Fritsche G, Kröner-Herwig B, Kropp P, Niederberger U, Haag G
Neurologische Klinik, Universität Essen, Hufelandstr. 55, 45122, Essen, Deutschland.
Schmerz. 2013 Jun;27(3):263-74. doi: 10.1007/s00482-013-1319-9.
This review summarizes the various forms of behavioral treatment of migraine which could demonstrate empirical efficacy. The main unimodal kinds of treatment are thermal and electromyography (EMG) biofeedback training and progressive muscle relaxation. The various relaxation techniques do not differ in their efficacy in treating migraine. On average a reduction in migraine frequency of 35-45 % is achieved. The mean effect sizes (ES) of various biofeedback techniques are between 0.4 and 0.6. Cognitive-behavioral treatment is applied as a multimodal treatment and on average achieves an improvement in migraine activity by 39 % and an ES of 0.54. All behavioral procedures can be used in combination or as an alternative to drug prophylaxis with comparable success. A combination of pharmacological and behavioral treatment can achieve additional success. There is strong evidence for the clinically significant efficacy of all forms of behavioral treatment in childhood and adolescence. There are no signs of differential indications.
本综述总结了偏头痛行为治疗的各种形式,这些形式已证明具有实证疗效。主要的单峰治疗类型是热生物反馈训练和肌电图(EMG)生物反馈训练以及渐进性肌肉松弛。各种放松技术在治疗偏头痛方面的疗效并无差异。平均而言,偏头痛发作频率可降低35%至45%。各种生物反馈技术的平均效应量(ES)在0.4至0.6之间。认知行为疗法作为一种多模式治疗方法,平均可使偏头痛活动改善39%,效应量为0.54。所有行为程序都可以联合使用,或者作为药物预防的替代方法,且成功率相当。药物治疗和行为治疗相结合可取得额外的成效。有强有力的证据表明,所有形式的行为治疗在儿童和青少年时期都具有临床上显著的疗效。没有差异适应症的迹象。