Migraine Linked To Weather
http://www.medicalnewstoday.com/articles/141609.php
New research from the US found that severe headaches such as migraine were linked to changes in weather, particularly to increased ambient temperature and to a lesser extent lower barometric pressure.

The study was the work of first author Dr Kenneth Mukamal, a physician in the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center (BIDMC), in Boston, Massachusetts, and colleagues, and is published online in the 10 March issue of the journal Neurology.

About 18 per cent of women and 6 per cent of men in the US report having migraine headaches, with young and middle aged adults particularly affected, wrote the researchers.

And while some small studies have suggested various aspects of weather and air pollution may trigger headaches, their conclusions have been inconsistent, they added.

Mukamal and colleagues carried out a study of 7,054 patients who attended the BIDMC emergency department between May 2000 and December 2007. Of these, 2,250 had migraine and 4,803 had tension or unspecified headache as their primary discharge diagnosis.

The study was a "case crossover" design, where for each "case" or patient, the levels of pollutants and other weather variables on the day they attended the hospital were compared directly to corresponding levels on the days before and in the weeks after the visit.

Mukamal and colleagues used meterological and pollutant monitors to measure air temperature, barometric pressure, humidity, and a range of pollutants such as fine particulate matter, black carbon, and nitrogen and sulfur dioxides.

The results showed that:
There was a linear direct relationship between higher mean ambient temperature in the 24 hours before a hospital visit and acute risk of headache.

For a 5 deg C increase in temperature (about 9 deg F) there was a 7.5 per cent rise in acute risk of headache (odds ratio [OR] of 1.075; 95 per cent confidence interval [CI], 1.021-1.033; p = 0.006).
Lower barometric pressure 48 to 72 hours prior to emergency room visits was also linked to increased risk of headache, but to a much lesser degree (OR 0.939 per 5 mm Hg; 95 per cent CI, 0.902-0.978; p = 0.002).
Mukamal and colleagues concluded that:

"Higher ambient temperature and, to a lesser degree, lower barometric pressure led to a transient increase in risk of headache requiring emergency department evaluation."

There was no evidence that air pollutants were linked to the onset of headache, but they said they could not rule out a smaller effect similar to that previously reported for stroke and other cardiovascular events.

Mukamal said in a press statement that their findings are consistent with the notion that severe headaches can be triggered by environmental factors.

"These findings help tell us that the environment around us does affect our health and, in terms of headaches, may be impacting many, many people on a daily basis," he added.

Mukamal suggested that patients talk with their doctors to try and find out what triggers their headaches. Although we can't change the weather, the doctor might be able to prescribe medication that could help avert headaches that follow weather changes.

"On a population basis, we need to be concerned about incremental temperature rises anyhow, and should advocate for responsible environmental management," said Mukamal.

"The annual cost attributed to migraines is estimated at 17 billion dollars, millions of people are adversely affected and the public health implications may be enormous," he added.

The National Institute of Environmental Health Sciences and the US Environmental Protection Agency funded the study.

"Weather and air pollution as triggers of severe headaches."
Kenneth J. Mukamal, Gregory A. Wellenius, Helen H. Suh, and Murray A. Mittleman.
Neurology 2009 72: 922-927.
Published online 10 March 2009.

    来自美国的新研究发现严重的头痛比如偏头痛和季节有联系,特别是周围环境温度增加和较小程度气压降低的情况下。
    这项研究的第一作者Kenneth Mukamal博士，是一位在以色列女执事医学中心全科医学和初级保健部门的医生，目前和他的同事在麻省的波士顿，该研究在Neurology杂志的4月10日在线版上被发表。
研究者称，在美国大约有18%的妇女和6%的男性有偏头痛，年轻人和中年人尤其会受到影响。
    当一些小规模研究提示各种各样天气和空气污染可以触发头痛时，他们的结论已经不一致，研究者们补充说。
    Mukamal和他的同事对2000年5月至2007年12月在BIDMC急诊科就诊的7054个病人进行了一项研究。其中2250人有偏头痛，4803人有精神紧张和未分类的头痛作为他们的主要诊断。
这是项“个案交叉”的设计，对每发“个案”或者病人来说，在他们来就诊的前几天和之后的几周内污染物的变化和季节的变换水平相一致。
    Mukamal和他的同事利用气象和污染物监测来衡量空气温度，气压，湿度以及一系列的污染物如细颗粒物、黑碳、氮和二氧化硫。
    结果显示：
    在就诊前，24小时内的的平均环境温度和急性头痛的风险有线性直接关系。
    每增加5摄氏度急性头痛的风险就增加7.5%（OR=1.075;95%可信区间[CI]，1.021-1.033;p=0.006)
    在急诊就诊前48至72小时的周围环境气压同样与头痛增加有关，但程度低的多。
    Mukamal等人总结道:
   “环境温度的增加和较小程度上的低气压导致了头痛风险的短暂增加，需要急诊科的评估。”
    没有证据表明空气污染与头痛的发病有联系，但是他们说不能排除先前公布的中风和其他心血管事件的较小影响。
    Mukamal在一份新闻稿中说，他们的研究结果一致认为严重头痛可以由环境因素引发。
   “这些发现有助于告诉我们，在我们周围的环境会影响我们的健康比如说头痛，可能会影响在日常生活中影响许多人，”他说。
    Mukamal建议病人与医生交流以便找出导致他们头痛的原因。尽管我们不能改变天气医生可以开药以帮助避免天气变化带来的头痛。
   “在人口基础上，无论如何我们需要关注温度的增加值，并应该倡导环境的责任化管理，”Mukamal说。
   “每年由偏头痛而导致的支出估计在170亿美元，数百万人受到不利影响并对公众健康带来巨大的影响，”他补充说。
    该研究项目由国家环境卫生科学研究所和美国环境保护署资助。
   “天气和环境污染是严重头痛的诱因。”

    从这篇报道看来，我们的中医理论早就提出过，人与自然的关系，并系统说明了“四时”、“六气”、“六淫”变化对人体机体的影响。由此看来，中医中药的优势将会逐渐凸现出来，作为中药研究的机构，我们将会致力于中医药理论的文化宣传及民族药物的开发。