Yamanaka Gaku, Morichi Shinichiro, Suzuki Shinji, Go Soken, Takeshita Mika, Kanou Kanako, Ishida Yu, Oana Shingo, Kawashima Hisashi
Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo 160-0023, Japan.
J Clin Med. 2020 Nov 19;9(11):3717. doi: 10.3390/jcm9113717.
Although migraines are common in children and adolescents, they have a robustly negative impact on the quality of life of individuals and their families. The current treatment guidelines outline the behavioral and lifestyle interventions to correct common causative factors, such as negative emotional states, lack of exercise and sleep, and obesity; however, the evidence of their effectiveness is insufficient. To create a plan for disseminating optimal pediatric headache education, we reviewed the current evidence for factors correlated with migraine. We assessed three triggers or risk factors for migraines in children and adolescents: stress, sleep poverty, and alimentation (including diet and obesity). While there is a gradual uptick in research supporting the association between migraine, stress, and sleep, the evidence for diet-related migraines is very limited. Unless obvious dietary triggers are defined, clinicians should counsel patients to eat a balanced diet and avoid skipping meals rather than randomly limiting certain foods. We concluded that there is not enough evidence to establish a headache education plan regarding behavioral and lifestyle interventions. Clinicians should advise patients to avoid certain triggers, such as stress and sleep disorders, and make a few conservative dietary changes.
尽管偏头痛在儿童和青少年中很常见,但它对个人及其家庭的生活质量有着极其负面的影响。当前的治疗指南概述了行为和生活方式干预措施,以纠正常见的致病因素,如负面情绪状态、缺乏运动和睡眠以及肥胖;然而,其有效性的证据并不充分。为了制定一个传播最佳儿科头痛教育的计划,我们回顾了当前与偏头痛相关因素的证据。我们评估了儿童和青少年偏头痛的三个触发因素或风险因素:压力、睡眠不足和营养(包括饮食和肥胖)。虽然支持偏头痛、压力和睡眠之间关联的研究在逐渐增加,但与饮食相关的偏头痛的证据非常有限。除非明确了明显的饮食触发因素,否则临床医生应建议患者均衡饮食,避免不规律进餐,而不是随意限制某些食物。我们得出结论,没有足够的证据来制定关于行为和生活方式干预的头痛教育计划。临床医生应建议患者避免某些触发因素,如压力和睡眠障碍,并在饮食上做出一些保守的改变。
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