Division of Neurology, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Women and Children's Research Institute, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada.
CNS Drugs. 2019 May;33(5):399-415. doi: 10.1007/s40263-018-0597-2.
Migraine is a disabling neurovascular disorder with few targeted, tolerable and effective treatments. Phytomedicines, or plant-based medicinal formulations, hold great promise in the identification of novel therapeutic targets in migraine. Many patients also turn toward herbal and plant-based therapies for the treatment of their migraines as clinical and preclinical evidence of efficacy increases. Patients seek effective and tolerable treatments instead of or in addition to current conventional pharmacologic therapies. We review some phytomedicines potentially useful for migraine treatment-feverfew (Tanacetum parthenium), butterbur (Petasites hybridus), marijuana (Cannabis spp.), Saint John's Wort (Hypericum perforatum) and the Damask rose (Rosa × damascena)-with respect to their mechanisms of action and evidence for treatment of migraine. The evidence for feverfew is mixed; butterbur is effective with potential risks of hepatotoxicity related to preparation; marijuana has not been shown to be effective in migraine treatment, and data are scant; Saint John's Wort shows relevant physiological activity but is a hepatic enzyme inducer and lacks clinical studies for this purpose; the Damask rose when used in topical preparations did not show efficacy in one clinical trial. Other plant preparations have been considered for migraine treatment but most without blinded randomized, placebo-controlled trial evidence.
偏头痛是一种致残性的神经血管疾病，目前仅有少数靶向、耐受且有效的治疗方法。植物药，即基于植物的药物制剂，在偏头痛的新型治疗靶点的发现方面具有很大的潜力。随着临床和临床前疗效证据的增加，许多患者也转向草药和植物疗法来治疗偏头痛。患者寻求有效和耐受的治疗方法，以替代或补充当前的传统药物治疗。我们回顾了一些可能对偏头痛治疗有用的植物药，如小白菊（Tanacetum parthenium）、缬草（Petasites hybridus）、大麻（Cannabis spp.）、贯叶连翘（Hypericum perforatum）和大马士革玫瑰（Rosa × damascena），讨论了它们的作用机制和治疗偏头痛的证据。小白菊的证据参差不齐；缬草有效，但与制剂相关的肝毒性风险；大麻在偏头痛治疗中未显示出有效性，且数据稀少；贯叶连翘具有相关的生理活性，但它是一种肝酶诱导剂，缺乏为此目的的临床研究；在一项临床试验中，局部应用的大马士革玫瑰制剂未显示出疗效。其他植物制剂也被考虑用于偏头痛治疗，但大多数没有盲法随机、安慰剂对照试验证据。
