Child & Adolescent Neuropsychiatry, Hospital S. Orsola Malpighi, Bologna University, Bologna, Italy.
Child Neurology, Pediatric Headache & Sleep Disorders Centre, Chair of Pediatrics, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Via Di Grottarossa, 1035-1039, 00189, Rome, Italy.
Ital J Pediatr. 2019 Mar 12;45(1):36. doi: 10.1186/s13052-019-0624-z.
Migraine is one of the most prevalent chronic pain manifestations of childhood. Despite the multitude of available treatments, parents are often concerned about chronic therapies and pediatricians have insufficient confidence in prescribing prophylactic drugs. Therefore, there is now growing interest for natural supplements used to control recurrent migraine headaches. Such approach may increase acceptance and adherence to long-term prophylaxis therapy in children.
This is an observational multicenter study performed in children (n = 91) with migraine, with (MO) or without aura (MA), or tension-type headache (TTH). A fixed-dose Andrographis paniculata, CoQ10, riboflavin, and magnesium, was administered for 16 weeks. Patients were evaluated at baseline (T0), at week 8 (T1) and at the end of treatment at week 16 (T2). A follow-up period occurred at week 20 (T3) and week 32 (T4).
The herbal supplement significantly reduced the frequency of headaches in TTH patients during treatment period (T0: 11.97 + 1.92 vs T2: 5.13 + 1.93; p < 0.001) and the efficacy was maintained after 16 weeks of treatment withdrawal (T4: 4.46 + 1.75; p < 0.001 vs T0). The frequency of migraine attacks was also reduced in the MO group during treatment (T0: 9.70 + 0.96 vs T2: 4.03 + 0.75; p < 0.01) and after withdrawal (T4: 2.96 + 0.65; p < 0.01 vs T0). Conversely, MA patients showed reduction in migraine's frequency during treatment (T0: 8.74 + 1.91 vs T2: 3.78 + 2.02; p < 0.01) but not at the end of the study (T4: 5.57 + 3.31; p > 0.05 vs T0). TTH patients did not report significant improvement of pain intensity. A significant effect was observed in the MO group during treatment (T0: 3.06 + 0.11 vs T2: 2.14 + 0.19; p < 0.001) and after treatment withdrawal (T4: 2.20 + 0.21; p < 0.001 vs T0). Likewise, MA group showed a significant treatment effect (T0: 2.57 + 0.20 vs T2: 0.86 + 0.45; p < 0.001) and the efficacy persisted at the end of the study (T4: 1.00 + 0.58; p < 0.001 vs T0).
This fixed-dose Tanacetum parthenium preparation improved headache frequency and pain intensity in children affected by TTH. Despite the main limits, this study supports the use of nutraceutical in pediatric headache/migraine.
偏头痛是儿童最常见的慢性疼痛表现之一。尽管有多种治疗方法，但家长通常担心长期治疗，而儿科医生对预防性药物的使用信心不足。因此，现在人们对用于控制复发性偏头痛的天然补充剂越来越感兴趣。这种方法可能会增加儿童对长期预防治疗的接受度和依从性。
这是一项在偏头痛（伴或不伴先兆的偏头痛[MO]或紧张型头痛[TTH]）患儿中进行的观察性多中心研究（n=91）。使用固定剂量的穿心莲、CoQ10、核黄素和镁进行治疗 16 周。患者在基线（T0）、第 8 周（T1）和治疗结束时第 16 周（T2）进行评估。在第 20 周（T3）和第 32 周（T4）进行随访。
在治疗期间，草药补充剂显著降低了 TTH 患者头痛的频率（T0：11.97+1.92 与 T2：5.13+1.93；p<0.001），并且在治疗停止 16 周后疗效仍然持续（T4：4.46+1.75；p<0.001 与 T0）。MO 组的偏头痛发作频率也在治疗期间（T0：9.70+0.96 与 T2：4.03+0.75；p<0.01）和治疗停止后（T4：2.96+0.65；p<0.01 与 T0）有所降低。相反，MA 患者在治疗期间（T0：8.74+1.91 与 T2：3.78+2.02；p<0.01）偏头痛的频率有所降低，但在研究结束时（T4：5.57+3.31；p>0.05 与 T0）则没有。TTH 患者的疼痛强度没有明显改善。MO 组在治疗期间（T0：3.06+0.11 与 T2：2.14+0.19；p<0.001）和治疗停止后（T4：2.20+0.21；p<0.001 与 T0）均观察到显著的治疗效果。同样，MA 组也显示出显著的治疗效果（T0：2.57+0.20 与 T2：0.86+0.45；p<0.001），并且在研究结束时疗效仍然持续（T4：1.00+0.58；p<0.001 与 T0）。
本研究采用固定剂量的青蒿制剂治疗儿童 TTH，可改善头痛发作频率和疼痛强度。尽管存在主要限制，但本研究支持在儿科头痛/偏头痛中使用营养补充剂。
