1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
2 Department of Rural Health, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
Cephalalgia. 2019 Apr;39(4):544-555. doi: 10.1177/0333102418781795. Epub 2018 Jun 4.
Mindfulness-based stress reduction/cognitive therapy are frequently used for pain-related conditions, but their effects on headache remain uncertain. This review aimed to assess the efficacy and safety of mindfulness-based stress reduction/cognitive therapy in reducing the symptoms of chronic headache.
MEDLINE/PubMed, Scopus, CENTRAL, and PsychINFO were searched to 16 June 2017. Randomized controlled trials comparing mindfulness-based stress reduction/cognitive therapy with usual care or active comparators for migraine and/or tension-type headache, which assessed headache frequency, duration or intensity as a primary outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Tool.
Five randomized controlled trials (two on tension-type headache; one on migraine; two with mixed samples) with a total of 185 participants were included. Compared to usual care, mindfulness-based stress reduction/cognitive therapy did not improve headache frequency (three randomized controlled trials; standardized mean difference = 0.00; 95% confidence interval = -0.33,0.32) or headache duration (three randomized controlled trials; standardized mean difference = -0.08; 95% confidence interval = -1.03,0.87). Similarly, no significant difference between groups was found for pain intensity (five randomized controlled trials; standardized mean difference = -0.78; 95% confidence interval = -1.72,0.16).
Due to the low number, small scale and often high or unclear risk of bias of included randomized controlled trials, the results are imprecise; this may be consistent with either an important or negligible effect. Therefore, more rigorous trials with larger sample sizes are needed.
基于正念的压力减轻/认知疗法常用于治疗与疼痛相关的疾病，但它们对头痛的疗效仍不确定。本综述旨在评估基于正念的压力减轻/认知疗法对缓解慢性头痛症状的疗效和安全性。
截至 2017 年 6 月 16 日，检索了 MEDLINE/PubMed、Scopus、CENTRAL 和 PsychINFO，以纳入比较基于正念的压力减轻/认知疗法与常规护理或活性对照药物治疗偏头痛和/或紧张型头痛的随机对照试验，主要结局为评估头痛频率、持续时间或强度。使用 Cochrane 工具评估偏倚风险。
纳入了五项随机对照试验（两项紧张型头痛；一项偏头痛；两项混合样本），共 185 名参与者。与常规护理相比，基于正念的压力减轻/认知疗法并未改善头痛频率（三项随机对照试验；标准化均数差=0.00；95%置信区间=-0.33，0.32）或头痛持续时间（三项随机对照试验；标准化均数差=-0.08；95%置信区间=-1.03，0.87）。同样，两组之间的疼痛强度也没有显著差异（五项随机对照试验；标准化均数差=-0.78；95%置信区间=-1.72，0.16）。
由于纳入的随机对照试验数量少、规模小，且往往存在高偏倚或偏倚不确定风险，因此结果不精确；这可能与重要或可忽略的疗效一致。因此，需要进行更多严格的、具有更大样本量的试验。
