Beier Dagmar, Callesen Henriette E, Carlsen Louise N, Birkefoss Kirsten, Tómasdóttir Hanna, Wűrtzen Hanne, Christensen Henrik W, Krøll Lotte S, Jensen Mette, Høst Christel V, Hansen Jakob M
Department of Neurology, Odense University Hospital and Southern University of Denmark, Odense, Denmark.
Freelance Methodologist, Metodekonsulent Callesen, Denmark.
Cephalalgia. 2022 Jan;42(1):63-72. doi: 10.1177/03331024211034489. Epub 2021 Aug 18.
Many people suffering from migraine combine pharmacological and non-pharmacological treatments. The purpose of this systematic review is to provide an updated guideline for some widely used non-pharmacological treatment options for migraine.
We conducted a systematic literature review of randomized studies of adults with migraine treated with manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education. The main outcomes measured were days with headache and quality of life. Recommendations were formulated based on the Grade of Recommendation, Assessment, Development and Evaluation (GRADE) approach including patient preferences based on expert opinion and questionnaire data.
The overall level of certainty of the evidence was low to very low. Manual therapy techniques and psychological treatment did not change the studied outcomes. Supervised physical activity might have a positive impact on quality of life, acupuncture on headache frequency, intensity, quality of life and the use of attack-medicine. Patient education might improve self-rated health and quality of life and increase the number of well-informed patients.
Based on observed effects, the lack of serious adverse events, and patients' preferences, we make weak recommendations for considering the investigated interventions as a supplement to standard treatment. Prospero CRD42020220132.
许多偏头痛患者同时采用药物治疗和非药物治疗。本系统评价的目的是为一些广泛使用的偏头痛非药物治疗方案提供最新指南。
我们对采用手法关节松动技术、有监督的体育活动、心理治疗、针灸和患者教育治疗成人偏头痛的随机研究进行了系统文献综述。主要测量的结果是头痛天数和生活质量。基于推荐分级、评估、制定和评价（GRADE）方法制定建议，包括基于专家意见和问卷调查数据的患者偏好。
证据的总体确定性水平为低至极低。手法治疗技术和心理治疗未改变所研究的结果。有监督的体育活动可能对生活质量有积极影响，针灸对头痛频率、强度、生活质量和急救药物的使用有影响。患者教育可能会改善自我评估的健康状况和生活质量，并增加了解情况的患者数量。
基于观察到的效果、缺乏严重不良事件以及患者的偏好，我们提出弱推荐，建议将所研究的干预措施作为标准治疗的补充。国际前瞻性系统评价注册库编号CRD42020220132。
