 　 ephalalgia, 2004 24(3): 188-96
論文抄録	Health-related quality of life was studied in 35 episodic cluster headache (CH) patients during and after the cluster period, using a generic (SF-36) and a headache-specific (MSQ2.1) instrument. The results were compared with those of age- and sex-matched migraineurs (n = 53) and healthy persons (n = 62). During the cluster period patients had lower scores than controls in all SF-36 and MSQ2.1 domains. The difference was significant for most SF-36 and all MSQ2.1 domains. Although CH patients had lower scores than migraineurs on most scales, the difference was significant only on SF-36 scores measuring bodily pain and social functioning. There was a good correlation between the two instruments. After the termination of the cluster period the quality of life of patients was similar to that of headache-free controls. Generic and headache-specific QoL are severely impaired in CH and this impairment is at least as severe as in migraine.
文献 PubMed−ID	15009012
エビデンスレベル	IIb
文献タイトル (日本語)	反復性群発頭痛における健康に関連したＱＯＬ
目的	群発頭痛患者の健康寿命の阻害はどの程度か
研究デザイン	よくデザインされた準実験的研究
研究施設	ハンガリーのブタペスト， Semmelweis University
対象患者	反復性群発頭痛患者 35例，片頭痛患者53例，健常人62例
介入	性，年齢を合わせている
主要評価項目とそれに用いた統計学的手法	SF-36の8項目およびMSQ 2.1の3項目 SPSS(Wilcoxon rank sum test, et al)
結果	群発頭痛患者では SF-36およびMSQ 2.1において，健常者に比して，有意差を認めた．また，片頭痛患者に比してSF-36のbodily painおよびsocial functioning の2項目で有意差を認めた．
結論	群発頭痛患者では生活上の機能障害が明らかである．
コメント	群発頭痛患者での生活上の機能障害を明らかにした．
備考	KEY WORDS Adult Aged Analysis of Variance Cluster Headache/diagnosis/psychology Comparative Study Female Health Status Health Surveys Human Male Middle Aged Quality of Life/*psychology Statistics, Nonparametric
作成者	荒木信夫

4) D'Amico. D.,Rigamonti. A.,Solari. A.,Leone. M.,Usai. S ,Grazzi. 　 L.,Bussone,.G . Health-related quality of life in patients with cluster 　 headache during active periods . Cephalalgia, 2002 22(10): 818-21
論文抄録	Cluster headache is characterized by excruciatingly painful headaches which occur one or several times during the day. Little is known about the functional consequences of this severe headache form. We assessed health-related quality of life in 56 consecutive patients, 34 of whom were episodic cluster headache patients during an active period, and 22 had chronic cluster headache. All patients completed the Short Form-36 (SF-36). We found lower scores in the studied patients than in those reported in the general population for all SF-36 domains. For most scales the difference was significant (P < 0.0001, Student's t-test, Bonferroni correction). Our findings suggest that cluster headache has marked functional consequences even when appropriate treatments are used.
文献 PubMed−ID	12485209
エビデンスレベル	IIb
文献タイトル (日本語)	群発頭痛の群発期における健康に関連したＱＯＬ
目的	群発頭痛患者の健康寿命の阻害はどの程度か
研究デザイン	よくデザインされた準実験的研究
研究施設	イタリアのミラノの C.Besta National Institute
対象患者	群発頭痛患者 56例
介入	一般人口 1636名におけるSF-36のデータと比較
主要評価項目とそれに用いた統計学的手法	SF-36の8項目 Wilcoxon rank sum test
結果	群発頭痛患者では SF-36の8項目中6項目において，健常者に比して，有意差を認めた．
結論	群発頭痛患者では生活上の機能障害が明らかである．
コメント	多数例の群発頭痛患者で生活上の機能障害を明らかにした．
備考	KEY WORDS Activities of Daily Living/psychology Adult Aged Cluster Headache/drug therapy/psychology Female Human Male Middle Aged Patients/statistics & numerical data Quality of Life/*psychology Statistics, Nonparametric
作成者	荒木信夫