偏头痛非药物防治中国专家共识
于生元,万琪,王伟,朱兵,李瑛,杨骏,周冀英,赵凌,赵吉平,赵宏,徐斌
摘要(Abstract):
目前,中国偏头痛呈现发病率高、致残率高、40~44岁时疾病负担达到高峰、女性高于男性的趋势。许多偏头痛患者对药物治疗依从性差、疗效欠佳、或不能耐受不良反应,导致急性镇痛药的滥用和头痛的慢性化。能够推荐给儿童和妊娠期偏头痛患者的药物极其有限。随着对偏头痛认识的不断深入和非药物防治经验的积累,以针灸为主的非药物治疗策略在偏头痛的防治中发挥了重要作用。对于不适合药物治疗的偏头痛患者,应推荐非药物防治策略。为规范我国广大医生对偏头痛的非药物防治方法,本共识经中西医结合专家讨论,针对无/有先兆偏头痛的急性发作期和间歇期,确定推荐调整生活方式、针灸疗法、神经调节技术、行为疗法四大类非药物防治方法,以供临床医生参考。
关键词(KeyWords): 偏头痛;非药物防治;专家共识
基金项目(Foundation):
作者(Author): 于生元,万琪,王伟,朱兵,李瑛,杨骏,周冀英,赵凌,赵吉平,赵宏,徐斌
DOI: 10.16780/j.cnki.sjssgncj.20210041
参考文献(References):
- [1] Headache Classification Committee of the International Headache Society(IHS)The International Classification of Headache Disorders, 3rd edition[J]. Cephalalgia, 2018, 38(1):1-211. DOI:10.1177/0333102417738202.
- [2]国际头痛分类第三版[OL]. https://ichd-3.org/wp-content/uploads/2018/10/ICHD-3-Chinese.pdf.
- [3] GREENBERG D, AMINOFF M J, SIMON R P. Lange Clinical Neurology, 11th Edition[M]. Mc Graw-Hill Education, 2020.
- [4] YU S, LIU R, ZHAO G, et al. The prevalence and burden of primary headaches in China:a population-based door-to-door survey[J]. Headache,2012, 52(4):582-591. DOI:10.1111/j.1526-4610.2011.02061.x.
- [5] YAO C, WANG Y, WANG L, et al. Burden of headache disorders in China, 1990-2017:findings from the Global Burden of Disease Study 2017[J]. J Headache Pain, 2019, 20(1):102. doi:10.1186/s10194-019-1048-2.
- [6] LIPTON RB, BIGAL ME, DIAMOND M, et al. Migraine prevalence,disease burden, and the need for preventive therapy[J]. Neurology, 2007, 68(5):343-349. DOI:10.1212/01.wnl.0000252808.97649.21.
- [7] SCHULTE LH, MAY A. Headache research in 2014:Advancing migraine therapy[J]. Lancet Neurol, 2015, 14(1):6-7. DOI:10.1016/S1474-4422(14)70295-9.
- [8] HANS-CHRISTOPH DIENER, DAGNY HOLLE-LEE, STEFFEN N?GEL, et al. Treatment of migraine attacks and prevention of migraine:Guidelines by the German Migraine and Headache Society and the German Society of Neurology[J]. Clinical Transl Neurosci, 2019, 3(1):2514183X18823377. DOI:10.1177/2514183X18823377.
- [9] LI Y, ZHENG H, WITT C M, et al. Acupuncture for migraine prophylaxis:a randomized controlled trial[J]. CMAJ, 2012, 184(4):401-410. DOI:10.1503/cmaj.110551.
- [10] ZHAO L, CHEN J, LI Y, et al. The Long-term Effect of Acupuncture for Migraine Prophylaxis:A Randomized Clinical Trial[J]. JAMA Intern Med, 2017, 177(4):508-515. DOI:10.1001/jamainternmed.2016.9378.
- [11] XU S, YU L, LUO X, et al. Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura:multicentre, randomised clinical trial[J]. BMJ, 2020, 368:m697.DOI:10.1136/bmj.m697.
- [12]中国针灸学会.循证针灸临床实践指南:偏头痛[M].修订版.北京:中国中医药出版社, 2014.
- [13] FINK A, KOSECOFF J, CHASSIN M, et al. Consensus methods:characteristics and guidelines for use[J]. Am J Public Health, 1984, 74(9):979-983. DOI:10.2105/ajph.74.9.979.
- [14]吴江,贾建平.神经病学[M].第三版.北京:人民卫生出版社, 2015.
- [15] PRINGSHEIM T, DAVENPORT W, MACKIE G, et al. Canadian Headache Society guideline for migraine prophylaxis[J]. Can J Neurol Sci,2012, 39(2 Suppl 2):S1-59.
- [16]孟宪慧,于金娜,吴彩凤.远近配穴针刺对偏头痛患者即刻止痛效应及远期总体疗效的临床观察[J].中国中医基础医学杂志, 2015(8):1004-1005.
- [17]王舒,陈祥芳,郭琳,等.针刺治疗偏头痛60例急性期临床疗效评价[J].辽宁中医杂志, 2006, 33(11):1489.
- [18] LI Y, LIANG F, YANG X, et al. Acupuncture for treating acute attacks of migraine:a randomized controlled trial[J]. Headache, 2009, 49(6):805-816. DOI:10.1111/j.1526-4610.2009.01424.x.
- [19]王艳妮,文国顺.通窍活血汤加减联合艾灸治疗偏头痛35例[J].河北中医, 2013, 35(1):39-40.
- [20]王宝祥,许俊杰,陆霞,等.石藤桃红止痛方联合头针治疗偏头痛急性发作的疗效观察[J].中国中医药科技, 2018, 25(3):388-389.
- [21]潘燕,陈倩.祛风通络中药+头针治疗偏头痛急性发作疗效及对P物质、5-羟色胺、同型半胱氨酸的影响[J].现代中西医结合杂志, 2017, 26(30):3360-3362.
- [22]李燕.刺络放血疗法治疗偏头痛的临床研究进展[J].国医论坛,2016(3):68-70.
- [23]崔修敏.刺络放血拔罐治疗偏头痛发作期的临床效果观察[J].世界最新医学信息文摘, 2018, 18(47):145.
- [24]宋晓琳,赵吉平,马新平.针刺配合火针治疗无先兆型偏头痛的疗效观察[J].环球中医药, 2018, 11(1):151-153.
- [25]王京京,吴中朝,胡静,等.偏头痛发作期针刺镇痛方案优选研究[J].针刺研究, 2013, 38(3):234-240.
- [26]焦玥,吴中朝,胡静,等.《循证针灸临床实践指南:偏头痛》2014更新版解读[J].中国针灸, 2016(36):751-756.
- [27]王永,金海鹏,李相良,等.电针预防性治疗偏头痛的随机对照临床研究[J].中国卫生标准管理, 2020, 11(2):85-89.
- [28]李枝锦,吴平财,李国政.吴茱萸汤联合温针灸治疗寒凝血瘀型无先兆偏头痛[J].中医学报, 2019, 34(12):2641-2645.
- [29]朱国祥,程子刚.温针灸结合叩刺法治疗偏头痛瘀血型79例疗效观察[J].针灸临床杂志, 1999(5):3-5.
- [30]邢爱群,陈垂海,吉晓天.耳穴压豆联合氟桂利嗪治疗无先兆型偏头痛的临床观察[J].针刺研究, 2019, 44(9):672-676.
- [31] TASSORELLI C, GRAZZI L, TOMMASO M de, et al. Noninvasive vagus nerve stimulation as acute therapy for migraine:The randomized PRESTO study[J]. Neurology, 2018, 91(4):e364-e373. DOI:10.1212/WNL.0000000000005857.
- [32] SILBERSTEIN S D, CALHOUN A H, LIPTON R B, et al. Chronic migraine headache prevention with noninvasive vagus nerve stimulation:The EVENT study[J]. Neurology, 2016, 87(5):529-538. DOI:10.1212/WNL.0000000000002918.
- [33] LAI Y H, HUANG Y C, HUANG L T, et al. Cervical Noninvasive Vagus Nerve Stimulation for Migraine and Cluster Headache:A Systematic Review and Meta-Analysis[J]. Neuromodulation, 2020, 23(6):721-731. DOI:10.1111/ner.13122.
- [34] CHOU D E, GROSS G J, CASADEI C H, et al. External Trigeminal Nerve Stimulation for the Acute Treatment of Migraine:Open-Label Trial on Safety and Efficacy[J]. Neuromodulation, 2017, 20(7):678-683. DOI:10.1111/ner.12623.
- [35] SCHOENEN J, VANDERSMISSEN B, JEANGETTE S, et al.Migraine prevention with a supraorbital transcutaneous stimulator:a randomized controlled trial[J]. Neurology, 2013, 80(8):697-704. DOI:10.1212/WNL.0b013e3182825055.
- [36] JIANG L, YUAN D L, LI M, et al. Combination of flunarizine and transcutaneous supraorbital neurostimulation improves migraine prophylaxis[J]. Acta Neurol Scand, 2019, 139(3):276-283. DOI:10.1111/ane.13050.
- [37] LIU Y, DONG Z, WANG R, et al. Migraine Prevention Using Different Frequencies of Transcutaneous Occipital Nerve Stimulation:A Randomized Controlled Trial[J]. J Pain, 2017, 18(8):1006-1015. DOI:10.1016/j.jpain.2017.03.012.
- [38] LIPTON R B, DODICK D W, SILBERSTEIN S D, et al. Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura:a randomised, double-blind, parallel-group, sham-controlled trial[J].Lancet Neurology, 2010, 9(4):373-380. DOI:10.1016/S1474-4422(10)70054-5.
- [39] STARLING A J, TEPPER S J, MARMURA M J, et al. A multicenter,prospective, single arm, open label, observational study of s TMS for migraine prevention(ESPOUSE Study)[J]. Cephalalgia, 2018, 38(6):1038-1048. DOI:10.1177/0333102418762525.
- [40] MOISSET X, PEREIRA B, CIAMPI DE ANDRADE D, et al.Neuromodulation techniques for acute and preventive migraine treatment:a systematic review and meta-analysis of randomized controlled trials[J]. J Headache Pain, 2020, 21(1):142. DOI:10.1186/s10194-020-01204-4.
- [41] PIOVESAN E J, WERNECK L C, KOWACS P A, et al. Anesthetic blockade of the greater occipital nerve in migraine prophylaxis[J]. Arq Neuropsiquiatr, 2001, 59(3-A):545-551.
- [42] DILLI E, HALKER R, VARGAS B, et al. Occipital nerve block for the short-term preventive treatment of migraine:A randomized,double-blinded, placebo-controlled study[J]. Cephalalgia, 2015, 35(11):959-968. DOI:10.1177/0333102414561872.
- [43] INAN L E, INAN N, KARADA??, et al. Greater occipital nerve blockade for the treatment of chronic migraine:a randomized, multicenter,double-blind, and placebo-controlled study[J]. Acta Neurol Scand, 2015,132(4):270-277. DOI:10.1111/ane.12393.
- [44] CUADRADO M L, ALEDO-SERRANOá, NAVARRO P, et al.Short-term effects of greater occipital nerve blocks in chronic migraine:A double-blind, randomised, placebo-controlled clinical trial[J]. Cephalalgia,2017, 37(9):864-872. DOI:10.1177/0333102416655159.
- [45] JACOBSON, EDMUND. THE TECHNIC OF PROGRESSIVE RELAXATION[J]. J NERV MENT DIS, 1924, 60(6):568-578.
- [46] BIANCA, MEYER, ARMIN, et al. Progressive muscle relaxation reduces migraine frequency and normalizes amplitudes of contingent negative variation(CNV)[J]. J Headache Pain, 2016, 17:37. doi:10.1186/s10194-016-0630-0.
- [47] BANDURA A, ADAMS N E. Analysis of self-efficacy theory of behavioral change[J]. Cognitive Ther Res, 1977, 1(4):287-310.
- [48] SULLIVAN A, COUSINS S, RIDSDALE L. Psychological interventions for migraine:a systematic review[J]. J Neurol, 2016, 263(12):2369-2377. DOI:10.1007/s00415-016-8126-z.
- [49] MAUSKOP, ALEXANDER. Nonmedication, alternative, and complementary treatments for migraine[J]. Continuum, 2012, 18:796-806.
- [50] LUTHE W, SCHULTZ J H. Autogenic therapy[M]. New York:Grune&Stratton, 1969.
- [51] FRITSCHE G, FRETTL?H J, HüPPE M, et al. Prevention of medication overuse in patients with migraine[J]. Pain, 2010, 151(2):404-413. DOI:10.1016/j.pain.2010.07.032.
- [52]孙风丽,张培莉,单希征,等.认知行为疗法对前庭性偏头痛患者焦虑抑郁情绪的影响[J].中国健康心理学杂志, 2016, 24(8):1216-1219.
- [53] PéREZ-MU?OZ A, BUSE D C, ANDRASIK F. Behavioral Interventions for Migraine[J]. Neurologic clinics, 2019, 37(4):789-813.DOI:10.1016/j.ncl.2019.07.003.
- [54] STUBBERUD A, VARKEY E, MCCRORY D C, et al. Biofeedback as Prophylaxis for Pediatric Migraine:A Meta-analysis[J]. Pediatrics,2016, 138(2):e20160675. DOI:10.1542/peds.2016-0675.
- [55] HA H, GONZALEZ A. Migraine Headache Prophylaxis[J]. Am Fam Physician, 2019, 99(1):17-24.