Tension-type headache (TTH) is the most prevalent neurological disorder worldwide and is characterized by recurrent headaches of mild to moderate intensity, bilateral location, pressing or tightening quality, and no aggravation by routine physical activity. Diagnosis is based on headache history and the exclusion of alternative diagnoses, with clinical criteria provided by the International Classification of Headache Disorders, third edition. Although the biological underpinnings remain unresolved, it seems likely that peripheral mechanisms are responsible for the genesis of pain in TTH, whereas central sensitization may be involved in transformation from episodic to chronic TTH. Pharmacological therapy is the mainstay of clinical management and can be divided into acute and preventive treatments. Simple analgesics have evidence-based effectiveness and are widely regarded as first-line medications for the acute treatment of TTH. Preventive treatment should be considered in individuals with frequent episodic and chronic TTH, and if simple analgesics are ineffective, poorly tolerated or contraindicated. Recommended preventive treatments include amitriptyline, venlafaxine and mirtazapine, as well as some selected non-pharmacological therapies. Despite the widespread prevalence and associated disability of TTH, little progress has been made since the early 2000s owing to a lack of attention and resource allocation by scientists, funding bodies and the pharmaceutical industry.

紧张型头痛（TTH）是世界范围内最普遍的神经系统疾病，其特征是轻度至中度的复发性头痛，双侧位置，按压或紧缩性质，并且不会因日常体育活动而加重。诊断基于头痛病史并排除其他诊断，临床标准由国际头痛疾病分类提供， 第三版。尽管生物学基础仍未解决，但外周机制似乎是造成 TTH 疼痛的原因，而中枢敏化可能参与了从偶发性 TTH 到慢性 TTH 的转变。药物治疗是临床管理的主体，可分为急性治疗和预防治疗。简单的镇痛药具有循证有效性，被广泛认为是急性 TTH 治疗的一线药物。对于频繁发作性和慢性 TTH 的个体，如果简单的镇痛药无效、耐受性差或禁忌，应考虑预防性治疗。推荐的预防性治疗包括阿米替林、文拉法辛和米氮平，以及一些选定的非药物疗法。