Straube Andreas, Müller Hilke, Stiegelbauer Verena, Frauwallner Anita
Klinik für Neurologie, Oberbayerisches Kopfschmerzzentrum, Klinikum Großhadern, LMU München, München, Deutschland.
Neurologische Klinik und Poliklinik, Ludwigs-Maximilians-Universität München, Klinikum Großhadern, Marchioninistraße 15, D-81377, München, Deutschland.
MMW Fortschr Med. 2018 Nov;160(Suppl 5):16-21. doi: 10.1007/s15006-018-1052-5. Epub 2018 Oct 26.
Patients with migraine often also suffer from gastrointestinal disorders such as irritable bowel syndrome, inflammatory bowel disease or celiac disease. All these diseases share increased intestinal permeability ("leaky gut") and thus increased inflammatory activity. There is an increase in proinflammatoric cytokines in the serum, which in turn can trigger migraine attacks. Probiotics can have a positive effect on the intestinal epithelium and reduce inflammatory activity. A first uncontrolled, small study of 39 migraineurs showed a decrease in the rate of attacks under the daily intake of a probiotic.
In an uncontrolled observational study, the influence of a specially formulated multispecies probiotic on the frequency of migraine attacks and the intensity of migraine-associated complaints was recorded. The self-assessment of 1,020 patients was evaluated.
Over the treatment period of 8 weeks, the number of headache days was reduced from 2 to 1.4 days per week. The headache intensity decreased from 5.1 to 2.1 points (0 = not present to 6 = very intensive). The migraine-associated complaints were reduced and the use of painkillers halved. All results were statistically significant (p ≤ 0.001).
It can be suggested that this multispecies probiotic formulation has a positive influence on intensity and frequency of migraine attacks. However, randomized, placebo-controlled trials are required for further confirmation.
偏头痛患者常常还患有胃肠道疾病，如肠易激综合征、炎症性肠病或乳糜泻。所有这些疾病都存在肠道通透性增加（“肠漏”），进而导致炎症活动增强。血清中促炎细胞因子增加，这反过来又可引发偏头痛发作。益生菌可对肠道上皮产生积极影响并降低炎症活动。一项针对39名偏头痛患者的初步非对照小型研究表明，每日摄入益生菌可使发作率降低。
在一项非对照观察性研究中，记录了一种特殊配方的多菌种益生菌对偏头痛发作频率及偏头痛相关症状强度的影响。对1020名患者的自我评估进行了评价。
在8周的治疗期内，每周头痛天数从2天减少至1.4天。头痛强度从5.1分降至2.1分（0分 = 无，6分 = 非常严重）。偏头痛相关症状减轻，止痛药的使用量减半。所有结果均具有统计学意义（p≤0.001）。
可以认为这种多菌种益生菌配方对偏头痛发作的强度和频率有积极影响。然而，需要进行随机、安慰剂对照试验以进一步证实。
