成人腹型偏头痛病例报告及文献综述

A case report and systematic review of adult abdominal migraine

摘要:

目的：分析成人腹型偏头痛（abdominal migraine, AM）的人口学特点和临床特征，提高对本病的认识。 方法：报道一例就诊于我院的成人AM病例，并计算机检索PubMed、Web of Science、LILACS、万方、维普及中国知网数据库，对自建库以来至2023年1月5日发表的成人AM病例报告进行系统综述。 结果：本研究共分析了28名成人AM病例。平均诊断年龄为41.1岁，偏头痛的家族史和/或个人史非常普遍（91.3%）。与儿童AM相比，成人对疼痛性质和区域的描述更加精确而丰富。此外，51.9%（14/27）的患者合并非消化系统症状。84.6%（11/13）的患者接受曲普坦类药物治疗后腹痛得到缓解。 结论：尽管成人AM的报告率呈现逐渐上升的趋势，但目前对这种疾病的认识仍然存在不足。对于反复出现不明原因腹痛的成人，需要考虑到AM的可能。在病史询问时尤其应重视非消化系统症状以及偏头痛相关病史。在进行适当的评估并排除药物禁忌后可以将曲普坦类药物作为一项诊断性检查或试验性治疗。

Abstract:

Objective: We analyzed the demographic characteristics and clinical features of adult abdominal migraine(AM) to increase the understanding of this disease. Methods: We reported an adult case diagnosed as abdominal migraine in our clinic. Based on a literature search of the medical databases PubMed, Web of Science, LILACS, the Chinese online libraries of CNKI, VIP INFORMATION and WANFANG DATA, we carried out a systematic review of the adult AM case reports published from the databases inception to January 5th 2023. Results: The mean diagnosis age was 41.1 years old. The family and/or personal history of migraine was very common (91.3%) in 28 reviewed patients. Adults have a more precise and abundant description of the nature or region of pain compared with children. Additionally, 51.9% (14/27) of patients presented non-gastrointestinal symptoms. Finally, 13 patients received triptans, out of which 84.6% benefited from them. Conclusion: Despite a gradual increase in the reporting rate of adult AM, there is still inadequate knowledge of this disease. We need to take into account the possibility of AM in adults with recurrent unexplained abdominal pain. In particular, we must pay attention to non- gastrointestinal symptoms as well as migraine-related history during medical history taking. Triptans may be considered as a diagnostic test and experimental treatment in patients with unexplained abdominal pain after appropriate evaluation and exclusion of medication contraindications.