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枕大神经阻滞对偏头痛患者疼痛严重程度的影响:一项系统评价和荟萃分析。

Influence of greater occipital nerve block on pain severity in migraine patients: A systematic review and meta-analysis.

作者信息

Tang Yongguo, Kang Junfang, Zhang Yu, Zhang Xuejun

机构信息

Department of Neurology, Fenghua People's Hospital, Fenghua 315500, China.

Department of Blood Purification Center, Fenghua People's Hospital, Fenghua 315500, China.

出版信息

Am J Emerg Med. 2017 Nov;35(11):1750-1754. doi: 10.1016/j.ajem.2017.08.027. Epub 2017 Aug 14.

Abstract

AIMS

Greater occipital nerve (GON) block may be a promising approach to treat migraine. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of GON block in migraine patients.

METHODS

PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the efficacy of GON block versus placebo in migraine patients were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. Meta-analysis was performed using the random-effect model.

RESULTS

Six RCTs were included in the meta-analysis. Overall, compared with control intervention in migraine patients, GON block intervention was found to significantly reduce pain score (Std. mean difference=-0.51; 95% CI=-0.81 to -0.21; P=0.0008), number of headache days (Std. mean difference=-0.68; 95% CI=-1.02 to -0.35; P<0.0001), and medication consumption (Std. mean difference=-0.35; 95% CI=-0.67 to -0.02; P=0.04), but demonstrated no influence on duration of headache per four weeks (Std. mean difference=-0.07; 95% CI=-0.41 to 0.27; P=0.70).

CONCLUSIONS

Compared to control intervention, GON block intervention can significantly alleviate pain, reduce the number of headache days and medication consumption, but have no significant influence on the duration of headache per four weeks for migraine patients.

摘要

目的

枕大神经(GON)阻滞可能是一种治疗偏头痛的有效方法。然而,其结果仍存在争议。我们进行了一项系统评价和荟萃分析,以探讨GON阻滞对偏头痛患者的疗效。

方法

系统检索了PubMed、EMbase、Web of science、EBSCO和Cochrane图书馆数据库。纳入评估GON阻滞与安慰剂对偏头痛患者疗效的随机对照试验(RCT)。两名研究者独立检索文章、提取数据并评估纳入研究的质量。采用随机效应模型进行荟萃分析。

结果

荟萃分析纳入了6项RCT。总体而言,与偏头痛患者的对照干预相比,发现GON阻滞干预可显著降低疼痛评分(标准平均差=-0.51;95%置信区间=-0.81至-0.21;P=0.0008)、头痛天数(标准平均差=-0.68;95%置信区间=-1.02至-0.35;P<0.0001)和药物消耗量(标准平均差=-0.35;95%置信区间=-0.67至-0.02;P=0.04),但对每四周头痛持续时间无影响(标准平均差=-0.07;95%置信区间=-0.41至0.27;P=0.70)。

结论

与对照干预相比,GON阻滞干预可显著减轻偏头痛患者的疼痛,减少头痛天数和药物消耗量,但对每四周头痛持续时间无显著影响。

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