Development The Case Database Of Headache And The Clinical Application

OBJECTIVE: Develop the nationwide headache-related database, which is used to collect, store, and analyze the medical records of headache, and provide a research platform for multi-center clinical epidemiology.METHODS: According to software engineering theory, we analyze the operation flow and information flow of clinical headache dispose. We choose the combination of Windows Server and Internet Information Server(IIS) as the background server platform. The client is based on the general browser. As for database, we choose SQL Server to manage all data, and use standard SQL sentence to implement query and statistics. Finally, we complete the design, test, and debug of the database system.RESULTS: The developed database system is simple, stable, optimized, and easy to use. It can satisfy the requirements of collection, management, statistics, and analysis of clinical data.CONCLUSIONS: Database employment is a new method of headache research, which helps implement quick collection, extraction, management, and analysis of multi-center data. OBJECTIVE: Analyze the constitution of headache category and the features of migraineurs by using the records in our headache database, compare the differences of history features between EM and CM to find out the risk factors that EM transfers to CM, and control these factors to prevent the transformation.METHODS: By collecting 245 cases of headache patients in our headache database, and according to the ICHD-Ⅱ(2004) and the updated appendix criteria for chronic migraine,analyze the structure of headache and case characteristic, we retrospectively analyzed 149 migraines, in which 96 cases were episodic migraines and other 53 cases were chronic migraines, studied demography information case characteristic of EM, CM, and TTH, and then analyzed their risk factors by screening out statistical variables and using Logistic stepwise regression analysis.RESULTS: Migraine is the major headache in our clinic service and female migraine patients account for 71.8% of migraine. The proportion of EM patients with only primary education is 47.9% and that of CM is 67.9%, respectively. Pain positions are mainly located at the region of bitamporal, where the pain levels are from middle to severe and the persistent periods are longer than four hours. By using logistic stepwise regression analysis, we screened out such factors: course of disease ( OR = 1.067 95%CI=1.016—1.121), primary headache episode frequency(OR=1.089,95%CI 1.001～1.185), Pittsburgh Sleep Quality Index(OR=1.352,95%CI 1.169～1.563), BMI value(OR=3.010,95%CI 1.172～7.730), analgesics overuse(OR=3.156,95%CI 1.005～9.967). All of these factors contributed to the transformation of patients from episodic to chronic migraine.CONCLUSIONS: Among all primary headaches, migraine has the greatest influence on the security of human health. That migraine becomes chronic is a severious complication. The interaction of dangerous factors aggravate the progress of becoming chronic. Improving sleeping quality, keeping fit and regulating medication treatments help reduce the risk that episodic migraine patients aggravate to chronic migraine.