Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Curr Neurol Neurosci Rep. 2021 May 10;21(7):33. doi: 10.1007/s11910-021-01120-3.
Headache affects and disables at least 1 billion people worldwide. Patients and providers seek new therapies to relieve headache without the side effects and financial burden of current treatments. This narrative review highlights recent treatment advances in integrative headache medicine: nutraceuticals and behavioral therapies.
Growing use of complementary and alternative medicine (CAM) therapies for headache (riboflavin, coenzyme Q10, magnesium, vitamin D, melatonin) alongside mainstream treatments is increasing with improving evidence of quality, safety, and tolerability. Increasing interest in medical cannabis is tempered by lack of evidence regarding safety and efficacy. Behavioral therapies including cognitive behavioral therapy (CBT), biofeedback, mindfulness-based stress reduction (MBSR), and acceptance and commitment therapy (ACT) improve patient resiliency and self-efficacy outcomes and reduce disability. The body of evidence for nutraceutical and behavioral CAM interventions for headache continues to grow and improve in quality. Providers and patients should educate themselves regarding CAM therapies as part of integrative headache management. Future studies should examine combinatorial trials of CAM therapies against current standards of headache care.
头痛影响和使全球至少 10 亿人丧失能力。患者和医务人员寻求新的疗法来缓解头痛，而又没有当前治疗方法的副作用和经济负担。本综述重点介绍了综合头痛医学的最新治疗进展：营养保健品和行为疗法。
补充和替代医学（CAM）疗法（核黄素、辅酶 Q10、镁、维生素 D、褪黑素）在主流治疗方法中越来越多地被用于治疗头痛，同时其质量、安全性和耐受性的证据也在不断增加。尽管对安全性和疗效的证据有限，但对医用大麻的兴趣仍在增加。认知行为疗法（CBT）、生物反馈、正念减压疗法（MBSR）和接受与承诺疗法（ACT）等行为疗法可提高患者的适应能力和自我效能感，并减少残疾。头痛的营养保健品和行为 CAM 干预措施的证据不断增加，并且质量也在不断提高。医务人员和患者应了解 CAM 疗法，作为综合头痛管理的一部分。未来的研究应该研究 CAM 疗法与当前头痛治疗标准的联合试验。
