Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
Nursing Department, National Cheng Kung University Hospital, Taiwan.
J Clin Nurs. 2023 Jun;32(11-12):2455-2465. doi: 10.1111/jocn.16368. Epub 2022 May 20.
To evaluate the effectiveness of the cold intervention on relieving migraine symptoms among adult patients with migraine.
A systematic review and meta-analysis of randomised controlled trials (RCT) and non-RCT studies were performed.
We searched five electronic databases including Cochrane Library and Cochrane CENTRAL, Embase, MEDLINE, Scopus and CINAHL from the date of inception to March 2021.
Research was eligible for the systematic review if they included adult patients with migraine, using cold regimen as intervention, and outcomes measuring the symptom alleviation of migraine. Two researchers independently conducted the searching process and data extraction. The certainty of evidence was assessed using GRADE approach to the main outcomes was used. The PRISMA checklist was used to assure the quality and transparency of report.
Six studies (4 RCTs and 2 non-RCTs) met the inclusion criteria. The cold interventions on migraine alleviation include a cold-gel headband, cold-gel cap, intraoral cooling, skin temperature biofeedback and cold wrap accompanied by massage. Compared to non-cold regimens, the cold interventions had a short-term effect on reducing migraine pain rated on the Visual Analog Scale (VAS) score at 30 min after intervention (Std. mean difference [SMD] -3.21; 95% CI -5.94, -0.48). Compared to the non-cold regimens, the cold interventions had marginal long-term effects on relieving migraine pain VAS score (SMD -0.44; 95% CI -0.91, 0.03) and nausea (SMD -0.56; 95% CI -1.17, 0.04) (24 h after intervention). The GRADE indicated that the certainty of evidence was rated from very low to moderate. Insufficient results on the outcomes of nausea and vomiting were discovered for the meta-analysis.
Cold intervention is an effective regimen to reduce migraine pain instantly. The long-term effect of cold interventions on migraine is not demonstrated. The effects of cold interventions on nausea and vomiting need more studies to verify.
评估冷干预对缓解偏头痛成年患者偏头痛症状的有效性。
对随机对照试验（RCT）和非 RCT 研究进行了系统评价和荟萃分析。
我们从成立日期到 2021 年 3 月，在 Cochrane 图书馆和 Cochrane 中心、Embase、MEDLINE、Scopus 和 CINAHL 等五个电子数据库中进行了搜索。
如果研究包括偏头痛成年患者，使用冷方案作为干预措施，并且结局测量偏头痛症状缓解，则研究符合系统评价的纳入标准。两名研究人员独立进行了搜索过程和数据提取。使用 GRADE 方法评估证据的确定性，主要结局采用 GRADE 方法。使用 PRISMA 清单确保报告的质量和透明度。
符合纳入标准的有 6 项研究（4 项 RCT 和 2 项非 RCT）。偏头痛缓解的冷干预包括冷凝胶头带、冷凝胶帽、口腔冷却、皮肤温度生物反馈和冷包裹伴按摩。与非冷方案相比，冷干预在干预后 30 分钟时对降低偏头痛疼痛视觉模拟评分（VAS）有短期效果（标准均数差[SMD] -3.21；95%置信区间[CI] -5.94，-0.48）。与非冷方案相比，冷干预对缓解偏头痛疼痛 VAS 评分（SMD -0.44；95% CI -0.91，0.03）和恶心（SMD -0.56；95% CI -1.17，0.04）有边缘长期效果（干预后 24 小时）。GRADE 表明证据的确定性等级从极低到中等。对于荟萃分析，发现恶心和呕吐结局的结果不足。
冷干预是一种有效缓解偏头痛疼痛的方案。冷干预对偏头痛的长期效果尚未得到证实。冷干预对恶心和呕吐的影响需要更多的研究来验证。
