Yamanaka Gaku, Kanou Kanako, Takamatsu Tomoko, Takeshita Mika, Morichi Shinichiro, Suzuki Shinji, Ishida Yu, Watanabe Yusuke, Go Soken, Oana Shingo, Kawashima Hisashi
Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo 160-0023, Japan.
J Clin Med. 2021 Jan 3;10(1):138. doi: 10.3390/jcm10010138.
Complementary and integrative medicines (CIMs) are increasingly used as a preventive antimigraine therapy. In this review, we aimed to summarize the evidence for the efficacy and safety of eight CIMs (riboflavin, coenzyme Q10, magnesium, melatonin, polyunsaturated fatty acids, and combination therapy of feverfew, vitamin D, and ginkgolide B) in pediatric migraine prevention. The level of evidence for riboflavin was relatively high; it was investigated by many studies with five/seven studies demonstrating its efficacy. Five studies investigated the use of melatonin, with one reporting negative results. There was insufficient evidence on the effectiveness of coenzyme Q10, magnesium, and polyunsaturated fatty acids. Combination therapy showed positive potential; however, reports on the individual antimigraine effects of the CIMs were lacking. A definitive conclusion was not reached regarding the specific integrative drugs clinicians should choose for pediatric migraines, owing to low-quality evidence and a limited number of studies. Integrative medications are becoming more common for pediatric migraine prevention as they do not produce serious side effects, and underlying research data suggest their efficacy in preventing migraine. Additional studies are warranted to confirm the role of CIMs in treating patients with migraines.
补充和整合医学(CIMs)越来越多地被用作预防性抗偏头痛疗法。在本综述中,我们旨在总结八种补充和整合医学疗法(核黄素、辅酶Q10、镁、褪黑素、多不饱和脂肪酸,以及小白菊、维生素D和银杏内酯B的联合疗法)在预防儿童偏头痛方面的疗效和安全性证据。核黄素的证据水平相对较高;许多研究对其进行了调查,其中五项/七项研究证明了其疗效。五项研究调查了褪黑素的使用情况,其中一项报告了阴性结果。关于辅酶Q10、镁和多不饱和脂肪酸有效性的证据不足。联合疗法显示出积极的潜力;然而,缺乏关于补充和整合医学疗法个体抗偏头痛作用的报告。由于证据质量低且研究数量有限,对于临床医生应选择哪种特定的整合药物来治疗儿童偏头痛,尚未得出明确结论。整合药物在预防儿童偏头痛方面越来越普遍,因为它们不会产生严重的副作用,而且基础研究数据表明它们在预防偏头痛方面具有疗效。有必要进行更多研究以证实补充和整合医学疗法在治疗偏头痛患者中的作用。