Zhang Hehui, Yang Xiaokai, Lin Yijun, Chen Linglong, Ye Hua
Department of Neurology, Wenzhou People Hospital, Wenzhou, Zhejiang Province, PR China.
Clin Neurol Neurosurg. 2018 Feb;165:129-133. doi: 10.1016/j.clineuro.2017.12.026. Epub 2018 Jan 5.
Greater occipital nerve (GON) block has some potential in treating migraine. We conduct a systematic review and meta-analysis to investigate the impact of GON block on pain management of migraine. We have systematically searched randomized controlled trials (RCTs) assessing the efficacy of GON block versus placebo for migraine in various databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. The primary outcome is pain intensity. Meta-analysis is performed using the random-effect model. Seven RCTs are included in the meta-analysis. Compared with control intervention in migraine patients, GON block intervention can significantly reduce pain intensity (Mean difference = -1.24; 95% CI = -1.98 to -0.49; P = 0.001) and analgesic medication consumption (Mean difference = -1.10; 95% CI = -2.07 to -0.14; P = 0.02), but has no remarkable impact on head duration (Mean difference = -6.96; 95% CI = -14.09 to 0.18; P = 0.0.06) and adverse events (RR = 0.93; 95% CI = 0.52 to 1.65; P = 0.80). GON block intervention is able to significantly reduce pain intensity and analgesic medication consumption in migraine patients.
枕大神经(GON)阻滞在偏头痛治疗中具有一定潜力。我们进行了一项系统评价和荟萃分析,以研究GON阻滞对偏头痛疼痛管理的影响。我们在包括PubMed、EMbase、Web of science、EBSCO和Cochrane图书馆数据库在内的各种数据库中系统检索了评估GON阻滞与安慰剂治疗偏头痛疗效的随机对照试验(RCT)。主要结局是疼痛强度。采用随机效应模型进行荟萃分析。荟萃分析纳入了7项RCT。与偏头痛患者的对照干预相比,GON阻滞干预可显著降低疼痛强度(平均差值=-1.24;95%CI=-1.98至-0.49;P=0.001)和镇痛药消耗量(平均差值=-1.10;95%CI=-2.07至-0.14;P=0.02),但对头痛持续时间(平均差值=-6.96;95%CI=-14.09至0.18;P=0.06)和不良事件(RR=0.93;95%CI=0.52至1.65;P=0.80)无显著影响。GON阻滞干预能够显著降低偏头痛患者的疼痛强度和镇痛药消耗量。